HRT vs TRT: What’s the Difference? Who Should Seek Treatment?

In this article, we attempt to clear up some confusion regarding the difference between hormone replacement therapy and testosterone replacement therapy. 

While they’re occasionally perceived as two completely different categories (or different sets of treatment options), the reality is that testosterone replacement therapy (TRT) is a form of hormone replacement therapy (HRT). 

Whereas HRT encompasses all hormone imbalance treatments, TRT includes just those that are intended to elevate testosterone levels and bring about certain related benefits.

Typically, TRT is considered to be for men, where HRT is often used in hormone treatment related to women. HRT may also be used in discussions about gender care, but that is beyond the scope and focus of this article. 

No two patients are exactly the same. And, it is for this reason that a wide variety of HRT treatments may be required to alleviate any patient’s particular hormone imbalances. 

A person’s hormone balance that is disrupted whether through age, the environment, or other causes can lead to a less than ideal lifestyle, unpleasant symptoms, and worse health outcomes over time. 

For this reason, it’s important that patients seek out lab testing to discover what aspects of their hormonal profile might be optimized.

In the following sections, we address the difference between HRT and TRT in detail, as well as some of the key factors when considering hormone replacement therapy, its benefits, and treatment options to ameliorate symptoms and improve the quality of life.  

What is HRT? 

HRT stands for ‘hormone replacement therapy.’ It is a medical treatment that involves administering hormones to restore balance to the endocrine system. 

Many forms of HRT are painless, non-invasive, and easy to use, such as capsules, patches and gels. Systemic therapy might also include injections which have benefits as they bypass the digestive system.

The factors contributing to hormone imbalance may include gender, age, genetic predisposition, and environmental causes referred to as endocrine disruptors. These disruptors include plastics, metals, and water systems that allow for micro-toxins that can wreak havoc on the body over time.

HRT is sometimes used as shorthand for hormonal treatments that help a female with issues during all stages of life including premenopause, perimenopause, and postmenopause. However, there are numerous other types of hormone imbalances that may need to be considered by a specialist on an individual basis. 

What is TRT?

TRT stands for ‘testosterone replacement therapy.’ It simply involves different therapeutic methods that increase the levels of testosterone in the body.  

The benefits of having higher testosterone levels include increased muscle mass, enhanced bone density, increased libido and sexual function, boosted energy, reduced fatigue, less brain fog, better sleep, and balanced mood and emotion, among others. 

Now let’s dive a bit deeper into some of the misconceptions surrounding the ‘differences between HRT and TRT,’ partially also to help potential patients hone in on what type of hormonal treatment might be available to them.   

Why Use HRT or TRT? Symptoms, Diagnosis, and Prescriptions 

The hormone profile in each patient typically needs to be understood before any prescription can be made. 

The results of personal lab draws can vary widely. There are a number of common reasons why patients seek out HRT or TRT. 

Let’s go through some of the different cases for both men and women.   

“Administering HRT or TRT can be done locally or systemically. Local treatments are intended for specific parts of the body, whereas systemic treatments spread throughout.” 

Hormone Replacement Therapy for Women

As women age, their ovaries start producing less estrogen as well as testosterone. This can result in unpleasant symptoms, including: 

• Insomnia

• Hot flashes 

• Night sweats

• Urinary hestitancy

• Fatigue and low energy

• Depression or mood disorders 

• Weight gain or metabolic changes 

• Cognitive issues like brain fog or unclear thinking

• Vaginal dryness, painful intercourse, and decreased libido

After labs are completed, there may be a valid reason to begin hormone replacement therapy, namely due to imbalances that occur between estrogen, testosterone, and progesterone. This can be considered the “hormonal triangle” [a name we created] of female sex hormones; a triangle that needs to be equilateral, or balanced at all angles.

A prescription for any hormone replacement generally requires lab testing to detect hormone disregularities. Then, hormonal supplements can help to restore the female hormone profile to more balanced levels. It is after several weeks or months when unpleasant symptoms often start to diminish and sometimes disappear completely.

Administration of HRT for women comes in many forms, including pills, patches, sprays, gels, vaginal rings, vaginal creams, injectables, and vaginal tablets. 

Lucidity Clinic offers a series HRT therapies for women.

For anyone experiencing the symptoms listed above, which might indicate a hormone imbalance, we strongly recommend scheduling an affordable hormone lab test to get results. 

These can be done in our clinic, at any LabCorp location, or with an at-home finger prick test we will mail directly to you. Once the at-home kit is received, you simply place a sample on the kit and mail it with a pre-paid label.

TRT (Testosterone Replacement Therapy) for Women?!

