One of the most common questions guys have before starting testosterone replacement therapy (TRT) is, “What can I expect when first starting treatment?”. I know this was a question I had once I finally decided that TRT was the right move for me. Below, I will dive into my personal experience of the mental and physiological changes I experienced during the initial 8-weeks so that others looking to make the jump can better understand what to expect in the beginning stages of treatment.
It is important to remember that everyone reacts to testosterone replacement therapy differently. Your experience will vary based on your physiology, medications, routine, TRT dosage, etc. However, my experience should give you a general idea of some of the impacts to expect if you decide to start.
I started on 150mg a week of testosterone cypionate, split up into three different injections: Monday, Wednesday, and Friday. The only other medication I incorporated into my regimen was low-dose Tadalafil daily at 2.5mg to help control blood pressure. Although Tadalafil is often used to treat erectile dysfunction, it is a vasodilator, so it is also great for getting a better pump in the gym and controlling high blood pressure.
Week 1
Many guys report not feeling a significant difference during week 1, but I began to notice a difference in my overall energy towards the end of the week. I just seemed to have more gas in the tank than usual with work, family, and any activities, including a slight increase in libido.
Week 2-4
During weeks 2-4, I started to see my mood, energy, and libido ramp up. The positive side effects I experienced were better memory, a noticeable difference in cognition, reduced fogginess, and decreased irritability. However, some adverse side effects started to emerge, including increased resting heart rate (90-100+ RHR), water retention, and Increased thirst.
I also needed to work out every day, or I would become incredibly restless, and it seemed to exacerbate my adverse symptoms if I remained sedentary and skipped the gym.
Weeks 5-6
Something interesting happened to me here. I felt fantastic over the past few weeks, but that started to change. Although I felt significantly better than before I was on TRT, my energy and mood began to regress slightly, which was somewhat perplexing since I hadn’t expected this to happen. Now, there are a few theories on why this can happen. Still, the one that seems the most intuitive to me is that when we first start TRT, we have our natural production + the testosterone we are injecting, which artificially increases our testosterone levels even more. However, once our natural production diminishes due to LSH and FSH reduction, our total testosterone begins to reduce and level off. I ended up fixing this by increasing my weekly dose slightly to maintain the higher energy levels I initially experienced (which I will discuss in another post).
Week 7-8
My resting heart rate returned to the pre-testosterone range (65-75 RHR). I also enjoyed a noticeable muscle fullness and increased recovery time from workouts. My libido also continued to increase significantly during this time. Overall, I was feeling really good at this point but there was still some room to dial in my dosage.
Recap:
Hopefully, this gives a solid breakdown of what to expect over the first couple of months of starting TRT. The positive side effects I experienced far outweighed the negatives in my case, especially considering most of them ended up resolving over time, especially soon after deciding to increase my dose to get dialed in more. Again, I’ll dive deeper into some of the doses I experimented with and what my lab work revealed in future posts.
