The First 1-3 Months
Doctor visits: Most docs will have you come in every couple of weeks for the first 2-3 months and then once every year.
Time to notice effect: You can notice some effects on libido within the first few hours (although it may be placebo). Effects on mood may take more like 2-3 weeks.
Mood Effects: Increase in energy and overall a better sense of well-being.
Libido Effects: Greater desire for sex. More frequent erections, especially during sleep.

Negative Side Effects: In this time, you'll probably get some night sweats. You may also get some acne breakouts. You probably won't notice a whole lot of other negative effects at this point.

3-Months and On
Fewer doctor visits
Night sweats and acne should decrease
First 1-3 days after injection, you'll feel great. Next 4-8 days you'll feel good. The next 8-14, you'll still probably feel slightly better than before you started. That's why I recommend E7D injections or more frequent--it evens it out so you feel great consistently.
Mood is likely more consistently good.
Libido effects may be slightly less than in the first 1-3 months, but still a big improvement.
Somewhat Common Positive Effects: Some TRT-users also may experience a loss of fat, increased muscle, Increase in strength, a deeper voice, and increase in facial and body hair.
New Negative Side Effects: It's possible that you might experience high estrogen at this point, so watch out for estrogen sides. If you experience increased headaches, nipple lactation, or worsening vision, talk to a doctor; this could indicate a pituitary tumor that is increasing in size due to the medication.
General Tips While on TRT
Get blood work. It's the only way to confirm low T and whether or not estrogen and/or prolactin are causing side effects.
Keep a daily log of your injections, your sex drive, and your mood. It can be useful to show to a doctor if you're trying to argue for/against adjusting medication. Plus, it can help determine if you're actually experiencing effects of the medication since the change is generally pretty gradual.
If you have problems telling other people you're on TRT that you'd like to open up to: remember that this isn't much different than having poor eyesight and getting glasses or lasik. You have abnormally low testosterone. The medication is helping you be "normal." That being said, some people may still view it as steroids and you won't be able to say anything to sway them. Depends on the person you're telling.
Injection Tips
Z-Track injection method is helpful, but not 100% necessary.
Quad injections are easy, but many prefer ventrogluteal.
You may also want to consider subcutaneous injections. They use a smaller needle and the absorption rate is a little slower, evening out your T levels.
Subcutaneous injection is excellent for TRT purposes. Subcutaneous injection sites.

The subcutaneous that I refer to here is not the same as an IM injection "leaking" and doesn't have the associated pain. An intentional sub-q injection is actually into the subcutaneous fat. It tends to form a small nodule which is easily absorbed. An injection which leaks gets between the muscle fascia and the subcutaneous fat. It absorbs more slowly and causes more irritation.

The easiest sites to use are near the umbilicus (belly button) or in the oblique fat pads (love handles) for e3d injections. It's easy to see what you are doing and both hands are available. Because of this, it's much easier than IM for regular small injections and just as effective. If the volume is 0.3 cc or less, it's completely painless and doesn't leave any visible signs unless you are very lean. At around 10% one may need to stop using the belly sites and stick to obliques. Even with 2 sites, each will be completely absorbed before you return to it.

There is less discomfort than IM. With good gear (eg: pharma) there is no PIP. It might sting for a few minutes but that's it.

A 29G 1/2" slin pin with 0.5cc syringe is a good size. They are low dead space needles, meaning there is less wasted gear. The only downside is that drawing can take a while, but since it's such a low volume it doesn't really add up to much time.

For instructions on doing the shots, watch this video: SUBCUTANEOUS TESTOSTERONE INJECTIONS - THE CUTTING EDGE WITH DR. JOHN CRISLER

The video and shows the belly and oblique sites.

Dr. Crisler recommends a 5/8" 25G needle. I had some leakage with a larger needle and the syringe / needle had a larger dead space that wasted gear. I'm much happier with 29G. His fears about a high-pressure jet are unfounded due to the viscosity of the oil.

Coming Off TRT
You may want to come off of TRT for a number of reasons (cost, sick of pinning, no longer wanting to be swole, etc). If it's solely for fertility concerns, you may not need to (see info above about HCG/HMG/Clomid). Otherwise, you'll want to make sure that you don't come off cold turkey and instead do an actual PCT. Coming off cold turkey, you risk having your HPTA remain shut down, tanking your test, and suffering depression, ED, and other low T side effects. See the Wiki for TRT-specific PCT recommendations.