Both menopausal and non-menopausal women may also experience symptoms as a result of low testosterone. Pre-menopausal women in their 30s to 40s may necessitate testosterone-only treatment. As a female enters her late 30s to 40s, progesterone is often added to help balance the overall hormone profile. And, by the time peri-menopause occurs in the mid- to upper-40s and into the 50s, estrogen replacement of some form begins. 

Symptoms that may indicate the need for testosterone replacement in women include the following: 

• Bone density loss (osteopenia and osteoporosis)

• Low mood or cognitive issues 

• Decreased muscle mass or strength

• Hypoactive sexual desire disorder (HSDD)

Testosterone may be recommended if lab results indicate low estradiol, low iron, high thyroid-stimulating hormone (TSH), and high Sex Hormone Binding Globulin (SHBG). 

Now, let’s take a look at the symptoms, treatments, and administration methods for men who may benefit from HRT, which are primarily oriented towards TRT (Testosterone Replacement Therapy), but not in all cases. 

Hormone Replacement Therapy for Men

In rare cases, some men may also benefit from other therapies besides testosterone replacement.

This may be indicated for men who have adequate testosterone but exhibit other hormonal imbalances. 

Potential treatments may include thyroid hormone therapy, cortisol monitoring, growth hormone (or related peptides), or other anabolic (steroid) agents.

Alternative therapies may be appropriate when the following symptoms arise:

• Dry skin or hair loss

• Low free testosterone

• Unexpected weight gain

• Depression or low mood

• Bradycardia or Slow Heart Rate

• Fatigue and lethargy (a lingering lack of motivation)

• Imbalance with Sex Hormone Binding Globulin (SHBG) 

The best way to know for sure is to obtain lab testing that is later interpreted by a medical healthcare professional. 

Now, let’s look into TRT for men, which is by far their most commonly sought form of hormone replacement therapy. 

Testosterone Replacement Therapy for Men

As men age, naturally produced testosterone tends to decline, leading to not only unpleasant symptoms, but potentially other detrimental health issues. 

Low testosterone is also referred to as hypogonadism, which refers to the less-than-ideal function of the testicles. Men who have low testosterone levels (hypogonadism) may experience the following: 

• Brain fog

• Bone loss

• Mood changes 

• Increased body fat

• Erectile dysfunction

• Fatigue and low energy 

• Low libido 

• Decreased muscle mass and strength 

Standard TRT generally follows protocols that include injectable testosterone cypionate used to raise internal testosterone levels (often called endogenous testosterone). 

TRT also includes a plethora of other add-on (or adjunct) therapies. These adjuncts are often used to help regulate estrogen (Aromatase Inhibitors, AIs), maintain testicular function and fertility, such as the ‘gold-standard’ injectable HCG (Human Chorionic Gonadotropin, hCG), Selective Estrogen Receptor Modulators (SERMs) such as oral Enclomiphene, and Dehydroepiandrosterone (DHEA) Supplementation.

Testosterone can be administered in the following ways: 

• Injections

• Nasal gels

• Capsules or Troches  

• Transdermal patches

• Transdermal creams or gels (applied painlessly to the skin)

• Subcutaneous Pellets (injected into the subcutaneous tissue) 

Lucidity offers a variety of options for men interested in alternative TRT treatment regimens, namely TRT cream and even oral Testosterone capsules. We do not offer patches or pellets due to efficacy and balance issues.

 We strongly recommend that men with the above symptoms at least consider having their hormonal lab work, done which will reveal any deficiencies in testosterone that could be treated. 

Testosterone replacement therapy under the guidance of an experienced healthcare professional can help alleviate the unpleasant symptoms of low testosterone.

In the next section, we share some important information about potential side effects.  

Risks, Side Effects, and Misconceptions About HRT (and TRT)

Initially, it’s important that patients adhere to dosage recommendations and remain in close contact with their doctor regarding any potential side effects. 

Testosterone injections, in particular, can lead to acne, pain at the injection site, or mood swings.   

One unfortunate common misconception about HRT is that it can contribute to breast cancer, propagated by an erroneous study released by the Women’s Health Initiative (WHI) in 2002, which has since been completely debunked.

We also encourage potential patients to learn more about the myths about HRT, which include the false claim that vaginal estrogen ‘is dangerous.’   

TRT or HRT Treatments with Lucidity 

In closing, we encourage readers to check out our various HRT subscription options, particularly if experiencing any of the symptoms listed above: 

• TRT replacement therapy for men

• HRT replacement therapy for women 

These monthly plans provide therapeutics that can help restore balance to the endocrine system with treatments that are recommended based on careful analysis of a blood draw, provided under the guidance of an experienced healthcare professional.