Can I take testosterone replacement (TRT) without checking testoterone

You can initiate it but it certainly is best to have a urologist or specialist check your testosterone levels so you will have a baseline. There can be some undesirable side effects so I doubt your doctor would prescribe without due diligence. Make sure you read all the literature you can get your hands on before making the decision so you will be aware of the benefits and or undesirable side effects. I am 80 years old and started testosterone pellet therapy approximately one year ago and it has been beneficial. I can tell a slight difference in the gym and my libido has increased. My doctor orders blood test periodically to check the levels.

I wish I could pinpoint the reason for my practically nonexistent libido. My testosterone level is normal. Certain images(not pornographic!) may cause slight elevation in hardness but not enough to really notice. I am 78 and would like to enjoy a few more years of sexual pleasure. My wife is somewhat willing. Thanks in advance.

Never start Testosterone without having the levels checked first - Mayo clinic also checks free Testosterone (gold standard) - this should be above 6.5 ng/dL but most men live > 10 ng/dL. Low T = symptoms + low biochemical levels. Replacement needs to normalize where the T should have been. Like most medications T is beneficial in the correct range (too low or too high causes problems).

Libido is complicated, but it will increase with higher T. Lifting weights, adequate protein intake, adequate sleep and stress mitigation can facilitate higher T levels naturally - all of these things will also make you live longer and ward off things like dementia, heart disease and cancer. There are numerous studies showing building muscle strength extends healthspan (not just lifespan)!

Best

Dr Kohler
Professor of Urology

@tkohler Dr. Kohler, I just had my total testosterone level checked (at age 76) and it is higher than 1000. Yet I do not feel any different and have none of the high symptoms. I suspect that my Free testosterone is low. How can I promote releasing some of my bound, total T to convert to Free T?

@heisenberg34 you could have very low 'FREE TESTOSTERONE' Levels. This can cause your problem as you're producing enough testosterone but it's the FREE stuff the body uses. I'd recommend Tadalafil 5mg daily.

@hammbro Gosh,
I've never seen a reference to Tadalafil raising Free-T levels. Is there a clinical study on that? I just do one injection a week of testosterone cypionate, upper thigh, painless. Very easy to do. The T-gel topical application will also raise T levels, but not necessarily Free-T levels.

@laughlin1947 Did you have to get a doctor's script for that injection? I imagine that you had a lab test for your T levels, right? I had my levels checked last year. Seems as if all is well. Perhaps being 78 plays a role. I just don't know. Little sex drive; not able to get very hard' cannot masturbate. Ah, the good like, right?

@heisenberg34 I have the same exact conditions as you have - zero libido, no erections, no morning erections, some slight libido stimulation when looking at porn, which is highly infrequent for me. I'm 78 years old also. Just no spontaneous libido, sadly enough. I do need an Rx from an endocrinologist (I've seen 3 endocrinologists by now) to get the Free-T medication. But my Free-T is in the normal range now and still no normal sex drive. No doctors have any support or answers or any program for trial. Maybe a sex therapist would have things to try. I've been to 3 urologists and most just said get a penile implant. That's not for me. I think the answer is buried somewhere in male hormone imbalances/levels such as serotonin and/or dopamine, I need to research it more, figure out dosage levels. I tried aromatase inhibitors on and off, and they made no difference. I at one time thought that the estrogen the body generates when taking the T injections was causing the problem, but that did not pan out. I see the endocrinologist in a few weeks, but my hopes are not high that he will have any ideas for me. There may always be a breakthrough however! If I find out something, I'll let you know. I think supplements are not successful either. Neither were Viagra, Cialis, etc.

@laughlin1947 I hope your research yields fruit. It's a shame that we patients end up having to do our own research into the health issues we have. Keep us posted on your research.