Benefits of TRT
Testosterone replacement therapy in men with low testosterone produces many positive benefits. These benefits can be broken down into conclusive benefits and inconclusive benefits. Conclusive benefits are benefits that are relatively certain, whereas inconclusive benefits are benefits that are not certain.

Conclusive Benefits: Testosterone replacement therapy has consistently shown to positively alter body composition. It increases muscle mass (via increased muscle synthesis) and decreases fat mass (via increased fat lipolysis), especially abdominal fat mass. It also slows or even reverses the loss of bone mineral density due to aging. TRT also increases libido.

Inconclusive Benefits: Testosterone replacement therapy may also improve sexual function (improve erectile function), improve mood, reduce depression. However, TRT has not been shown to conclusively improve erectile function and mood. The primary reason why TRT may not help with erectile dysfunction or mood/depression is because both conditions can be related to one or more of many potential underlying medical conditions unrelated to testosterone levels. Without addressing such underlying conditions, testosterone alone will likely not improve erectile dysfunction or mood/depression.

Side Effects of TRT
The following are potential side effects of TRT.

Polycythemia – Polycythemia occurs when red blood cell production increases too much. Testosterone stimulates the production of red blood cells. Thus, TRT may increase red blood cell levels beyond normal. High red blood cell levels cause the blood to thicken and clot, which can potentially lead to a stroke. Oftentimes, if red blood cell production rises to dramatically, TRT dosages must be lowered or stopped. Additionally, your physician may perform a phlebotomy (a withdrawal of blood to lower red blood cell levels). The risk appears to be higher with IM preparations and may be due to the supraphysiologic levels that are seen with infrequent injections.

Infertility – TRT interrupts the body’s normal release of testosterone. It also impairs the production of sperm. While infertility is usually reversible, it is important for men who wish to preserve their fertility to talk with their physician prior to commencing TRT.

Sleep Apnea – TRT may worsen sleep apnea in men who have been previously diagnosed.

Gynecomastia – TRT may alter the balance of testosterone and estrogen in the body in certain men. Some men’s bodies metabolize testosterone in estradiol more readily than normal. This aromatization causes the breast tissue to swell. It is important to address any issues with gynecomastia quickly. Unfortunately, medical treatment of gynecomastia that has persisted beyond a year is often ineffective. Gynecomastia Wiki - Gynecomastia Subreddit

Fluid Retention - Fluid retention may occur in the arms and legs at the beginning of therapy. It generally resolves after the first few months of treatment.

Alteration of Lipid Levels - Testosterone therapy may adversely affect cholesterol levels, slightly lowering HDL cholesterol and slightly raising LDL cholesterol. Most cases of adverse affects to cholesterol deal with supraphysiological doses of testosterone, not replacement doses.

The Endocrine Society Clinical Practical Guidelines detail the conditions in which testosterone administration is associated with a high risk of adverse outcome and in which testosterone should not be administered:

Very high risk of serious adverse outcomes

Metastatic prostate cancer
Breast cancer
Moderate to high risk of adverse outcomes

Unevaluated prostate nodule or induration
PSA >4 ng/ml (>3 ng/ml in individuals at high risk for prostate cancer, such as African-Americans or men with first-degree relatives who have prostate cancer)
Hematocrit >50%
Severe lower urinary tract symptoms associated with benign prostatic hypertrophy as indicated by AUA/IPSS >19
Uncontrolled or poorly controlled congestive heart failure

TRT Side Effects - Medscape

Related Posts
Word of caution to the naturally low-T crowd.
/u/sixxsix creates this entry
After 1 year on TRT
The Epically Long TRT Story
10 pins in and smiling
The journey to good TRT
4 Months starting TRT TRT is amazing
10 Things to look for in a doctor for TRT
Subcutaenous Test Injection Sites - Self Experiment (For Science)

Studies
Subcutaneous administration of testosterone. A pilot study report.

CONCLUSION: Therapy with weekly subcutaneous testosterone produced serum levels that were within the normal range in 100% of patients for both peak and trough levels. This is the first report, which demonstrated the efficacy of delivering weekly testosterone using this cheap, safe, and less painful subcutaneous route.

__________________
[email protected]
[email protected]
[email protected]
[email protected]