Testosterone replacement therapy (TRT) – Testosterone replacement therapy (TRT) can be administered in many forms. Most patients will begin their treatment process with transdermal (TD) application routes. The most common form is a gel that is applied to clean, dry skin every day at the same time, usually after a man gets out of the shower. TD application is easy, well tolerated and allows for excellent absorption of testosterone and an even delivery of the hormone on a daily basis. There are minimal side effects. Some men will have a mild skin irritation while others may see an increase in their hematocrit, which will then need to be monitored. Injection therapy is another effective option. This involves the injection of testosterone on either a bi-monthly or weekly basis. The injections will give a high concentration of testosterone for the first few days and will decline to a low level after 10-12 days. It is a very effective therapy, but it does require the patient or patient’s partner to learn how to inject or make frequent office visits. Once starting TRT, patients should notice improved energy levels, exercise tolerance, libido and erectile function within the first few weeks of therapy. Optimal results will be achieved within about three to six months. Center for Men’s Health patients will return to the TUCC four to six weeks after their first dosing to ensure adequate serum levels. Once a good regimen has been established, blood work will be checked periodically.