Once You Start TRT, Can You Stop?

Testosterone replacement therapy (TRT) is prescribed to you only after you have been detected with low testosterone levels in your blood work. It is meant to replenish the low levels of testosterone which your body cannot produce endogenously.

Once you have started TRT, you will see a host of positive effects like improved bone and muscle mass, fat reduction, fewer mood swings and irritability, more concentration, an improved sex drive, and further improvements in secondary sexual characteristics.

However, these effects take time, a minimum of 12-20 weeks. Hence, stopping testosterone therapy anytime before this will not yield any benefits. However, TRT is a lifelong routine, with dose modifications as and when needed. Hence, if you are planning to stop TRT abruptly, it might not be the best idea. Please speak to your healthcare provider for details on stopping TRT, if possible.

Why is stopping TRT a big deal?

If you are considering testosterone therapy, you may be wondering what will happen if you decide to stop. While the short answer is yes, you can stop testosterone replacement therapy (just like any other medication, any day), the catch lies in its consequences. Testosterone therapy can be used to treat a variety of conditions, such as low testosterone levels, delayed puberty, and gender dysphoria. However, once you start testosterone therapy, your body will depend on it to function properly, since it cannot make the required testosterone by itself.

If you suddenly stop taking testosterone, your body may experience a low testosterone level and may go into withdrawal (1). This can cause a range of symptoms, such as fatigue, depression, decreased sex drive, and hot flashes. However, there are safe ways to stop testosterone therapy, and it is important to work with your healthcare provider to develop a plan that is right for you.

Potential Risks and Side Effects of Stopping Testosterone Therapy

It is important to understand the potential risks and side effects of testosterone replacement therapy before stopping it abruptly, also known as “cold turkey” (1), especially if your starting testosterone levels are extremely low.

Cardiovascular Disease and Heart Attack

Increased Risk of Blood Clots

Testosterone therapy (in high levels) has been linked to increased pulmonary and deep vein thromboembolism in some patients. Hence it might be a wise idea to stop testosterone therapy to reduce the risk of increased blood clots in patients who already present with risk factors for clotting (2). If you experience any unusual swelling or pain in your legs while using TRT, please seek medical attention immediately (but stop only when advised).

Cardiovascular Disease and Heart Attack

Testosterone is known for exerting a cardioprotective effect. Low testosterone levels are associated with an increased risk of cardiovascular disease and heart attack (3). Testosterone therapy can help to reduce this risk, but stopping testosterone therapy can increase the risk again. It is important to consult with your healthcare provider before stopping testosterone therapy.

Thinning Hair and Oily Skin

Testosterone therapy can help to improve hair growth and reduce oily skin. Stopping testosterone therapy can result in thinning hair and increased oiliness of the skin (4).

Mood Swings and Depression

Low testosterone levels have previously been linked to mood swings and depression. Testosterone therapy can help to improve mood and reduce depression, but stopping testosterone therapy can cause these symptoms to return (4).

Also Read: How TRT Can Help Treat Depression

Loss of Muscle Mass and Strength

Testosterone is involved in maintaining lean muscle mass and bone strength. Testosterone therapy can help to increase muscle mass and strength and reduce central adiposity. Stopping testosterone therapy can prove to be counter-reactive and cause all the lost fat to resurface.

Fatigue and Low Energy Levels

Low testosterone levels can cause fatigue and low energy levels. Testosterone therapy can help to improve energy levels, but stopping testosterone therapy can reinfuse fatigue and low energy levels in the system (1,4).

Also Read: Impact of TRT on Chronic Fatigue

Decreased Sexual Function and Libido

Low testosterone levels can cause decreased sexual function and libido. Testosterone therapy can help to improve sexual function and libido, but stopping testosterone therapy can again reduce the sex drive, and affect the patient’s private life severely.

Also Read: How TRT Can Help Treat Low Libido

It is important to consult with your healthcare provider before stopping testosterone therapy. Your healthcare provider can help you develop a plan for weaning off testosterone therapy to minimize the risk of side effects and withdrawal symptoms.

If Not Stopping Testosterone Therapy Abruptly….

Testosterone replacement therapy is a lifelong treatment if not indicated otherwise. If you are considering stopping testosterone therapy, it is important to understand the potential risks and benefits of stopping testosterone therapy.

Gradual Weaning Off of Testosterone Therapy

If you decide to stop testosterone therapy, it is important to gradually wean off the treatment to make the transition smoother. Abruptly stopping testosterone therapy can make unpleasant symptoms such as fatigue, depression, and decreased libido, resurface (1).

Exploring Alternative Treatment Options

If you are stopping testosterone therapy due to side effects or other concerns, it may be helpful to explore alternative treatment options. Some alternatives to testosterone therapy include human chorionic gonadotropin (HCG) therapy, which can help stimulate natural testosterone production and lifestyle changes such as exercise and a healthy diet.

