This information is strictly for convenience purposes and is NOT MEDICAL ADVICE. There is absolutely no guarantee that the protocol(s) I am prescribed will translate into identical bloodwork or results for you. You want to do hormone replacement therapy? Go see an endocrinologist and do it right. I'll even give you the doctor to see. I'm just a stupid kid anyway. Don't listen to me. Ever!
Forward by Good Looking Loser
Our comprehensive hormone replacement therapy (HRT) series (click for index) covers several topics and compounds. I tried my best to simplify and organize it for you.
We won't get too advanced or discuss every hormone or element of blood work, but we will take a comprehensive look at the basics.
After a decade of putting a needle in my butt on a weekly basis, I have plenty to tell you about and plenty of bloodwork to show.
We'll also explore the seldom discussed side effects and if hormone replacement therapy is really all it's cracked up to be and most important - who should consider speaking to their doctor about HRT.
My 10+ Year History and Background with Hormone Replacement Therapy
On September 24 2015, I turned 33.
My 33rd birthday marks, almost to the day, exactly 10 years of self-administering hormone replacement therapy.
(as of 2009, I have a prescription for every compound I use)
Hormone replacement therapy (usually limited to discussion on testosterone replacement therapy - see part 2 and 3) has become a popular subject on the ever-growing "men's side" of the Internet.
I am a Top 1% expert on hormone replacement therapy via over a decade of sheer hands-on experience (swallowing or injecting myself with hormones), experimentation and ongoing anti-aging research.
Although my early 20's left much to be desired, in some areas, I was ahead of my time. I was taking advantage of "life hacks" long before they ever became publicized on the Internet for every resourceful 20 year old to see.
All of those lonely Saturday nights that I spent on the Internet in my early 20's actually did pay off a bit!
Although I've not yet covered my personal experience with hormone replacement therapy, I have already covered quite a bit on testosterone and anabolic steroids, I encourage you to read these discussions -
What is Hormone Replacement Therapy?
(and What Can It Do For You?)
For newbies -
In simple terms, hormone replacement therapy is taking or 'supplementing' hormones that your body would otherwise naturally produce in order to achieve more desirable levels.
This can certainly be beneficial, at any age, if you have hormonal deficiencies (e.g. low testosterone, slow thyroid/metabolism) but it may also be beneficial if you don't have deficiencies but simply want to achieve optimal male hormone levels to defy aging or genetics.
The second approach (non-mandatory male optimization) is more controversial.
In the United States (and most countries), you need to be old, sick or transgender to be considered for professional endocrine (hormone) treatment by most doctors.
I, like most guys in your 20's and 30's, fall into the 'non-mandatory male optimization' category.
(male optimization, not transgender haha)
I will discuss both scenarios throughout.
How Do I Find Out What My Testosterone Levels Are?
Until you can quantitatively confirm how your endocrine system reacts to 8+ weeks of a specific hormone replacement therapy protocol - bi-monthly blood work is mandatory. Not optional.
You shouldn't just go by 'how you feel' until you really know what you are doing.
You need to find out where you are starting from and follow your hormone levels (and cardiovascular health) throughout the year until you and your physician know exactly how your body is responding to the therapy.
There's a few options for this, I have done all of them and I recommend either #1 or #2.
Reading and comprehending blood work can be confusing for newbies, but if you are going to self-administer hormone replacement therapy to supplement for deficiencies (or simply just to live an 'optimal' life), it's time to learn a little bit about what's actually going on inside your body.
Ignorance about health is not bliss.
Besides, interpreting blood work is actually pretty simple, after you take 1 or 2 blood tests and look up the scales and ranges, you'll know all virtually all you need.
You can always show the numbers to your doctor too.
Hormone Replacement Therapy - A Big Decision?
Unlike most "life or death" decisions, starting hormone replacement therapy in your 20's or 30's (especially if you don't need to) is actually a significant choice since it is likely to be a lifetime decision.
(more on the 'lifetime decision' later...)
When I got into anabolic steroids in 2002 (and eventually self-administering testosterone replacement therapy in 2005), there was no public bodybuilding forum that spoke openly about hormone replacement therapy that catered to guys under 50 years old.
The "HRT issue" was really taboo.
(I don't know if things have changed, I stopped reading bodybuilding forums when I started picking up girls in 2007)
Myself and many others in their early and mid 20's were led to believe that "staying on" was an irreversible, permanent "hardcore" practice that was solely reserved for those who have professional bodybuilding aspirations and wouldn't mind if they went sterile. It was implied that "cycling" (crashing your natural testosterone for months at a time and taking female fertility drugs, e.g. Nolvadex, to restore them) was somehow much healthier.
Turns out -
Neither are true.
At the same time, I understand the public de-facto ban on HRT discussion.
Openly discussing hormone replacement therapy on public forums would make it seem like "no big deal" and a lot of young-dumb-kids who are just trying to look good for the beach would start using steroids recklessly and indefinitely. At the same time, there's plenty of young-intelligent-guys that are seeking information on the subject and don't have a good doctor or honest bodybuilder friend who will help them.
