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Long-Term Testosterone Replacement

Written by Author - Authors Medical experts of the National HRT Clinic - April 21, 2016


For some individuals, treatment with supplemental testosterone is not just a one-time, quick-fix for a condition commonly referred to as Low T. Instead, it may be an ongoing process aimed at improving and protecting a man’s overall health and sexual enjoyment. Long-term testosterone replacement has been shown to be both beneficial and safe for use by men and women, alike. Yes, women can also suffer from a decline in testosterone production, specifically during menopause.

Here are some of the results gathered from a number of prominent studies on this subject:

  • Elderly hypogonadal men receiving long-term testosterone had fewer complaints of bladder outlet obstructions symptoms than those who did not receive this treatment following two years of testosterone therapy
  • Increased red blood cell count was shown in both short term and long term studies, and has been successfully used to treat anemia in males
  • Most men report better sleep and a lessening of their sleep apnea symptoms
  • The majority of men studied reported improvements in the areas of energy, libido, and mood

One significant reason to engage in long-term testosterone use is to prevent or improve other health concerns that are often present in conjunction with Low T. Many general physicians and other specialists not well versed in hormone replacement tend to overlook checking testosterone levels when other health conditions are present.

The areas of concern that may be associated with low testosterone levels include:

  • Heart Disease
  • Type 2 Diabetes
  • Obesity
  • Osteoporosis
  • High Blood Pressure
  • High Cholesterol and Triglycerides
  • Sleep Apnea
  • Dementia, Alzheimer’s Disease
  • Anemia

If any of these health issues are present, and symptoms of Low T are reported, testosterone testing should be ordered as treatment may bring widespread benefits.

Are There Side Effects from Long-Term Testosterone Replacement?

One of the biggest concerns in the past regarding long term side effects of testosterone therapy was prostate cancer. Numerous studies have shown that this is no longer a concern that would prevent a man from receiving treatment. In fact, testosterone supplementation has been found to decrease prostate size, reducing the risks of BPH – benign prostatic hyperplasia.

One word of caution – a man who is currently being treated for prostate cancer should not receive testosterone treatment.

When examining long-term testosterone use, side effects are no different than they are for a person who is just using this treatment for a short time.

The biggest concerns for men are the following:

  • Irritation or redness at the injection site
  • Skin rash or irritation if using a gel or patch
  • Changes in sexual desire
  • Oily skin or acne
  • Headache
  • Breast enlargement
  • Anxiety or depression
  • Nausea
  • Vomiting
  • Hair loss
  • Changes in skin color
  • Facial or body hair growth

It is important to note that these symptoms are not common, and most men do not have any adverse effects from the use of testosterone supplementation.

Women who are prescribed testosterone cream may exhibit the following side effects of treatment:

  • Changes in menstrual patterns
  • Adult acne
  • Enlarged clitoris
  • Growth of facial or body hair
  • Hair loss
  • Deepening of the voice

Symptoms such as these are most likely a sign that the dosage of testosterone is too high for the body to use. The doctor will typically lower the dosage, and the symptoms will subside.

The occurrence of supplemental testosterone long-term side effects has not been shown to be an issue, and the health benefits warrant the use of this treatment if medically prescribed.

Safety of Long-Term Testosterone Replacement Puts Minds at Ease

Extensive research into the long-term use of testosterone has shown it to be one of the safest forms of hormone replacement available today. This is especially true for women who may not be candidates for other types of HRT due to high-risk factors such as breast cancer or blood clots.

Long-term testosterone replacement therapy has been successfully used by millions of men throughout the world. Current research does not lead to increased risk for cardiovascular problems, prostate cancer, or worsen urinary tract symptoms. In fact, some men report an improvement in their UT symptoms.

Is testosterone therapy safe for long term use if a person has sleep apnea?

Sleep apnea is a potentially serious issue as it can interfere with one’s quality of sleep, as well as shorten a person’s lifespan. While some reports have shown a correlation between testosterone replacement and a worsening of sleep apnea symptoms, those effects are often short-lived. Because TRT helps with weight loss – the number one way to improve the severity of sleep apnea, low testosterone treatment options such as injections for men and cream for women can actually reduce problems associated with sleep apnea.

The other significant concern for some males is erythrocytosis – a condition that occurs when red blood cell production increases to a dangerous level. This risk is extremely low, and long-term testosterone studies have not demonstrated a significant risk of adverse effects.

Some people choose to start out with short-term testosterone therapy to see how their body reacts before deciding if they want to continue with their treatment. Some may only need a short period of treatment in order to deal with specific issues.

The overall testosterone replacement therapy cost is rarely an issue since this is a very affordable method of hormone replacement – of course, dependent on the type of TRT chosen for use.

Who Can Benefit from Testosterone Replacement?

Male or female, if your testosterone production has decreased to the point where you are exhibiting undesirable symptoms that are affecting your life, long term testosterone replacement may be for you. It does not matter if you are in your thirties or seventies; Low T can take away the enjoyment in your sex life, interfere with mobility by decreasing bone density and lean muscle tissue, and even affect your memory.

The sooner you begin to receive your treatment, the quicker you will receive the many benefits derived from long-term testosterone use. In order to find out if this treatment is going to make a difference in your life, please contact the hormone specialists at National HRT for a complimentary consultation. Do not let another day go by without taking action that can put the joy back in your life.

Medically reviewed by   Reviewers National HRT Staff - Updated on July 18, 2019

Please note that the information provided in this article is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.


  1. Testosterone Replacement Therapy: Long-Term Safety and Efficacy Giovanni Corona, Alessandra Sforza, and Mario Maggicorresponding author World J Men’s Health. 2017 Aug; 35(2): 65–76. Published online 2017 Apr 30
  2. Results of long term testosterone replacement therapy in men with abdominal obesity, erectile dysfunction, and testosterone deficiency. Fillo J, Breza J Jr, Ondrusova M, Luha J, Ondrus D, Dubravicky J, Breza J, Labas P, Levcikova M.Bratisl Lek Listy. 2018;119(9):577-580.
  3. Outcomes of Long-Term Testosterone Replacement in Older Hypogonadal Males: A Retrospective Analysis Ramzi R. Hajjar Fran E. Kaiser John E. Morley The Journal of Clinical Endocrinology & Metabolism, Volume 82, Issue 11, 1 November 1997, Pages 3793–3796, Published: 01 November 1997
  4. Long-term testosterone therapy improves urinary, sexual function and quality of life August 15, 2017, Boston University Medical Center