From the FDA Drug Label
During exogenous administration of androgens, endogenous testosterone release is inhibited through feedback inhibition of pituitary luteinizing hormone (LH). At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH)
When you stop Testosterone Replacement Therapy (TRT), endogenous testosterone production may be affected. The drug label states that exogenous androgen administration inhibits endogenous testosterone release through feedback inhibition of pituitary hormones. However, it does not directly state what happens when TRT is stopped.
- The label does not provide information on how long it takes for the body to recover its natural testosterone production after stopping TRT.
- It also does not specify whether the natural production of testosterone will resume at pre-TRT levels. Since the label does not explicitly address the question of what happens to natural testosterone production after stopping TRT, no conclusion can be drawn 1.
From the Research
Stopping Testosterone Replacement Therapy (TRT) can temporarily halt or significantly reduce your body's natural testosterone production, but the most recent and highest quality study suggests that natural production typically resumes after discontinuing TRT. When you take external testosterone, your body detects adequate hormone levels and reduces its own production through a negative feedback loop involving the hypothalamus and pituitary gland 2. This natural production typically resumes after discontinuing TRT, but recovery time varies significantly between individuals—from weeks to months or even longer. Factors affecting recovery include treatment duration, dosage, age, and individual physiology.
Key Points to Consider
- The effects of TRT on the body's natural testosterone production are complex and can vary significantly between individuals 3, 4.
- Stopping TRT can lead to symptoms of low testosterone during the recovery period, including fatigue, decreased libido, and mood changes 5, 6.
- Some studies suggest that exercise can improve the effects of TRT and the durability of response after cessation of treatment 6.
- To help restore natural production, some doctors prescribe a post-therapy protocol including medications like hCG, clomiphene, or anastrozole to stimulate the body's testosterone production system.
Recommendations
- Anyone considering stopping TRT should work closely with their healthcare provider to develop a personalized discontinuation plan rather than stopping abruptly.
- A personalized plan may include medications to stimulate the body's testosterone production system, as well as lifestyle changes such as exercise to improve overall health and well-being 6.
- It is essential to carefully weigh the potential benefits and risks of stopping TRT and to prioritize morbidity, mortality, and quality of life as the primary outcomes.