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Is TRT necessary?

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  • Is TRT necessary?

    Some background: 39yo, Right I/O in 2019. Lefty has been bothering me a bit. Urologist thinks it's somatic, but I'm pretty sure I'm not crazy (would be great if I were).

    It got me wondering about TRT. I've been reading about it and it sounds pretty annoying to get right. What would happen if you didn't bother? Could you get used to it or compensate somehow?

    Here are some symptoms of Low-T, and my reaction to them.

    Low libido - don't care
    Depression - big concern, family history
    Mood Swings - also a concern
    Loss of body and facial hair - don't care
    Feeling lethargic - big concern
    Menopausal-like hot flashes - maybe you get used to it? don't women?
    Progressive decrease in muscle mass - keep in check with exercise?
    Impotence - don't care, at least not at this point...
    Semen containing little or no sperm - don't care, done having kids.
    Weight gain? some concern

    From what I've read it seems TRT is a given. I figure most responses will be that I would be insane to skip it. Perhaps there are people who don't do it and are okay?
    Last edited by ballermann; 02-04-20, 06:00 PM.

  • #2
    My uro waited two weeks before starting TRT (because he wanted the onc to sign off on it), so I have a little insight:

    Libido: you are right, you won/'t have any & you wont care, your partner might, though..
    Depression: didn't happen to me
    Mood swings: nope, just consistently low mood
    Loss of hair: didn't happen in two weeks chemo made it happen though
    Lethargic: hard to tell, surgery takes it's toll
    Hot flashes: OMG! they are real & very uncomfortable, I'm very glad to be on TRT & not have them any more. I'm guessing they would eventually go away.
    Muscle loss is real and exercise might slow, but not eliminate it
    Impotence: see libido
    Semen; will have no sperm with or without TRT
    Weight gain: seems to happen with age, regardless of TRT

    Having said that, TRT isn't a big PITA to be avoided. Some guys have more trouble getting it dialed in than others, but most don't. I was originally on daily topical gels & pretty happy with them, an insurance change switched me to injections which don't seem to do as well IMHO, but are more convenient at one per 3 weeks. You'll figure out what works with little effort.

    That is, of course if you need it at all. Nothing you've said indicates any real concern for TC2, after all. TC is almost always painless, swelling or a hard spot is the most reliable indicator short of an U/S. Those that had pain almost always had pain from something else & were just lucky the pain led to a Dx. Get an U/S to put your mind at ease if you need to &stop worrying is my advice.
    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP


    • #3
      Have you had your levels checked? Anxiety/Depression can also cause pretty much all those side effects. Find the cause, then treat the cause.

      As a no-nutter post cancer I've been on TRT for 4 years now. I can't really say things are much different than pre cancer, other than things that probably can be attributed to me being in my upper 30's instead of lower 30's now!
      6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
      6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
      7/7/15: bHCG 56, AFP 42, LDH 322
      7/13/15: begin 4xEP, end 9/18/15
      10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
      10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
      4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
      4/20/16: RPLND @ IU - teratoma only!
      10/22/19: all clears up to this date!


      • #4
        I would take a look at the American Urological Association's testosterone guidelines. Specifically, the counseling statements 13, 14, 15.

        I think a key part that you might be missing is that low testosterone is a risk factor for cardiovascular disease so I think receiving the replacement, if needed, would certainly be advantageous.

        Oct. 2005 felt lump but waited over 7 months.
        06.15.06 "You have Cancer"
        06.26.06 Left I/O
        06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
        06.30.06 It's Official - Stage I Seminoma
        Founded the Testicular Cancer Society
        6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

        For some reason I do not get notices of private messages on here so please feel free to email me directly at if you would like to chat privately so as to avoid any delays.