Testosterone and TRT: What the Research Actually Says
Posted
By Tom Henkenius · Published August 22, 2026 · Updated September 2026 · Sources: peer-reviewed trials and professional-society guidance, linked throughout.
The Secretary of Defense ordered testosterone screening for every service member over 30 and posted a video calling for a "High-T" military.
Scott Galloway talks about being on TRT.
Your feed has a clinic that will prescribe it after a ten question form.
All of this got me to stop and ask, what's up with all the testosterone talk? I know that my body makes testosterone and that's part of being a guy, but that's basically the end of my knowledge. Googling was, shall we say, challenging, because it's hard to know what's legit. And honestly, it's gotten political.
The goal here is to strip out the noise and focus on what the people who actually study it have to say. No position, no politics, just what the researchers put in writing.
Testosterone is the main male sex hormone. It drives sex drive and sperm production, and it also affects muscle, bone, red blood cells, body hair, and skin. Levels peak in your twenties and drift down from your thirties or forties onward, which is normal aging, not a disease.
A genuine clinical deficiency is called hypogonadism. It is diagnosed with symptoms plus at least two early-morning blood tests, not a quiz.
TRT stands for testosterone replacement therapy. It is prescription testosterone given as a gel, injection, patch, or pellet to bring a deficient man's levels back into the normal range. In the trials, TRT reliably improved sexual function, corrected anemia, and modestly helped mood and bone density. It did not improve vitality, energy, cognition, or walking ability. It carries real side effects, including thicker blood, suppressed fertility, and, the part nobody covers, oilier skin and accelerated hair loss in men who are genetically prone.
The rest of this explains the above in more detail.
What is testosterone, and what does it do?
Testosterone is a hormone. Your testicles make most of it, on instructions from your brain. Your pituitary gland sends the signal, your testicles respond, and when levels get high enough your brain dials the signal back down. Think of it like a thermostat.
What does it do? More than I knew. Sex drive and sperm production, obviously. But also muscle mass, bone density, red blood cell production, body hair, where your body stores fat, and some contribution to mood and energy. It also talks to your skin, which we will come back to.
Your levels peak in your late teens and twenties. Then they start a slow decline, generally beginning somewhere in your thirties or forties, and they keep drifting down from there. That is the standard issue male timeline.
Declining is not the same thing as deficient. Declining is natural. Deficient has a clinical name: hypogonadism.
It's also interesting to know, your testosterone level swings over the course of the day. It's usually highest in the morning, and then declines through the day. That's why a legitimate test is drawn early, fasting, and repeated.
Total testosterone vs. free testosterone
Most of the testosterone in your blood is bound up to proteins and not available to your tissues. Total testosterone measures all of it. Free testosterone measures the small fraction that's actually unattached and usable. The Endocrine Society's position is that a real diagnosis looks at both, because a man can have a normal-looking total and a genuinely low free level, or the reverse. If a clinic tests one number once and hands you a prescription, that's not the standard of care.
What are the symptoms of low testosterone in men?
The symptoms of low testosterone are pretty generic: tired, low sex drive, low mood, foggy, losing muscle, weight gain around the middle.
All of those can also be symptoms of: bad sleep, stress, drinking, depression, being overweight, or thyroid problems. Those are also common side effects from half a dozen medications.
The point is to say, an online quiz isn't going to help you one way or another. Hypogonadism is between you and your doctor.
Why is everyone talking about testosterone in 2026?
The short version: the rules changed, and the marketing followed.
A large safety trial published in 2023 found that testosterone did not increase heart attacks or strokes in the men studied, which eased the cardiovascular concerns that had hung over it for a decade. The FDA dropped its cardiovascular warning in February 2025. In December 2025 the agency convened an expert panel that recommended going further and revising the labels again.
That last move specifically opens the flood gates. The FDA requiring a label that says testosterone replacement therapy is not shown to help as we get older didn't stop doctors from prescribing it, but it did keep companies from marketing it that way. When that language goes, telehealth companies can advertise directly to every man over forty who feels tired. And just a reminder, telehealth companies love to advertise on podcasts.
That is most of why your feed changed. Not a conspiracy, not a breakthrough. A regulatory door opened, an industry walked through it, and then it became a political story.
