How Testosterone Replacement Therapy Has Evolved Over Time Male menopause, low testosterone (low t) and testicular hypofunction all refer to the fact that male testosterone levels are low. The cause may be different, but the treatment is the same. Bioidentical testosterone replacement therapy (BHRT) and testosterone replacement therapy (TRT) also mean the same thing, at least in the United States because synthetic testosterone drugs can damage the liver. This makes them a poor choice for long term use. On your next trip down to Mexico you will see some of these behind the counter. The synthetic testosterone imitators are illegal in most first world countries. Examples are: methyltestosterone, fluoxymesterone, oxymetholone, oxandrolone, ethylestrenol, stanozolol, danazol, methandrostenolone, and norethandrolone. Much has changed in 20 years since I graduated from naturopathic medical school. Back in the day, regular insurance-based doctors were very reluctant to prescribe testosterone. They would usually refer patients to an endocrinologist. To qualify for testosterone the patient would have to have very low levels, below 250 typically. Back then, after seeing the specialist, the patient would have to come in every two weeks, or perhaps once a month, and receive a shot at the doctor’s office. The problem with this is that for days following the...