Anxiety is not a direct side effect of Testosterone Replacement Therapy (TRT), but it can sometimes occur in individuals undergoing treatment. Understanding the factors that may contribute to anxiety while on TRT can help in effectively managing and reducing these symptoms.

Potential Causes of Anxiety on TRT

• Lack of Cardiovascular Exercise: Anxiety is more commonly seen in individuals with a sedentary lifestyle, particularly those who do not engage in regular cardiovascular exercise. Increased energy levels from TRT, without adequate physical activity to channel that energy, can lead to feelings of restlessness or anxiety.
• Hormonal Adjustments: While TRT itself does not typically cause anxiety, hormone levels may fluctuate during the initial weeks of treatment, leading to periods of anxiety or mood changes. This is usually temporary as the body adjusts to the new hormone levels.

Monitoring and Adjusting Hormones

Anxiety may be an up-and-down experience during the first few months of TRT as hormone levels stabilize. To ensure that anxiety is not related to hormonal imbalances:

• 8-Week Blood Test: After 8 weeks on TRT, blood work is done to check hormone levels. This helps determine if any imbalances might be contributing to anxiety and allows for adjustments to the treatment protocol if necessary.

When to Seek Further Advice

If anxiety persists beyond the initial adjustment period of a few months:

• Consult a Local GP: It is advisable to speak with a local General Practitioner (GP) to evaluate ongoing anxiety symptoms and explore additional management options.

Managing Anxiety on TRT

• Incorporate Cardiovascular Exercise: Regular cardio exercise, such as walking, running, swimming, or cycling, can significantly help in reducing anxiety by releasing endorphins and improving mood. Aim for at least 150 minutes of moderate-intensity cardio per week.
• Practice Stress-Reduction Techniques: Activities like meditation, deep breathing, and mindfulness can help calm the mind and reduce anxiety symptoms.
• Establish a Routine: Creating a daily routine with regular exercise, balanced nutrition, and consistent sleep patterns can provide structure and reduce anxiety.
• Monitor Caffeine and Alcohol Intake: Both caffeine and alcohol can exacerbate anxiety. Limiting their intake, especially during the evening, may help mitigate symptoms.