What counts as a low testosterone level?
Here is the second thing that made googling this hard. There is no settled answer.
The American Urological Association puts the cutoff at 300 ng/dL.
The Endocrine Society says 264 ng/dL.
Other professional bodies land at 200 and 230.
Depending on which threshold and which symptom definition you use, the share of American men who actually qualify is small. The most cited estimate comes from the Boston Area Community Health survey, which put symptomatic androgen deficiency at roughly 5.6 percent of men aged 30 to 79. Stricter definitions put it lower still.
And underneath all of it, the Endocrine Society says testing is often inaccurate, and explains that because assays are not standardized, "the same blood sample can read 'low' or 'normal,' depending on the lab." Harvard Health puts a number on the practical consequence: for men with borderline-low levels, "a repeat test would show a normal range about 30% of the time."
To me the lesson is clear: this is a conversation with a doctor, and it takes more than one blood draw. What we can tell you is what the research found on the other side of that line, because that part is much clearer than the argument about where the line goes.
What does testosterone replacement therapy actually do?
The cleanest evidence comes from the Testosterone Trials, funded by the National Institutes of Health rather than by anyone selling testosterone. 790 men, all 65 or older, all with genuinely low levels confirmed by two morning tests. They were given either testosterone gel or a placebo gel every day for a year.
Outcome measured
Result vs. placebo
Sexual function
Improved, moderately, and most consistently of anything measured
Anemia
Improved and corrected
Mood and depressive symptoms
Improved slightly
Bone density and strength
Improved slightly
Vitality
No improvement
Cognitive function
No improvement
Walking ability
No significant difference
Results of the NIH-funded Testosterone Trials, 790 men aged 65+ with confirmed low testosterone, one year of daily testosterone gel vs. placebo gel.
Those first four are real. For a man with a genuine deficiency, this is medicine that works.
Testosterone did not improve vitality. It did not improve cognitive function. In the trial specifically designed to test walking ability, there was no significant difference between the men on testosterone and the men on placebo.
And what about energy? This is the thing I keep seeing promised in the ads. Researchers went looking for it, in the group of men most likely to benefit from it, in a double blind study, and did not find it.
What are the risks and side effects of TRT?
The Testosterone Trials asked whether TRT worked. A second and much larger trial asked whether it is dangerous. Known as the TRAVERSE trial, it enrolled 5,246 men aged 45 to 80, all of whom already had heart disease or were at high risk for it. This study was funded by the companies that make testosterone, but keep in mind that is standard practice when the FDA requires a safety study.
The headline from the TRAVERSE trial: testosterone did not increase heart attacks or strokes compared to placebo. Major cardiac events occurred in 7.0 percent of the testosterone group and 7.3 percent of the placebo group.
The rest of that same trial got considerably less coverage.
Pulmonary embolism, a blood clot in the lung, was more common on testosterone, 0.9 percent versus 0.5 percent.
Atrial fibrillation (irregular heartbeat) was more common, 3.5 percent versus 2.4 percent.
Acute kidney injury was more common, 2.3 percent versus 1.5 percent.
Fractures were higher in the testosterone group in a follow-on substudy, 3.5 percent versus 2.5 percent, which is genuinely odd given that testosterone builds bone.
The FDA required a new warning about increased blood pressure.
Thicker blood
One that didn't make the TRAVERSE headlines but that every prescriber watches for: testosterone tells your body to make more red blood cells. That's exactly why it corrects anemia. Push it too far and you get the opposite problem, erythrocytosis, blood that is thicker than it should be, which is why men on TRT get their hematocrit checked on a schedule. It's usually managed by adjusting the dose or the formulation. It is also one of the most common reasons a prescription gets changed.
Your body stops making its own
Then there is the thermostat. Remember that your brain dials your own production down when levels are high. Take testosterone and your body stops making its own. Testicular shrinkage is a normal, documented consequence.
TRT also suppresses sperm production. The Endocrine Society specifically recommends against starting testosterone therapy in men who are planning to have children in the near term. If you are 34 and think you might want kids someday, again, talk to your doctor. Coming off it is not always a clean reversal.
What TRT does not do
It does not prevent diabetes. A substudy of the TRAVERSE trial followed men with low testosterone and prediabetes and found no meaningful difference in who went on to develop diabetes, and no improvement in blood sugar control. The authors wrote plainly that it should not be used for that purpose.
Its long-term prostate cancer risk is unknown. The backstory here is that prostate cancer feeds on testosterone. That's not theoretical, it's the basis of a real treatment: advanced prostate cancer is often managed by cutting testosterone off, which shrinks the tumor. So the obvious worry has always been the reverse, that adding testosterone to a man who has a small undetected cancer would speed it up. The problem is that prostate cancer can take a decade or two to become clinically apparent, and the trial ran about three years. The study is shorter than the disease. The Endocrine Society is calling for a long-term men's health study to close that gap.
It does not have an evidence base for making a normal man feel younger. There is essentially no research supporting what most of the marketing is actually about, which is taking testosterone when your levels are normal in order to feel younger, build muscle, or perform better.
It is not a weight loss drug, and weight loss may be the actual treatment. The Endocrine Society has said that if a man's low testosterone traces back to being overweight with no other identified cause, weight loss is the first-line treatment. Not the prescription. Sleep, alcohol, and untreated sleep apnea sit in the same category: fix those first, because they suppress testosterone on their own and because they cause most of the symptoms people blame on low T.
Are testosterone levels actually declining across generations?
This is the question underneath a lot of the noise. Several studies have reported that average testosterone in men has drifted downward over the past few decades, independent of age. In other words, a 40-year-old today has less testosterone than his dad did at 40. The candidates offered for why include obesity rates, sedentary work, sleep, and environmental exposures. It is a real and active area of research. It is also not, on its own, a reason for any individual man to start a prescription. What's happening to a population and what's happening to you are two different things.
How testosterone affects your skin and hair
We sell grooming products, not medicine. But there is one piece of this that lands squarely in our lane and almost nobody covers it, so here it is.
Testosterone changes your skin and your hair.
Some of your testosterone converts into a second hormone called DHT (dihydrotestosterone), which is the more aggressive of the two. DHT does two things you can see in the mirror.
1. It turns up your oil
DHT tells the oil glands in your skin to grow and produce more. Acne is the most commonly reported skin side effect of testosterone therapy, showing up in roughly 1 to 9 percent of men depending on the formulation, usually in the first three to twelve months. If you are on T and breaking out along your jaw for the first time since high school, that is not your face betraying you. That is chemistry.
2. It shrinks vulnerable hair follicles
To be precise, testosterone itself does not cause male pattern baldness. DHT does, and only in men who carry the genetic susceptibility for it. If you were always going to thin, this can move the timeline up. If you were not, it generally does not create the problem out of nowhere.
Both effects can also happen at completely normal testosterone levels. Correcting a real deficiency into the normal range is enough to trigger them in men who are prone.
What to actually do about it
If that is happening to you, the answer is not to quietly stop your medication. Tell your prescriber, because dose and formulation are adjustable. Then treat your skin and scalp like they are operating in a different environment, because they are.
You would probably benefit from a gentle daily face cleanser. And if being oily is new to you, just keep in mind that oil control doesn't mean stripping the oil. All that does is cause your skin to produce more of it.
I started this because I did not know anything, and I finished it knowing roughly this:
Testosterone declines in every man, and declining is not a disease.
For the small number of men with a genuine deficiency, replacing it works, and it works best on the specific things the research actually measured.
For everyone else, the loudest promises are the ones with the least proof behind them.
Get the real information. Ask a doctor who wants more than one blood draw. Be suspicious of anything that promises you your twenties back.
Confidence is built. Usually out of unexciting answers.
We send one email a week worth opening. Grooming that works, myths we have put through the wringer, and the occasional trend we tell you to skip. No spam, no fifteen-step routines.
Frequently asked questions about testosterone and TRT
What does TRT stand for?
TRT stands for testosterone replacement therapy. It is prescription testosterone given as a gel, injection, patch, or implanted pellet. It's used to bring a man with a diagnosed deficiency back into the normal range.
What is a normal testosterone level for a man?
