After 8-12 weeks of TRT, if biochemical markers improve but symptoms do not, it is generally not advisable to continue treatment, unless for specific reasons like bone health in cases of osteopenia with low estradiol and testosterone.

“we would give trt for a period of 8 to 12 weeks we would determine that we've fixed the biochemical issue so they go from being at say the 30th percentile to being at the 80th percentile and then we assess the symptoms and sometimes the man says I don't feel any better so you fix the number but you haven't fixed the symptoms and with very few exceptions at that point I would say it doesn't make sense to continue this we should stop doing it now one exception to that would be if you were doing it for bone health so if a man has osteopenia and he has low estradiol and low testosterone we don't really care about symptoms”