TRT Treatments and Testosterone Services Available

Testosterone deficiency (hypogonadism) affects a significant proportion of Australian men, with symptoms including fatigue, low libido, reduced muscle mass, mood changes, poor concentration and erectile dysfunction. Many men with clinically low testosterone remain undiagnosed because their symptoms are attributed to stress or ageing.

Diagnosis requires both clinical symptoms and pathology confirmation. A single total testosterone result is often insufficient — free testosterone and SHBG must also be considered, as a man with a 'normal' total testosterone may have significantly reduced bioavailable testosterone due to elevated SHBG.

Our GPs assess the full clinical picture: morning testosterone collection (before 10am when levels peak), total and free testosterone, LH and FSH to distinguish primary from secondary hypogonadism, and relevant metabolic markers. Assessment is repeated to confirm results before any treatment is initiated.

The European Male Ageing Study (EMAS) criteria and Endocrine Society guidelines inform our diagnostic approach, ensuring that assessment goes beyond a single number on a lab report.

Where testosterone deficiency is confirmed on pathology and symptoms are consistent with clinical hypogonadism, our GPs can prescribe TGA-approved testosterone replacement therapy.

Available options in Australia include: Reandron 1000 (testosterone undecanoate injection, administered every 10–14 weeks), testosterone enanthate injection (administered every 1–2 weeks), Testogel (1% topical testosterone gel, applied daily), and Axiron (topical testosterone solution applied to the axilla daily). Patches are also available where preferred.

Reandron is available on the PBS for men with documented hypogonadism, reducing the cost significantly for eligible patients. Your GP will advise on PBS status and expected pharmacy costs for each formulation before prescribing.

All TRT prescriptions are subject to thorough clinical assessment and documented pathology evidence of deficiency. We do not prescribe testosterone for lifestyle optimisation or performance enhancement — only for clinically confirmed testosterone deficiency.

Safe and effective TRT requires structured ongoing monitoring. TRT GP Australia provides a systematic monitoring schedule throughout your treatment journey.

Initial review at 6–8 weeks post-commencement assesses: testosterone levels (trough for injections, 4–8 hours post-application for gels), haematocrit (TRT can stimulate red blood cell production — elevated haematocrit increases cardiovascular risk), oestradiol (testosterone converts to oestrogen via aromatisation), and symptom response.

Subsequent 3-monthly reviews for the first year monitor the same parameters, with dose adjustments made as needed. Once stable, reviews typically extend to every 6 months. PSA is monitored annually for men over 40, and more frequently if there is any clinical concern.

All follow-up consultations are conducted via telehealth and are bulk billed for eligible Medicare card holders.

Low libido, erectile dysfunction and reduced sexual satisfaction are common presenting symptoms of testosterone deficiency, but they can also be caused or exacerbated by non-hormonal factors including cardiovascular disease, diabetes, psychological factors, relationship dynamics and medications.

Our GPs conduct a comprehensive sexual health assessment that considers hormonal and non-hormonal contributing factors. This includes assessment of testosterone, prolactin and thyroid function, as well as cardiovascular risk factors (hypertension, dyslipidaemia, diabetes) that are independently associated with erectile dysfunction.

Where erectile dysfunction has a predominantly non-hormonal or vascular component, our GPs can assess suitability for PDE5 inhibitors (sildenafil, tadalafil) alongside or independently of TRT, where clinically appropriate.

Our approach is thorough and non-judgmental. Sexual health is an important component of overall wellbeing, and our GPs take these concerns seriously.

Exogenous testosterone suppresses the hypothalamic-pituitary-gonadal (HPG) axis, reducing LH and FSH secretion and consequently suppressing intratesticular testosterone production and spermatogenesis. This can lead to significant reductions in sperm count and, in some cases, azoospermia (no sperm in ejaculate).

For men who may wish to father children in the future, this is a critical consideration before commencing TRT. Suppression of sperm production is generally reversible after cessation of TRT, but recovery can take 6–18 months and is not guaranteed in all cases.

Our GPs discuss fertility implications in detail before initiating any testosterone therapy. Options for men concerned about fertility include: sperm banking prior to commencing TRT, alternative protocols using HCG (human chorionic gonadotropin) to maintain intratesticular testosterone without suppressing spermatogenesis, and clomiphene citrate (an off-label alternative that stimulates endogenous testosterone production).

If fertility preservation is a priority, your GP may recommend a referral to a reproductive endocrinologist or fertility specialist before commencing treatment.

Low testosterone is associated with a range of comorbidities including metabolic syndrome, type 2 diabetes, cardiovascular disease and reduced bone density. These associations are bidirectional — low testosterone can worsen metabolic health, and metabolic dysfunction can further suppress testosterone production.

Our GPs assess for relevant associated conditions as part of the initial evaluation. Where metabolic syndrome, insulin resistance or significant dyslipidaemia is identified, your GP will discuss management strategies alongside TRT.

Bone health is an important consideration in men with longstanding testosterone deficiency. Your GP can arrange a DEXA scan referral to assess bone mineral density where clinically indicated.

Where specialist input is required — for example, for complex secondary hypogonadism, suspected pituitary pathology, or concurrent fertility treatment — our GPs provide referrals to endocrinologists, urologists, or reproductive specialists as appropriate.