Men’s Health and Urology: When to Consider Testosterone Replacement Therapy

November 9, 2025

At Big Apple Medical Care, we are dedicated to delivering comprehensive men’s health and urology services, including personalized Testosterone Replacement Therapy (TRT) solutions tailored to your unique needs Big Apple Medical Care. Our aim is to help you regain vitality, optimize well-being, and navigate TRT safely and effectively.

Understanding Testosterone and Its Role in Men’s Health

Testosterone is a key hormone that drives sexual function, muscle mass, bone density, mood, energy levels, and cognitive health. Levels naturally decline with age and can be further affected by conditions such as obesity, diabetes, stress, sleep disorders, and certain medications.

Nearly 40% of men over age 45 exhibit low testosterone, rising to over half by age 75.
Clinical hypogonadism is defined as testosterone below 300 ng/dL confirmed on two separate morning tests, accompanied by symptoms

Recognizing Symptoms of Low Testosterone

Men may notice persistent symptoms that warrant evaluation, such as:

Fatigue, low energy, low libido, erectile dysfunction
Loss of muscle mass, increased body fat
Mood disturbances, depression, irritability, impaired cognition
Bone weakening or thinning

Because many of these symptoms are nonspecific, a thorough clinical assessment is vital.

Initial Management: Lifestyle Interventions

Before starting Testosterone replacement therapy, lifestyle modifications are key and can often improve testosterone levels:

Weight loss and vigorous exercise reduce aromatase activity, lowering conversion of testosterone to estrogen.
Addressing sleep apnea, improving sleep quality, and managing stress and diet can also boost hormonal balance.

When to Consider Testosterone Replacement Therapy

TRT becomes a recommended option when:

Low testosterone levels (< 300 ng/dL on repeated tests).
Persistent symptoms affecting quality of life despite lifestyle optimization.
No medical contraindications, such as:
- Advanced prostate cancer
- Recent heart attack or stroke
- Desire for fertility (TRT can suppress sperm production)

Our approach at Big Apple Medical Care emphasizes individualized evaluation and shared decision-making.

TRT Modalities: Tailored to Your Lifestyle

We offer diverse TRT delivery options to suit varied preferences and needs:

Intramuscular injections: administered weekly or biweekly.
Topical gels or patches: applied to skin daily.
Subdermal pellets: long-lasting implants placed every few months.
Intranasal sprays (e.g., Natesto): needle-free, preserves fertility, used multiple times daily.
Newer oral formulations: in development, showing promise for safety without liver toxicity.

We work closely with patients to select the most appropriate, effective, and sustainable modality.

Safety, Monitoring & Prostate Health

TRT carries potential side effects, requiring vigilant monitoring:

Polycythemia (high red blood cell count) → increased clot risk
Acne, breast enlargement, fluid retention
Suppressed fertility, potential sensitization of prostate tissue

Prostate safety: Historically, there were concerns about Testosterone Replacement Therapy promoting prostate cancer or worsening BPH. However:

Emerging evidence shows no increased risk when TRT is properly supervised
Patients undergo thorough prostate evaluation, including PSA testing, digital rectal exam, and imaging when necessary, prior to TRT initiation.
Ongoing surveillance — symptom tracking, lab monitoring, and imaging — ensures timely detection of changes and enables safe continuation or adjustment of therapy.

Optimizing TRT with Integrated Urological Care

At Big Apple Medical Care, TRT is delivered within a holistic men’s health program, integrating:

Urological assessment, including prostate and sexual function evaluation.
Lifestyle guidance, weight and cardiovascular health support.
Personalized follow-up, ensuring symptom improvement and mitigating risks.

Our comprehensive approach ensures TRT enhances your health—not just hormonal numbers.

Conclusion: Informed TRT = Improved Quality of Life

Testosterone Replacement Therapy, when carefully selected and monitored, can restore energy, libido, muscle health, mood, and overall vitality. At Big Apple Medical Care, we: