Testosterone Therapy (TRT) in Richmond, BC
Assessment, lab testing and monitoring for men with symptoms of low testosterone
Testosterone replacement therapy (TRT) is a prescription treatment for men whose symptoms and blood tests point to low testosterone. At RAAC in Richmond, BC, Dr. Charles Jiang starts with a physician assessment and lab testing, then monitors you regularly. TRT is not right for everyone and carries risks, which we review with you.
- Lab-guided
- Blood tests before and during treatment
- Physician
- Assessment and follow-up
- 29+ Years
- Dr. Jiang's Clinical Experience
- Lab-guided
- Blood tests before and during treatment
- Physician
- Assessment and follow-up
- 29+ Years
- Dr. Jiang's Clinical Experience
What Is Testosterone Replacement Therapy (TRT)?
TRT is a prescription treatment that supplies testosterone to men whose blood tests confirm low levels and who have symptoms. It is one option among several, and it requires ongoing medical monitoring.
Testosterone can be given as injections, gels, patches or pellets. At RAAC, pellet therapy is one option: small pellets, each about the size of a grain of rice, are placed under the skin near the hip and release testosterone gradually over several months. Which approach suits you depends on your lab results, health history and preferences. Each method has its own advantages and drawbacks, including the fact that a pellet cannot be removed from your system quickly once placed.
Less Frequent Dosing
Pellets are placed about every 4-6 months, compared with weekly injections or daily gels. Timing varies from person to person.
Fewer Daily Reminders
Some men prefer not to apply a gel or inject themselves regularly. Others prefer the flexibility of adjustable options, which we discuss with you.
Physician Oversight
Dr. Jiang manages your plan with blood work before treatment and regular follow-up tests, and adjusts or stops treatment if needed.
How Testosterone Pellets Work
Testosterone pellets are one way of delivering the hormone. They release it gradually over several months, and your levels are checked with blood tests.
Placement Procedure
Pellets about the size of a grain of rice are placed under the skin near the hip after the area is numbed. They are gradually absorbed over roughly 4-6 months.
Gradual Release
Pellets release testosterone slowly. Levels still vary between individuals, which is why follow-up blood tests are part of the plan.
Fewer Appointments
There is no daily application, and no skin-to-skin transfer risk to partners or children as there can be with gels.
Points to Consider
Once placed, a pellet cannot be easily adjusted or stopped. Minor bruising, soreness or, rarely, infection or pellet extrusion can occur. Dr. Jiang goes through these trade-offs before you decide.
Is TRT Right for You?
TRT is considered for men with low testosterone confirmed on blood tests (commonly below about 300 ng/dL) who also have symptoms. A physician decides whether it is appropriate for you.
TRT May Be Considered If You Have
- +Persistent fatigue or low energy despite adequate sleep
- +Reduced sex drive or erectile difficulties
- +Loss of muscle mass or increased abdominal fat
- +Poor concentration or low mood without a clear cause (other causes are also checked)
- +Reduced bone density identified by your doctor
- +Morning testosterone below the reference range on two separate blood tests
TRT May Not Be Recommended If You
- –Have prostate cancer or breast cancer
- –Have severe untreated sleep apnea
- –Have heart failure that is not controlled, or a recent cardiovascular event
- –Have a high red blood cell count (hematocrit above 50%)
- –Are trying to conceive (TRT can reduce sperm production)
What Might Change With Treatment
Responses to TRT vary. Some men notice changes in energy, mood, body composition or sexual function, while others notice little. It does not suit everyone and is not a cure for aging.
Energy and Vitality
Some men with confirmed low testosterone report less fatigue. If improvement happens, it often appears over several weeks.
Body Composition
Studies in men with low testosterone have reported modest increases in lean mass and decreases in fat mass. Exercise and nutrition remain important.
Sexual Function
Studies suggest testosterone may improve libido in men with low levels. Effects on erections are less consistent, and other causes are assessed too.
Mood and Concentration
Some men report better mood and focus. Evidence is mixed, and low mood has many possible causes that your doctor will consider.
What Your Doctor Looks At
Low testosterone symptoms overlap with many other conditions. Your assessment looks at several areas before and during any treatment.
Physical Energy and Strength
Fatigue, exercise recovery and muscle mass.
Sexual Health
Libido and erectile function, along with other possible contributors such as circulation and medications.
Concentration and Mood
Changes in focus, mood and motivation, and whether other causes need attention.
Sleep
Sleep quality and sleep apnea screening, since poor sleep can lower testosterone and TRT can worsen untreated apnea.
Metabolic Health
Weight, blood sugar and cholesterol, which are reviewed alongside hormone results.
Bone Health
Risk factors for low bone density, discussed with your family doctor where relevant.
Your TRT Journey
From the first assessment through blood tests, treatment decisions and follow-up, each step is overseen by a physician.
