This can happen due to improper functioning of the testicles or because of the defective pituitary gland or the hypothalamus (part of the brain) that control the working of testicle. Side Effects TRT therapy may increase energy levels, allow you to gain muscle mass and even turn your sex switch 'on' but the flip side are some side effects that may occur after taking testosterone externally. They are mentioned below: Fluid Retention: The problem of fluid accumulation is observed especially in older men. This may lead to leg or ankle swelling, worsening of congestive heart failure or high blood pressure. Acne: Testosterone replacement therapy can cause and even worsen existing skin problems like acne. Testosterone regulates functioning of the sebaceous glands (located primarily under the facial skin) that produces oily matter (sebum) to keep the skin moist and prevent it from becoming dry. However, TRT can lead to sudden rise in testosterone levels, as a result of which the sebaceous glands may respond by producing surplus amount of sebum, making the skin oily.

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