Treatment education
What is testosterone replacement therapy (TRT)?
General information about testosterone replacement therapy in Australia: what it is, how doctors assess whether it is appropriate, and the risks and monitoring involved.
An overview
Testosterone replacement therapy (TRT) is a prescription-only medical treatment. A doctor may consider it for men with male hypogonadism, which means the body does not produce enough testosterone because of a problem with the testes, the pituitary gland or the brain.
Testosterone levels fall gradually with age, but a slow age-related decline on its own is not usually a reason for treatment. Many symptoms linked to low testosterone, such as tiredness, low mood or low sex drive, also have other causes that need a different approach.
How a doctor decides
- A detailed history of symptoms, health conditions and medicines
- A physical examination
- At least two early-morning blood tests showing low testosterone, plus other hormone tests
- A search for underlying causes, such as weight, sleep apnoea, medicines or pituitary conditions
- A discussion of fertility plans, because treatment can reduce sperm production
In Australia, PBS-subsidised treatment must be started by an endocrinologist, urologist or sexual health physician. Read how the Australian care pathway works.
Risks and monitoring
Like any prescription medicine, testosterone treatment has risks. These can include reduced fertility, a raised red blood cell count, acne, breast tenderness, fluid retention and effects on sleep apnoea. It is not suitable for men with some conditions, including certain cancers. Anyone on treatment needs regular blood tests and reviews. See our guide to side effects and safety monitoring.
Lifestyle and other causes
Sleep, body weight, physical activity, alcohol and stress all affect testosterone levels. A doctor will usually look at these factors first. Our guide to lifestyle factors and medical treatment explains this in more detail.
Talking to a doctor
If you have symptoms, the first step is a doctor assessment. You can see your own GP, or get matched with an experienced men's health doctor for an assessment. Treatment options and costs are discussed with your doctor.
Comparisons people ask about
- GP vs men's health clinic — the trade-offs of each starting point.
- Testosterone gel vs injections — how doctors think about delivery methods.
- Treatment delivery methods — the broader overview.
Frequently asked questions
What is testosterone replacement therapy?
Testosterone replacement therapy (TRT) is a prescription-only treatment that a doctor may consider for men whose low testosterone has been confirmed by blood tests and clinical assessment. Whether it is appropriate is an individual medical decision.
Who decides whether it is appropriate?
A doctor decides after reviewing symptoms, examination findings, repeated morning blood tests and the possible causes. In Australia, subsidised treatment must be started by an endocrinologist, urologist or sexual health physician.
What are the risks?
Risks can include reduced fertility, a higher red blood cell count, acne, fluid retention and effects that need ongoing monitoring. It is not suitable for everyone. Your doctor can explain the risks that apply to you.
How much does it cost?
Treatment options and costs are discussed with your doctor. Ask about consultation fees, blood-test billing and follow-up needs before booking.
Take the free 2-minute symptom check
The ADAM symptom check shows whether your symptoms may be worth discussing with a doctor. You can also request a callback to get matched with a men's health doctor at a partner clinic, by telehealth or in person, for an assessment.
Start the free assessmentWant to talk to someone first? Read how getting matched with a doctor works.
*Blood tests may be bulk billed where eligible, subject to doctor assessment and clinical indication.