Before Your Procedure
Complete comprehensive blood panel including total/free testosterone, PSA, hematocrit, and metabolic markers
Morning blood draw (8-10 AM) on two separate occasions to confirm low testosterone
Full medical history review including current medications and supplements
Discussion of fertility goals — testosterone therapy can affect sperm production
Avoid blood thinners, aspirin, and NSAIDs for 5-7 days before the procedure
Assessment and Pellet Placement
Assessment and Lab Testing
A review of your symptoms and history, plus blood tests to check testosterone and related markers.
Consultation
Dr. Jiang explains your results, the options, the possible benefits and the risks, and whether TRT is appropriate for you.
Pellet Placement (if chosen)
A short in-clinic procedure, usually 10-15 minutes. The area is numbed with local anesthetic and pellets are placed under the skin near the hip.
Aftercare and Follow-up
Simple wound-care instructions, then follow-up blood tests at about 4-6 weeks to check your levels and how you are responding.
After Pellet Insertion
Keep the insertion site clean and dry for 24-48 hours; avoid soaking in baths or pools for 5-7 days
Avoid strenuous lower body exercise and heavy lifting for 5-7 days to prevent pellet extrusion
Minor bruising or tenderness at the site is common and usually settles within a week; contact us about increasing redness, swelling, discharge or fever
Follow-up blood work at about 4-6 weeks, and regularly afterwards, to check testosterone, red blood cell count and PSA where appropriate
Your physician decides if and when another placement is appropriate, based on symptoms and lab results
**Individual results vary and are not guaranteed. TRT is a prescription therapy with risks, including a higher red blood cell count, reduced sperm production, acne, fluid retention and breast tenderness. Regular lab monitoring is required.
TRT Questions Answered
What is testosterone replacement therapy (TRT)?+
TRT is a prescription treatment for men whose symptoms and repeated blood tests show low testosterone. It can be given by injection, gel, patch or pellet. At RAAC in Richmond, BC, Dr. Charles Jiang assesses you first and orders lab tests, then monitors you if treatment goes ahead.
Who is a candidate for TRT, and what tests are needed?+
TRT is considered for men with symptoms plus low testosterone on at least two morning blood tests. Testing usually also includes PSA, hematocrit and metabolic markers. TRT is generally not recommended with prostate or breast cancer, severe untreated sleep apnea or uncontrolled heart failure. Your physician makes the final decision.
What are the risks and side effects of TRT?+
Possible effects include a higher red blood cell count, acne, fluid retention, breast tenderness, worsening of sleep apnea and reduced sperm production and fertility. Questions remain about long-term prostate and cardiovascular effects. With pellets, there can also be bruising, infection or extrusion at the site. We monitor you with regular blood tests and review risks before you start.
How do pellets differ from injections or gels?+
Pellets are placed about every 4-6 months, while injections are usually weekly to every few weeks and gels are daily. Gels can transfer to others through skin contact. Pellets cannot be quickly adjusted or removed once placed, whereas injections and gels can be changed more easily. The choice depends on your health, preferences and lab results.
Will TRT affect my fertility?+
Yes, testosterone therapy can reduce sperm production and may cause infertility. If you may want children, tell Dr. Jiang before starting so that other approaches can be discussed.
How often are follow-up visits and blood tests needed?+
Blood tests are usually repeated about 4-6 weeks after starting, then at intervals set by your physician. These check testosterone, red blood cell count and, where appropriate, PSA. If you have pellets, the timing of any further placement depends on your symptoms and results.
Is TRT covered by BC MSP or extended health insurance?+
BC MSP does not cover private testosterone therapy at the clinic. Some extended health plans may cover part of the associated blood tests. We provide itemized receipts for you to submit, and you should check your own plan.
What does TRT cost in Richmond, BC?+
Cost depends on your lab tests, the treatment chosen and follow-up needs. We explain the cost of each component at your consultation before you decide. Patients visit us from across Vancouver and Greater Vancouver.
Is pellet placement uncomfortable?+
The area is numbed with local anesthetic, and the procedure takes about 10-15 minutes. Most people feel pressure rather than pain, and most resume normal activities the same day, with some tenderness or bruising possible at the site. Heavy lower-body exercise is usually avoided for several days.
How long until I notice any change?+
It varies. Some men notice differences in energy or mood within a few weeks, while changes in muscle or body fat, if they occur, take months. Some men notice no meaningful change, and treatment is reviewed if there is no benefit.
Can TRT be combined with other men's health care at RAAC?+
When clinically appropriate, your physician may discuss other men's health services alongside TRT. Each is assessed on its own, and evidence for some is limited. Individual results vary.
Do I need to see my family doctor as well?+
We recommend keeping your family doctor informed. Low testosterone can be a sign of another health condition, and your regular doctor can help with other checks such as cardiovascular risk and bone health.
Ready to Talk About Your Symptoms?
Book a consultation with Dr. Charles Jiang to discuss your symptoms, review your blood work and learn whether testosterone therapy is appropriate for you. TRT is a prescription therapy with risks, and not every man is a candidate.