Although "staying on" (committing indefinitely to hormone replacement therapy) is not necessarily a LIFETIME requirement (Scotty just came off cold turkey after 10+ years of HRT and is totally fine), it isn't something to be taken lightly. Unlike most subjects in life where the best practice is to learn from experience or trial and error - you really should learn all you can about hormone replacement therapy before you start.
It also helps to have an experienced, emotionally healthy friend (not a no-life bodybuilder who gets suicidal if he loses 5 lbs. of muscle) that will speak honestly about his experience and tell you what you can expect.
That's where I come in.
When I Decided To "Stay On"
(and Why You Should Really Think About It More Than I Did)
Regardless of age, is it my non-medical option that HRT is a no-brainer for guys that have low testosterone/thyroid levels and have genuinely tried for 6+ months to increase them naturally.
(will give specific numbers later)
However, I want guys who simply want to optimize their testosterone [but actually don't need] hormone replacement therapy to do some major thinking before opting in for this possible lifetime commitment.
The 'HRT for optimization' takes maturity, prior steroidal experience and access to medical professionals and/or high-quality anabolic steroids.
I cannot say that I had all 3 when I started.
In late September 2005, shortly after finishing a 16-week steroid cycle, I decided to forgo my usual post cycle therapy (what you do after a steroid cycle to restore your natural testosterone levels) and "stay on" a replacement dose of testosterone.
Although the benefits from the past 10 years of HRT have outweighed the negatives, and even though I had very high "Steroid IQ" for a 23 year old, my decision to begin a lifetime of testosterone replacement therapy was impulsive.
In September of 2005 my ex-girlfriend had supposedly taken her own life, I had an awful Summer - my Grandfather died, I destroyed my knee playing football (ending any chances to walk-on the Florida Gators 2006 team) and I even won a trip to Hawaii that turned out to be semi-fake. I found myself, once again, living alone in a yet another new college town. The gym, my fragile ego and my massive 6-2, 243lb. bloated body was all I had. Working out was literally my entire life and I'd go 2 or 3 months without talking to a single human (in-person) other than whoever was at the front desk at Gainesville Health & Fitness.
(related: "Plight of the Lonesome Bodybuilder" (How I Beat Gym Addiction)"
I wasn't emotionally healthy.
During the post cycle period when I had nothing to do and I was starting to come to grips with the reality that my life was definitely not going according to plan. In 4th grade, I won "Most Likely to Be President of the United States" (joke, but people seemed to think I had potential), yet now, I was 23, still a college sophomore with no sex life, steroid addiction and attending my 4th full-time school. Most of my friends had already graduated and gotten jobs or were in prestigious graduate schools.
I was falling behind in life and I knew it.
It was under these circumstances that I elected to "stay on".
Post cycle was boring and my life felt meaningless. I just wanted to get back into the gym, it was the only place that I felt alive.
Over the long-term, the decision ended up being the correct one for me, but it was made quite hastefully -
Despite my declining emotional health and limited access to injectables at the time, I rationalized the decision by saying -
I'm going to be on HRT someday anyway...
I might as well just start now...
Although I wasn't completely certain at the time (it was 2005, the Internet didn't have multiple credible sources that showed their face, bloodwork and said steroids were safe and doctors were reluctant to prescribe HRT to men under 60), I figured that - worst case scenario - I could eventually recover if I had to get off testosterone or I could find an anti-aging clinic that would allow me to do it legally. Despite the incredible amount of mainstream misinformation about anabolic steroids, I knew the compounds were safe if used responsibly and likely nothing would be irreversible.
(as part of his recovery, Scotty also came off nearly 10 years of Testosterone therapy cold-turkey and has made a full recovery)
Even though I ended up being correct and eventually found several doctors to sign off on my hormone replacement therapy protocols, I should not have made an emotional decision to start under those circumstances.
I want every guy to really be honest about his emotional health before making the decision to begin a lifetime of hormone replacement therapy. Talk to other guys on the forum about what your life is like. It is a significant decision that requires maturity, intelligence and lifetime access to anabolics or competent endocrinologists.
Do not rush into this.
It's not just as simple as "staying on".
There's other concerns and inconveniences such as travel, access, money, living with roommates, realistic long-term fitness goals, having kids (just use HCG/HMG), sensitivity to elevated DHT/Estrogenic side effects, importing, physician/insurance relationship, mandatory blood tests to renew your prescription and "What if I go to jail? Will they let me continue my HRT?" that may need your consideration.
Very few guys in their 20's think about any of this stuff.
I'm a "shoot first, ask questions later" guy, just not on this subject.
You NEED to learn and think about it beforehand.
In my opinion, you should only consider hormone replacement therapy if -
(1) Your testosterone (or other hormone) levels are low for your age and you have been unsuccessful in trying to bring them up with lifestyle changes.
(2) You want to optimize your testosterone (or other hormone) levels and have over 2 years of training naturally and an additional 2 years of training with anabolic steroids.
I had 4 years of natural training experience and 4 years of 'cycling' before I opted for HRT.
Throughout the guide, I will discuss other concerns and questions that you should consider.
Our series on hormone replacement therapy continues here -
Super helpful testosterone replacement therapy resource -
Non-medical questions and comments on in-depth subjects such as hormone replacement therapy are best left in our forum, blog comments have been disabled.