There is no single agreed number. The American Urological Association uses a cutoff of 300 ng/dL, the Endocrine Society uses 264 ng/dL, and other bodies use 200 or 230. Levels are also highest in the morning and fall through the day, and the same blood sample can read differently at different labs, which is why diagnosis requires at least two early-morning tests.
What are the symptoms of low testosterone in men?
Fatigue, low sex drive, low mood, brain fog, loss of muscle, and weight gain around the middle. All of these are also symptoms of poor sleep, stress, drinking, depression, obesity, and several common medications. This is why symptoms alone, or an online quiz, cannot diagnose it.
Does TRT give you more energy?
The NIH-funded Testosterone Trials specifically measured vitality and energy in older men with confirmed low testosterone and found no improvement over placebo. Sexual function, anemia, mood, and bone density did improve. Energy is the most heavily advertised benefit and the one with the weakest evidence.
Does TRT cause hair loss?
Testosterone itself does not cause male pattern baldness. DHT, a hormone your body converts some testosterone into, does but only in men who carry the genetic susceptibility. If you were already going to thin, TRT can move the timeline up. If you were not genetically prone, it generally does not create the problem.
Does TRT cause acne?
Acne is the most commonly reported skin side effect of testosterone therapy, appearing in roughly 1 to 9 percent of men depending on the formulation, usually within the first three to twelve months. DHT increases oil gland size and output. Talk to your prescriber about dose and formulation rather than stopping treatment on your own.
Does TRT affect fertility?
Yes. TRT suppresses your body's own testosterone production and with it sperm production. The Endocrine Society recommends against starting testosterone therapy in men who plan to have children in the near term.
Can you increase testosterone naturally?
Addressing the things that suppress it is the first-line approach. The Endocrine Society has said that when low testosterone traces back to excess weight with no other identified cause, weight loss is the first-line treatment rather than a prescription. Sleep, alcohol intake, and untreated sleep apnea belong in the same conversation.
Is the U.S. military really testing testosterone?
Yes. On July 15, 2026, Defense Secretary Pete Hegseth announced mandatory annual testosterone screening for active duty and reserve service members aged 30 and older, with voluntary testing for those under 30 and optional testosterone replacement therapy for those found deficient.
Tom Henkenius is the founder of Henkey's, a curated men's grooming shop built around the Henkey's Standard: solid ingredients, delivers on its promise, builds confidence. This piece is educational and is not medical advice. Talk to a physician about testosterone testing or therapy.
Snyder PJ, et al. "Effects of Testosterone Treatment in Older Men."New England Journal of Medicine, 2016, and related Testosterone Trials results on bone density and anemia, JAMA Internal Medicine, 2017.
Testosterone and TRT: What the Research Actually Says
By Tom Henkenius · Published August 22, 2026 · Updated September 2026 · Sources: peer-reviewed trials and professional-society guidance, linked throughout.
The Secretary of Defense ordered testosterone screening for every service member over 30 and posted a video calling for a "High-T" military.
Scott Galloway talks about being on TRT.
Your feed has a clinic that will prescribe it after a ten question form.
All of this got me to stop and ask, what's up with all the testosterone talk? I know that my body makes testosterone and that's part of being a guy, but that's basically the end of my knowledge. Googling was, shall we say, challenging, because it's hard to know what's legit. And honestly, it's gotten political.
The goal here is to strip out the noise and focus on what the people who actually study it have to say. No position, no politics, just what the researchers put in writing.
Quick Guide
The unexciting version
Testosterone is the main male sex hormone. It drives sex drive and sperm production, and it also affects muscle, bone, red blood cells, body hair, and skin. Levels peak in your twenties and drift down from your thirties or forties onward, which is normal aging, not a disease.
A genuine clinical deficiency is called hypogonadism. It is diagnosed with symptoms plus at least two early-morning blood tests, not a quiz.
TRT stands for testosterone replacement therapy. It is prescription testosterone given as a gel, injection, patch, or pellet to bring a deficient man's levels back into the normal range. In the trials, TRT reliably improved sexual function, corrected anemia, and modestly helped mood and bone density. It did not improve vitality, energy, cognition, or walking ability. It carries real side effects, including thicker blood, suppressed fertility, and, the part nobody covers, oilier skin and accelerated hair loss in men who are genetically prone.
