Live Well Be Well with Sarah Ann Macklin | Health, Lifestyle, Nutrition TRT: Who Actually Needs It? Risks, Benefits, and Fertility Considerations | Dr. Suks Minhas | Be Well Moments
Oct 24, 2025
Dr. Suks Minhas, a urologist and men's health expert, dives into testosterone replacement therapy (TRT) and its complexities. He discusses who truly benefits from TRT and the critical importance of fertility planning. The podcast highlights the difference between primary and secondary hypogonadism and the need for thorough testing. Dr. Minhas warns about TRT's impact on sperm production and explores alternatives like clomiphene for those concerned about fertility. He also examines how age and fatherhood may influence testosterone levels, alongside societal pressures surrounding TRT.
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Safer Than The Old Narrative
- Exogenous testosterone is now seen as less harmful than previously believed, with weaker links to prostate cancer and cardiovascular risk.
- Emerging data make TRT more acceptable but raise concerns about recreational use and social pressures.
Treat Only With Symptoms And Low Labs
- Only treat patients who have symptoms plus true biochemical low testosterone, not just relative drops from youth.
- Do not start TRT if total testosterone is above 12 nmol/L because studies link thresholds to symptoms.
Differentiate Types Before Treatment
- Differentiate primary versus secondary hypogonadism before treatment because causes and management differ.
- Screen for metabolic conditions and review lifestyle as part of evaluating low testosterone.