Testosterone optimisation, often called TRT (testosterone replacement therapy), involves prescribed testosterone to treat clinically low levels, which can affect energy, mood, muscle, libido and bone health. It has also become popular in wellness and longevity circles for men seeking to raise normal-range levels, which is a different and more contested use.
For men with genuinely, clinically low testosterone (diagnosed on blood tests and symptoms), replacement therapy has good evidence for improving symptoms under medical supervision. Evidence and appropriateness for men with normal-range levels seeking optimisation is far more contested, and this wellness use carries the same risks without the clear clinical indication.
Testosterone therapy can affect fertility (often significantly, by suppressing natural production), red blood cell counts, and has considerations around cardiovascular and prostate health that require monitoring. Starting it is not easily reversible in terms of natural production, which is a serious consideration for younger men.
Legal and prescription status: testosterone is prescription-only. This is prescription-only medicine and must never be sourced or self-dosed outside a regulated prescription. It requires proper diagnosis (blood tests confirming low levels), and ongoing medical monitoring of blood counts, prostate and cardiovascular markers. Fertility implications must be discussed before starting, particularly if you may want children. This is not a casual optimisation decision.
Prescription cost where clinically indicated; private optimisation clinics charge ongoing fees for treatment and monitoring.
Endocrine Society and clinical guidance on testosterone replacement for hypogonadism. Literature on TRT risks (fertility, haematocrit, cardiovascular monitoring). Educational information only. Prescription-only medicine.