The rest of this explains the above in more detail.
What is testosterone, and what does it do?
Testosterone is a hormone. Your testicles make most of it, on instructions from your brain. Your pituitary gland sends the signal, your testicles respond, and when levels get high enough your brain dials the signal back down. Think of it like a thermostat.
What does it do? More than I knew. Sex drive and sperm production, obviously. But also muscle mass, bone density, red blood cell production, body hair, where your body stores fat, and some contribution to mood and energy. It also talks to your skin, which we will come back to.
Your levels peak in your late teens and twenties. Then they start a slow decline, generally beginning somewhere in your thirties or forties, and they keep drifting down from there. That is the standard issue male timeline.
Declining is not the same thing as deficient. Declining is natural. Deficient has a clinical name: hypogonadism.
It's also interesting to know, your testosterone level swings over the course of the day. It's usually highest in the morning, and then declines through the day. That's why a legitimate test is drawn early, fasting, and repeated.
Total testosterone vs. free testosterone
Most of the testosterone in your blood is bound up to proteins and not available to your tissues. Total testosterone measures all of it. Free testosterone measures the small fraction that's actually unattached and usable. The Endocrine Society's position is that a real diagnosis looks at both, because a man can have a normal-looking total and a genuinely low free level, or the reverse. If a clinic tests one number once and hands you a prescription, that's not the standard of care.
What are the symptoms of low testosterone in men?
The symptoms of low testosterone are pretty generic: tired, low sex drive, low mood, foggy, losing muscle, weight gain around the middle.
All of those can also be symptoms of: bad sleep, stress, drinking, depression, being overweight, or thyroid problems. Those are also common side effects from half a dozen medications.
The point is to say, an online quiz isn't going to help you one way or another. Hypogonadism is between you and your doctor.
Why is everyone talking about testosterone in 2026?
The short version: the rules changed, and the marketing followed.
A large safety trial published in 2023 found that testosterone did not increase heart attacks or strokes in the men studied, which eased the cardiovascular concerns that had hung over it for a decade. The FDA dropped its cardiovascular warning in February 2025. In December 2025 the agency convened an expert panel that recommended going further and revising the labels again.
That last move specifically opens the flood gates. The FDA requiring a label that says testosterone replacement therapy is not shown to help as we get older didn't stop doctors from prescribing it, but it did keep companies from marketing it that way. When that language goes, telehealth companies can advertise directly to every man over forty who feels tired. And just a reminder, telehealth companies love to advertise on podcasts.
Then in July 2026 it went from a medical story to a national one. On July 15, Defense Secretary Pete Hegseth announced mandatory annual testosterone screening for active duty and reserve service members aged 30 and up, with voluntary testing below that age and optional TRT for anyone found deficient. The next day, the Endocrine Society issued a statement essentially reminding everyone what a real diagnosis requires.
That is most of why your feed changed. Not a conspiracy, not a breakthrough. A regulatory door opened, an industry walked through it, and then it became a political story.
What counts as a low testosterone level?
Here is the second thing that made googling this hard. There is no settled answer.
Depending on which threshold and which symptom definition you use, the share of American men who actually qualify is small. The most cited estimate comes from the Boston Area Community Health survey, which put symptomatic androgen deficiency at roughly 5.6 percent of men aged 30 to 79. Stricter definitions put it lower still.
And underneath all of it, the Endocrine Society says testing is often inaccurate, and explains that because assays are not standardized, "the same blood sample can read 'low' or 'normal,' depending on the lab." Harvard Health puts a number on the practical consequence: for men with borderline-low levels, "a repeat test would show a normal range about 30% of the time."
To me the lesson is clear: this is a conversation with a doctor, and it takes more than one blood draw. What we can tell you is what the research found on the other side of that line, because that part is much clearer than the argument about where the line goes.
What does testosterone replacement therapy actually do?
The cleanest evidence comes from the Testosterone Trials, funded by the National Institutes of Health rather than by anyone selling testosterone. 790 men, all 65 or older, all with genuinely low levels confirmed by two morning tests. They were given either testosterone gel or a placebo gel every day for a year.
