How long do the benefits of testosterone replacement therapy take to appear and reach a peak?

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The benefits of testosterone replacement therapy in men with low testosterone (also known as hypogonadism) have been extensively studied. However, the same level of attention has not been given to understanding the time-course of testosterone effects in men receiving treatment. This article reviewed studies of testosterone replacement therapy to better understand the time-course for the start of treatment effects and the length of time required to reach maximum benefits.

Key Findings

  • Increased sexual interest generally appears after 3 weeks and levels off at 6 weeks
  • Increases in erections and sexual satisfaction occur within 6 months
  • Improvements in quality of life are clear within 3-4 weeks and continue for some time
  • Improvement in depression or mood is noted after 3-6 weeks and reaches a maximum after 18-30 weeks
  • Beneficial effects on blood lipids appear after 4 weeks and reach a maximum after 6-12 months
  • Improvements in blood glucose levels become evident after 3-12 months
  • Changes in body composition and muscle strength occur within 12-16 weeks and stabilize at 6-12 months
  • Improvements in bone density show after 6 months and continue for at least 3 years
  • Minor changes in prostate size and a slight increase in the level of prostate-specific antigen occur with treatment, leveling off after 12 months. Any further increases may be related to normal aging rather than testosterone treatment.

Source: Onset of effects of testosterone treatment and time span until maximum effects are achieved. Saad F, Aversa A, Isidori AM, et al. Eur J Endocrinol 2011;165(5):675-685.

Background information

Testosterone replacement therapy can produce profound physical and/or mental changes in patients with low testosterone. The benefits of testosterone replacement on physical and sexual function, energy levels, fat and muscle mass, blood lipids and bone density in men with low testosterone are well accepted. An understanding of when the effects of testosterone can and should be expected is also important. It helps your doctor monitor your response to the treatment and detect any unwanted effects that may occur, and it may be useful and interesting for you to know when treatment effects will set in and whether the benefits will continue or level off. Therefore it is important to know when an effect can be expected and when its maximal effect has been reached.

This review article adds to the understanding of how testosterone works in the body and provides useful information for physicians who treat men with low testosterone and for patients receiving testosterone replacement therapy. It shows that, while some of the benefits of testosterone appear quickly (see Figure), the full benefits on sexual satisfaction, body composition and bone strength may take longer to develop fully.

Figure: Time Course of Testosterone Effects in Weeks

Last updated: 2019