How long does testosterone take to work?

For men, testosterone plays an important role in the development of male sex characteristics, sperm cell production, regulation of sex drive, and enlargement of the testes and penis. It’s an essential hormone for men’s health. However, women also produce testosterone in small amounts—it is a precursor to estrogen. This sex hormone also stimulates protein synthesis, thereby promoting skeletal muscle growth.

If you have a testosterone deficiency, your healthcare provider might recommend a treatment called testosterone replacement therapy (TRT). TRT can help increase testosterone levels and improve symptoms like erection problems or erectile dysfunction, low libido, and low muscle strength. 

It can take testosterone a few days to a few months to work, depending on the symptom you’re treating, the type of administration, and various health factors. For instance, one study found that it may take up to six months to see the effects of TRT on erections, while its impact on depressive mood may be detectable after three to six weeks of treatment. 

How long does it take for TRT to work?

TRT works to increase testosterone levels and improve symptoms associated with low testosterone levels. “The timeframe for experiencing the effects of TRT varies depending on individual factors and the type of administration,” explains Linda Khoshaba, NMD, founder of Natural Endocrinology Specialists (NES) in Scottsdale, Arizona. Generally, TRT will begin to work gradually, with symptoms appearing over the duration of treatment. The timelines for different symptoms are:

• A few days to improve mood and energy levels
• A few weeks to begin improving muscle mass and strength
• Several months for significant improvement in sexual function and bone density

Signs that testosterone therapy is working

Results a person may expect from testosterone treatment include:

• Increased levels of testosterone
• Improved sexual function and increased sexual desire
• Increased muscle strength and lean muscle mass
• Changes in how the body metabolizes lipids like triglycerides and cholesterol
• An increase in bone strength and density
• Better lean body mass percentage
• Enhanced quality of life and overall well-being
• Reduced body fat mass
• Improved insulin sensitivity 
• May reduce the risk of cardiovascular health issues

Over time, and when used appropriately, testosterone hormone replacement therapy can help improve symptoms of low testosterone, including:

• Low sperm count
• Reduced sex drive
• Bone loss
• Decreased body hair and sparse beard growth
• Reduced lean muscle mass
• Sleep problems
• Reduced glycemic control
• Body fat accumulation and weight gain
• Constant fatigue

Factors that influence testosterone effectiveness

Different health and lifestyle factors may affect the effectiveness of TRT and how long the effects last.

• Physical activity level: An individual’s physical activity level may influence TRT’s effectiveness. A 2019 study published in the Journal of Clinical Medicine indicated that regular exercise may increase the chances of having a sustained TRT effect after treatment. 
• Type of TRT and administration method: The efficacy of testosterone treatment may vary depending on the kind of testosterone preparation being used: injection, transdermal (patch, gel, or pellet), oral, nasal, topical, or buccal formulation. For instance, a comparison of TRT medications indicated that a Delatestryl injection normalized testosterone levels in up to 72% of patients, while the Androderm patch achieved normal levels in up to 92% of patients when treating hypogonadism. 
• Underlying medical conditions and adverse effects: TRT may worsen pre-existing health problems like certain cardiovascular diseases and obstructive sleep apnea. Also, adverse effects, such as urinary retention, reduced sperm production, and acne, may occur during testosterone treatment, causing some people to discontinue treatment. 
• Duration of treatment: The duration of TRT treatment may vary depending on the type of TRT and the goal of the treatment. However, for people receiving the same treatment type (oral, gels, and injectables), evidence suggests that longer treatment periods may sustain the treatment response compared to shorter treatment periods.
• Individual body response: Some individuals may respond more dramatically to TRT than others due to genetics and other factors.
• Diet: Dietary factors can influence serum testosterone levels and impact androgen response. In a 2021 systemic review and meta-analysis of studies, a low-fat diet appeared to reduce testosterone levels in men. The effects of proteins on testosterone are also being studied. Very high-protein foods (more than 3.4 g/kg/day) may reduce testosterone levels, while moderate-to-high protein (1.25–3.4 g/kg/day) diets may not, according to a recent study. Micronutrients like vitamin D, zinc, and magnesium may also affect testosterone concentrations and synthesis.

How to maximize the effectiveness of testosterone therapy

According to Ramkishen Narayanan, MD, a board-certified urologist at Providence Saint Joseph Medical Center in Burbank, California, lifestyle modifications can increase testosterone and possibly relieve hypogonadism symptoms enough before formal TRT is even considered. Steps to maximize the effectiveness of your testosterone treatment plan include: 

• Reducing stress and getting enough sleep
• Avoiding recreational drug use and limiting alcohol intake
• Losing weight if your BMI falls within the overweight or obese range
• Exercising regularly, especially by doing weight- or resistance-based training
• Being compliant with the treatment of existing medical conditions and the underlying cause of hypogonadism
• Going for regular checkups after the TRT prescription so your healthcare provider can follow up with blood tests to know your progress
• Working with a registered dietitian to ensure your diet consists of foods that promote testosterone and its effects
  

“Consult a qualified and experienced naturopathic endocrinologist or other healthcare professionals; focus on a holistic approach to wellness, address underlying issues, and optimize overall health alongside TRT,” Khoshaba advises.

It’s also crucial to understand that TRT is not a magic bullet, and its effectiveness and how long it takes to work depend on individual circumstances. It may not be the best treatment approach for everyone with low T, and like all medications, it is also associated with side effects. It is also essential to work with a licensed prescriber to ensure safe use because misuse or abuse may lead to an increased risk of stroke, heart attack, depression, and liver damage.