Those first four are real. For a man with a genuine deficiency, this is medicine that works.
Testosterone did not improve vitality. It did not improve cognitive function. In the trial specifically designed to test walking ability, there was no significant difference between the men on testosterone and the men on placebo.
And what about energy? This is the thing I keep seeing promised in the ads. Researchers went looking for it, in the group of men most likely to benefit from it, in a double blind study, and did not find it.
What are the risks and side effects of TRT?
The Testosterone Trials asked whether TRT worked. A second and much larger trial asked whether it is dangerous. Known as the TRAVERSE trial, it enrolled 5,246 men aged 45 to 80, all of whom already had heart disease or were at high risk for it. This study was funded by the companies that make testosterone, but keep in mind that is standard practice when the FDA requires a safety study.
The headline from the TRAVERSE trial: testosterone did not increase heart attacks or strokes compared to placebo. Major cardiac events occurred in 7.0 percent of the testosterone group and 7.3 percent of the placebo group.
The rest of that same trial got considerably less coverage.
Thicker blood
One that didn't make the TRAVERSE headlines but that every prescriber watches for: testosterone tells your body to make more red blood cells. That's exactly why it corrects anemia. Push it too far and you get the opposite problem, erythrocytosis, blood that is thicker than it should be, which is why men on TRT get their hematocrit checked on a schedule. It's usually managed by adjusting the dose or the formulation. It is also one of the most common reasons a prescription gets changed.
Your body stops making its own
Then there is the thermostat. Remember that your brain dials your own production down when levels are high. Take testosterone and your body stops making its own. Testicular shrinkage is a normal, documented consequence.
TRT also suppresses sperm production. The Endocrine Society specifically recommends against starting testosterone therapy in men who are planning to have children in the near term. If you are 34 and think you might want kids someday, again, talk to your doctor. Coming off it is not always a clean reversal.
What TRT does not do
It does not prevent diabetes. A substudy of the TRAVERSE trial followed men with low testosterone and prediabetes and found no meaningful difference in who went on to develop diabetes, and no improvement in blood sugar control. The authors wrote plainly that it should not be used for that purpose.
Its long-term prostate cancer risk is unknown. The backstory here is that prostate cancer feeds on testosterone. That's not theoretical, it's the basis of a real treatment: advanced prostate cancer is often managed by cutting testosterone off, which shrinks the tumor. So the obvious worry has always been the reverse, that adding testosterone to a man who has a small undetected cancer would speed it up. The problem is that prostate cancer can take a decade or two to become clinically apparent, and the trial ran about three years. The study is shorter than the disease. The Endocrine Society is calling for a long-term men's health study to close that gap.
It does not have an evidence base for making a normal man feel younger. There is essentially no research supporting what most of the marketing is actually about, which is taking testosterone when your levels are normal in order to feel younger, build muscle, or perform better.
It is not a weight loss drug, and weight loss may be the actual treatment. The Endocrine Society has said that if a man's low testosterone traces back to being overweight with no other identified cause, weight loss is the first-line treatment. Not the prescription. Sleep, alcohol, and untreated sleep apnea sit in the same category: fix those first, because they suppress testosterone on their own and because they cause most of the symptoms people blame on low T.
Are testosterone levels actually declining across generations?
This is the question underneath a lot of the noise. Several studies have reported that average testosterone in men has drifted downward over the past few decades, independent of age. In other words, a 40-year-old today has less testosterone than his dad did at 40. The candidates offered for why include obesity rates, sedentary work, sleep, and environmental exposures. It is a real and active area of research. It is also not, on its own, a reason for any individual man to start a prescription. What's happening to a population and what's happening to you are two different things.
How testosterone affects your skin and hair
We sell grooming products, not medicine. But there is one piece of this that lands squarely in our lane and almost nobody covers it, so here it is.
Testosterone changes your skin and your hair.
Some of your testosterone converts into a second hormone called DHT (dihydrotestosterone), which is the more aggressive of the two. DHT does two things you can see in the mirror.
1. It turns up your oil
DHT tells the oil glands in your skin to grow and produce more. Acne is the most commonly reported skin side effect of testosterone therapy, showing up in roughly 1 to 9 percent of men depending on the formulation, usually in the first three to twelve months. If you are on T and breaking out along your jaw for the first time since high school, that is not your face betraying you. That is chemistry.
