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Low testosterone facts and statistics

Testosterone replacement therapy is on the rise. Discover key stats, pricing, usage trends, and medical insights on how TRT treats low testosterone in men.
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By | Jul. 15, 2025 Medically reviewed by Anne Jacobson, MD, MPH
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Key takeaways

  • Male hypogonadism is a condition characterized by low levels of testosterone, typically found in men over 40 years old, and increasing with age.

  • Testosterone replacement therapy (TRT) is a common treatment for male hypogonadism.

  • TRT doesn’t just raise the amount of testosterone and balance hormone levels. For men with low testosterone, it can also improve libido, muscle mass, bone density, blood sugar, and more.

  • Although the price of TRT has decreased in recent years, it can still be expensive for anyone paying out of pocket. Fortunately, many insurance plans cover it.

In this article:

Testosterone is one of the body’s vital hormones. The primary male sex hormone contributes to everything from muscular growth to bone strength, facial hair, vocal changes, and sperm production in men. It also contributes to ovarian function and bone strength in women, but female testosterone levels are much lower. Some men have low testosterone levels, especially as they age, leading them to seek out testosterone replacement therapy.

Here are all the important facts and figures about low testosterone and its treatments.

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How many people have male hypogonadism?

Hypogonadism is a condition defined by the decreased production of sex hormones. In the case of testosterone, hypogonadism can stem from issues with the testicles or adrenal glands, pituitary gland tumors, autoimmune disorders, genetic disorders, injury, or prostate cancer treatment. It’s diagnosed by measuring free testosterone concentrations and total testosterone levels using blood tests. If there is a testosterone deficiency, a healthcare provider may begin hormone therapy.

Symptoms of low testosterone (low T) may include low sex drive, erectile dysfunction, reduced muscle mass, fatigue, increased body mass index (BMI), mood changes, and more. Often age-related, it’s much more common in older men, but it can affect men of any age.

How many men use testosterone replacement therapy?

Over the past couple of decades, the number of American men using testosterone replacement has increased significantly. Multiple studies have found that men’s testosterone levels have been gradually decreasing since the 1980s. It’s unclear what’s causing these low testosterone levels, but increasing obesity, lack of physical activity, an unhealthy diet, alcohol abuse, and endocrine-disrupting chemicals might all be contributing factors.

Regardless, testosterone replacement therapy (TRT) has been increasing in popularity for years now. Dr. Jason B. Carter, urologist and medical advisor at Aeroflow Urology, attributes this rise to “direct-to-consumer marketing increasing public awareness about low T and a growing cultural emphasis on aging well, improving athletic, sexual, and work performance, and increasing vitality.” He also says that “online and telehealth clinics and a growing number of more traditional physicians who are willing to diagnose and treat low T and hypogonadism have made access easier.”

  • Prescriptions for testosterone replacement therapy (TRT) increased from 7.3 million in 2019 to over 11 million in 2024. (CBS News, 2025)
  • In 2022 alone, there was a 27% increase in testosterone therapy patients, including a 35% increase in people aged 45-54 and a 58% increase in people aged 35–44. (PLoS One, 2024)
  • Between 2018 and 2022, the largest increase in testosterone therapy patients was in the South (52%), followed by the West (28%) and Northeast (23%). There was no increase in the Midwest. (PLoS One, 2024)
  • The global TRT market was valued at approximately $1.9 billion in 2024 and is expected to reach $2.9 billion in 2034. (Global Market Insights, 2025)

How effective is TRT? 

Part of the reason TRT has grown so much in popularity is that it can have a variety of benefits. “A lot of men feel noticeably better on TRT; it can boost energy, mood, sex drive, and muscle strength,” says Dr. David Shusterman, a urologist at NY Urology. “If a patient has true hypogonadism and symptoms, I usually recommend TRT. It can make a big difference. But it’s important to make sure the diagnosis is accurate and to monitor therapy carefully.” Here are some effects of TRT for men diagnosed with low testosterone:

  • A 2018 study suggests that TRT is effective in treating mild erectile dysfunction. For adult males with moderate or severe ED, it can improve sex drive, but is less effective at treating ED. (Current Opinion in Urology, 2018)
  • Research from 2021 found that TRT can reduce fasting blood sugar, total cholesterol, and triglycerides in men with low testosterone, obesity, and Type 2 diabetes. (Arab Journal of Urology, 2021)
  • A 2018 review found that TRT increased both muscle mass and strength in middle-age and older men with low testosterone. (Journal of Cachexia, Sarcopenia and Muscle, 2018)
  • In a 2017 study, TRT was associated with greater estimated bone strength. (JAMA Internal Medicine, 2017)
  • However, a 2024 study found that although TRT is known to increase bone density, it did not decrease the incidence of fractures. (The New England Journal of Medicine, 2024)

How much do Americans spend on testosterone?

Testosterone replacement therapy is a rapidly growing industry, and it’s also becoming more accessible every year. That said, it isn’t always cheap for people paying out of pocket. Fortunately, most insurance plans will cover TRT if a healthcare provider deems it medically necessary. Either way, hundreds of millions of dollars change hands every year in the name of achieving normal testosterone levels.

How many Americans use insurance for testosterone replacement?

It’s difficult to put an exact number on how many Americans get insurance coverage for testosterone because there isn’t much data on it. Also, coverage depends entirely on the specific insurance provider and plan, so not everyone who has health insurance will get their TRT covered. That said, there are a few stats that can help get a sense of nationwide TRT insurance coverage:

How many Americans pay for testosterone out of pocket?

Again, it’s tough to give an exact number, since there aren’t records of this kind of data. However, according to a study from KFF, around 25.3 million Americans are uninsured—about 9.5% of the population. So, around one out of every ten people might not have insurance to help cover their medications. Plus, not every insurance plan will cover TRT, so some insured patients will also need to pay out of pocket. 

Testosterone side effects

Like any other medication, testosterone treatment comes with the risk of adverse effects. The most common side effects for testosterone cypionate (depo-testosterone), for example, are injection site redness (26%) and injection site reaction (4%). Other side effects can include:

  • Acne
  • Tiredness
  • Sleep issues
  • Mood swings
  • Weight gain
  • Headache
  • Joint pain
  • Back pain

On top of that, serious side effects of TRT can include:

  • Allergic reactions
  • Blood clots
  • Heart attack
  • Increased blood pressure
  • Liver injury
  • Prolonged or painful erection
  • Stroke
  • Swelling of the ankles, hands, or feet
  • Depression or suicidal thoughts
  • Infertility
  • Difficult breathing during sleep
  • Enlarged, painful breasts

“In some cases, TRT can affect fertility, so that’s something we talk about before starting treatment,” Dr. Shusterman says. “Regular monitoring helps us catch and manage any issues early.”

Of course, not everyone in testosterone therapy experiences adverse effects, and for many people, the benefits outweigh the negatives. Plus, “a physician who is knowledgeable in diagnosis of low T and hypogonadism, TRT, and management of TRT side effects should be able to monitor for and treat side effects of TRT and adjust TRT doses as needed to limit and/or avoid side effects,” Dr. Carter says.