In conclusion, stopping testosterone therapy is a decision that should be made in consultation with your healthcare provider. Gradually weaning off testosterone therapy and exploring alternative treatment options can help minimize any potential side effects and make the transition smoother.

What Happens When You Stop TRT?

One of the most significant consequences of stopping testosterone therapy is the onset of withdrawal symptoms (1). These symptoms can include fatigue, mood swings, depression, joint and muscle weakness, and decreased libido. Additionally, stopping testosterone therapy can cause a decrease in muscle mass, an increase in body fat, and a decrease in strength.

Negative Impact on Mood and Energy Levels

Stopping testosterone therapy can also affect your mood and energy levels negatively. Testosterone plays a key role in regulating mood and energy, and stopping therapy can lead to a decrease in both. You may experience feelings of fatigue, irritability, and a lack of motivation.

Changes in Body Composition and Sexual Function

Testosterone therapy is often used to improve sexual function and body composition, and stopping therapy can lead to a reversal of these benefits. You may experience a decrease in libido, erectile dysfunction, and a reduction in muscle mass. Additionally, stopping therapy can lead to an increase in body fat and a decline in strength. Studies have also shown worsening of prostate volume, prostate-specific antigen (PSA) levels, and bladder wall thickness in men who stopped testosterone therapy abruptly.

In conclusion, stopping testosterone therapy can have a range of negative consequences on your health and well-being. It is important to speak with your healthcare provider before making any changes to your testosterone therapy regimen. They can help you develop a plan that minimizes the risk of negative side effects and ensures that you maintain optimal health and well-being.

Monitoring Testosterone Levels After Stopping Testosterone Therapy

If you have decided to stop testosterone therapy, it is important to monitor your testosterone levels to ensure that they return to normal. Here are some ways to monitor your testosterone levels after stopping testosterone therapy.

Blood Tests

Your healthcare provider may recommend regular blood tests to monitor your testosterone levels after stopping testosterone therapy. Blood tests can help determine whether your testosterone levels have returned to normal or if you are experiencing low testosterone levels.

Symptoms of Low Testosterone

It is important to be aware of the symptoms of low testosterone, which can include fatigue, decreased libido, decreased muscle mass, and decreased bone density (1,4). If you experience any of these symptoms after stopping testosterone therapy, it is important to talk to your healthcare provider.

In addition to monitoring your testosterone levels and symptoms, it is important to maintain a healthy lifestyle after stopping testosterone therapy. This includes eating a healthy diet, exercising regularly, and getting enough sleep.

Remember that stopping testosterone therapy can have different effects on different people. It is important to work with your healthcare provider to determine the best course of action for you.

FAQs

What are the effects of stopping TRT after 1 month?

Any form of TRT will take a minimum of 3-4 months to show any effects. Hence stopping TRT after 1 month will not be beneficial in any way. Please consult your doctor for expert opinions on starting and stopping TRT.

Will stopping TRT after 3 months be harmful for me?

The effects of TRT only surface after 3-4 months of therapy. However, there is a good chance that all the benefits can be replaced by the same symptoms of testosterone deficiency once you stop TRT. Please understand that TRT is meant to replenish your body’s testosterone reserves as it cannot do so endogenously. Hence it is a wise idea to continue TRT until your doctor says so. In most cases, it is a lifelong affair.

Once you start testosterone therapy can you stop?

You can stop TRT only if your doctor says so. It all depends on how low your testosterone reserves are at the beginning of therapy, how your body responds to it, and how well you adhere to your current regimen. There are chances that you can face similar testosterone-deficient symptoms once you stop testosterone therapy, and you will need to restart. However, these decisions are best left between the patient and their practitioners. Please do not self-medicate (or stop) based on temporary results.

References Yassin A, Nettleship JE, Talib RA, Almehmadi Y, Doros G. Effects of testosterone replacement therapy withdrawal and re-treatment in hypogonadal elderly men upon obesity, voiding function and prostate safety parameters. The Aging Male. 2016 Jan 2;19(1):64-9. https://doi.org/10.3109/13685538.2015.1126573. Sharma R, Oni OA, Chen G, Sharma M, Dawn B, Sharma R, Parashara D, Savin VJ, Barua RS, Gupta K. Association between testosterone replacement therapy and the incidence of DVT and pulmonary embolism: a retrospective cohort study of the Veterans Administration Database. Chest. 2016 Sep 1;150(3):563-71. https://doi.org/10.1016/j.chest.2016.05.007. Goodale T, Sadhu A, Petak S, Robbins R. Testosterone and the Heart. Methodist DeBakey cardiovascular journal. 2017 Apr;13(2):68. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512682/. Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2010 Jun 1;95(6):2536-59. https://doi.org/10.1210/jcem.95.8.9995.