Testosterone Replacement Therapy (TRT)

Medical testosterone replacement therapy for men with clinically confirmed low testosterone (hypogonadism or andropause), available as topical gel, injectable or other modalities. Treatment begins with a baseline blood panel, followed by an individualised prescription and regular monitoring.

Testosterone replacement therapy (TRT) at Pulse Clinic Singapore is a medically supervised programme designed for men whose blood tests confirm testosterone deficiency. The clinic's doctors see a wide range of presentations — from men in their 30s experiencing unexplained fatigue, reduced libido and difficulty building muscle, through to older men navigating the gradual hormonal decline of andropause. Treatment at Pulse Clinic begins with a thorough consultation and a baseline blood panel. The panel measures total and free testosterone, SHBG, LH, FSH, prolactin, oestradiol, full blood count, liver enzymes, PSA (for men over 40) and a metabolic screen. This baseline is essential both to confirm the diagnosis and to rule out underlying causes of low testosterone such as pituitary tumours, sleep apnoea or thyroid disease. Once a clinical decision is made to commence TRT, the doctor discusses the available modalities. Testosterone gel (e.g. Testogel, AndroGel) is a popular first-line option: applied daily to the shoulder or upper arm, it maintains relatively stable serum levels and is straightforward to titrate. Injectable testosterone undecanoate (Nebido) is given every 10 to 14 weeks in clinic and suits patients who prefer not to manage daily medication. Other options including shorter-acting injections and combination protocols may be discussed depending on individual circumstances. Follow-up blood tests are scheduled at 6–12 weeks post-initiation to assess response and safety. The clinic monitors haematocrit (elevated red cell mass is a key TRT side-effect), PSA trajectory, oestradiol, lipids and liver enzymes. If oestradiol rises above optimal range — common in men with higher body fat — an aromatase inhibitor may be added. Ongoing monitoring appointments are typically every three months once the patient is stable. Pulse Clinic is particularly experienced in managing TRT for gay and bisexual men and for transgender men (FTM), providing gender-affirming hormone therapy in a non-judgmental setting. The clinic is also well-versed in managing TRT alongside PrEP or other sexual health medications.