2. It shrinks vulnerable hair follicles
To be precise, testosterone itself does not cause male pattern baldness. DHT does, and only in men who carry the genetic susceptibility for it. If you were always going to thin, this can move the timeline up. If you were not, it generally does not create the problem out of nowhere.
Both effects can also happen at completely normal testosterone levels. Correcting a real deficiency into the normal range is enough to trigger them in men who are prone.
What to actually do about it
If that is happening to you, the answer is not to quietly stop your medication. Tell your prescriber, because dose and formulation are adjustable. Then treat your skin and scalp like they are operating in a different environment, because they are.
You would probably benefit from a gentle daily face cleanser. And if being oily is new to you, just keep in mind that oil control doesn't mean stripping the oil. All that does is cause your skin to produce more of it.
Related from the shop: gentle daily face cleansers · oil control for men · hair loss and thinning care
The bottom line on testosterone and TRT
I started this because I did not know anything, and I finished it knowing roughly this:
Get the real information. Ask a doctor who wants more than one blood draw. Be suspicious of anything that promises you your twenties back.
Confidence is built. Usually out of unexciting answers.
We send one email a week worth opening. Grooming that works, myths we have put through the wringer, and the occasional trend we tell you to skip. No spam, no fifteen-step routines.
Frequently asked questions about testosterone and TRT
What does TRT stand for?
TRT stands for testosterone replacement therapy. It is prescription testosterone given as a gel, injection, patch, or implanted pellet. It's used to bring a man with a diagnosed deficiency back into the normal range.
What is a normal testosterone level for a man?
There is no single agreed number. The American Urological Association uses a cutoff of 300 ng/dL, the Endocrine Society uses 264 ng/dL, and other bodies use 200 or 230. Levels are also highest in the morning and fall through the day, and the same blood sample can read differently at different labs, which is why diagnosis requires at least two early-morning tests.
What are the symptoms of low testosterone in men?
Fatigue, low sex drive, low mood, brain fog, loss of muscle, and weight gain around the middle. All of these are also symptoms of poor sleep, stress, drinking, depression, obesity, and several common medications. This is why symptoms alone, or an online quiz, cannot diagnose it.
Does TRT give you more energy?
The NIH-funded Testosterone Trials specifically measured vitality and energy in older men with confirmed low testosterone and found no improvement over placebo. Sexual function, anemia, mood, and bone density did improve. Energy is the most heavily advertised benefit and the one with the weakest evidence.
Does TRT cause hair loss?
Testosterone itself does not cause male pattern baldness. DHT, a hormone your body converts some testosterone into, does but only in men who carry the genetic susceptibility. If you were already going to thin, TRT can move the timeline up. If you were not genetically prone, it generally does not create the problem.
Does TRT cause acne?
Acne is the most commonly reported skin side effect of testosterone therapy, appearing in roughly 1 to 9 percent of men depending on the formulation, usually within the first three to twelve months. DHT increases oil gland size and output. Talk to your prescriber about dose and formulation rather than stopping treatment on your own.
Does TRT affect fertility?
Yes. TRT suppresses your body's own testosterone production and with it sperm production. The Endocrine Society recommends against starting testosterone therapy in men who plan to have children in the near term.
Can you increase testosterone naturally?
Addressing the things that suppress it is the first-line approach. The Endocrine Society has said that when low testosterone traces back to excess weight with no other identified cause, weight loss is the first-line treatment rather than a prescription. Sleep, alcohol intake, and untreated sleep apnea belong in the same conversation.
Is the U.S. military really testing testosterone?
Yes. On July 15, 2026, Defense Secretary Pete Hegseth announced mandatory annual testosterone screening for active duty and reserve service members aged 30 and older, with voluntary testing for those under 30 and optional testosterone replacement therapy for those found deficient.
Tom Henkenius is the founder of Henkey's, a curated men's grooming shop built around the Henkey's Standard: solid ingredients, delivers on its promise, builds confidence. This piece is educational and is not medical advice. Talk to a physician about testosterone testing or therapy.
The research behind this piece