Before and after: 42-year-old man on testosterone therapy – Insider

Weston Boucher, a 42-year-old menswear designer and model, said testosterone replacement therapy, or TRT, has helped restore his energy, improve his mental health, and put on more than five pounds of muscle, but he thinks he looked better before the treatment.  
Despite benefits like better energy and mental health, he wishes he had waited longer before trying TRT, Boucher previously told Insider.
“I want guys to be cautious of it, as it’s not a magic pill,” he said in a follow-up interview.
One result has been more muscle mass and an easier time maintaining it. But he’s also gained water weight, and his overall physique doesn’t measure up to his previous peak, said Boucher, who has posted extensively about his TRT journey on his YouTube channel. 
“I’m not really working out to build muscle right now, it just stays on,” he said. “But it hasn’t translated into my perception of what lean muscle looks like.”
A longtime health-conscious athlete, Boucher said careful diet and exercise did more for his physique than hormones, and the primary benefits weren’t related to the mirror but to his mental and physical well-being. 
He said the process of adjusting to hormones, including to address increased estrogen levels, has been lengthy, challenging, and expensive, and anyone considering the treatment should be aware of the commitment involved.   
Many men may have clear symptoms of low testosterone, but if their hormone levels were high enough to start with, a decrease may not fall into the current standard for low testosterone, Dr. Ananias C. Diokno, a urologist, previously told Insider.
It’s a good idea to test early and know your testosterone levels by age 30 to detect if a significant drop may be causing issues, Diokno said. 
Boucher initially started TRT after experiencing common signs of low testosterone including loss of sex drive, brain fog, depression, and fatigue, as well as trouble maintaining muscle and strength. 
The most dramatic benefits were alleviating his long-term depression, improving his energy and sex drive, and boosting his gym performance. 
While there can be aesthetic changes with hormone therapy, it’s primarily a tool, along with proper medical care, to address overall health and well-being. Boucher cautioned against men using it simply to gain more muscle and strength without focusing on lifestyle first.  
“To jump to any synthetic before diet and exercise is a massive risk and, in my opinion, will lead to regret,” he said. “Never underestimate the power of the human body and our biology. When you give the body what it needs, it can figure out a whole hell of a lot.”
Boucher said his peak physique was when he was 36 to 40, after years of careful workouts and strict, low-fat dieting to build a lean, muscular look. He’s since prioritized health instead. 
“I knew it wasn’t healthy or sustainable,” he said. “Now I look at diet much more for overall wellness than for a cover shoot.”

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TRT can cause a series of complex changes in the body, including shifting levels of other hormones. Boucher said it increased his estrogen levels, too — a common side effect
To cope, he said he’s had to take other supplements and be particular about his diet, in addition to adjusting the TRT treatment over time.  
Other side effects have included hair loss and shrinking testicles. 
“Until your hormone levels are balanced, it doesn’t matter if you have really healthy test levels,” he said. “Know you’re taking this long list of things to counter side effects. People need to realize that level of commitment.”
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