7 Things People Get Wrong About Testosterone Replacement Therapy (TRT)

Posted on March 15, 2025 by Justin Houman

Testosterone Replacement Therapy (TRT) is one of the most misunderstood treatments in men’s health. Despite its growing popularity, myths and misconceptions surround it—often scaring men away from getting the care they need.

I see this every day in my practice. A patient will come in, exhausted, struggling with low energy, low libido, and brain fog. He’s tried everything—diet, exercise, sleep, supplements—but nothing works. When I bring up TRT as an option, I can see the hesitation in his eyes.

“Isn’t that like steroids?”
“Won’t it make me infertile forever?”
“Doesn’t it cause heart attacks?”

He’s not alone. Misinformation is everywhere, and I’m here to set the record straight. Here are seven things people get wrong about TRT—so you can make an informed decision about your health.

1. TRT is Just for Bodybuilders and Athletes

The biggest misconception about TRT is that it’s the same as anabolic steroid abuse. Many people think of it as something bodybuilders use to get massive muscles.

Here’s the reality: TRT is medical treatment, not performance enhancement. It’s for men with clinically low testosterone who suffer from fatigue, depression, loss of muscle, and reduced quality of life.

Think of it like this: If you have a thyroid disorder, you take thyroid medication. If you have diabetes, you take insulin. Low testosterone is no different—it’s a medical condition that deserves proper treatment.

2. TRT Causes Infertility Permanently

This one has some truth, but it’s not the full story. TRT can suppress natural sperm production, but it doesn’t make a man permanently infertile.

Here’s why: When you take external testosterone, your body reduces its own natural production, including sperm. But for many men, fertility can be preserved with the right approach—by adding medications like hCG or enclomiphene, which keep sperm production going.

I’ve helped countless men start families while on TRT, using tailored treatment plans. If fertility is a concern, work with a specialist who knows how to manage it properly.

3. TRT Causes Heart Attacks and Strokes

This myth refuses to die. Years ago, some flawed studies suggested TRT increased the risk of heart attacks. But newer, more rigorous research tells a different story.

In fact, men with low testosterone are actually at a higher risk for heart disease. Properly managed TRT can improve cardiovascular health by lowering fat mass, increasing muscle, and improving blood sugar control.

I had a patient, a 55-year-old man, who was afraid TRT would hurt his heart. After treatment, his cholesterol improved, he lost 20 pounds, and his energy skyrocketed. Instead of harming his health, it helped him get his life back.

4. TRT is a “Magic Fix” for Every Man

Some men hear about TRT and think it’s an instant cure-all. They expect to feel like a superhero overnight. That’s not how it works.

TRT is a tool—not a miracle drug. It works best when combined with a healthy lifestyle. You still need to eat well, exercise, manage stress, and get enough sleep.

I’ve seen men who start TRT and feel incredible within weeks. Others need adjustments before they get the full benefits. Patience and proper medical guidance are key.

5. Natural Methods Always Work Better Than TRT

Can diet, exercise, and sleep improve testosterone? Absolutely. But for some men, it’s not enough.

I had a patient, a 38-year-old father of two, who did everything “right.” He ate clean, lifted weights, and slept well. But his testosterone was still low, and he felt terrible. No amount of broccoli and deadlifts were going to fix it.

Some men need TRT because their body simply isn’t producing enough testosterone. No amount of natural lifestyle changes can replace what’s missing.

6. TRT Will Make You Angry and Aggressive

Hollywood loves this stereotype—the “roid rage” myth. But TRT doesn’t turn men into raging monsters.

In fact, many men with low testosterone experience irritability and mood swings due to hormonal imbalances. When properly prescribed, TRT often improves mood, reducing anxiety and depression.

A patient of mine, a 42-year-old executive, told me his wife noticed he was “calmer and more patient” after starting TRT. Instead of making him more aggressive, it made him feel like himself again.

7. Once You Start TRT, You Can Never Stop

This one scares a lot of men. They think once they start TRT, they’re locked in for life.

The truth? You can stop TRT if needed. However, it needs to be done correctly—with a proper post-therapy plan to help your body restart its own testosterone production.

That said, many men choose to stay on TRT because it makes them feel better. Why would you go back to feeling exhausted, unmotivated, and weak if you don’t have to?

The Bottom Line

TRT isn’t for everyone, but for the right men, it can be life-changing. The key is working with a knowledgeable doctor who understands the science—not falling for fear-mongering myths.

If you’re struggling with symptoms of low testosterone, get tested, get informed, and get the facts. Because when it comes to your health, the truth matters more than the myths.