Dr. Alexander Grant, MD, PhD: Urologist & Men's Health Advocate

Does TRT raise blood pressure? What the science says

Dec 15, 2025 · 10 min read

In a 2023 New England Journal of Medicine trial of over 5,000 men, testosterone replacement therapy did not increase major cardiovascular events, although some individuals can develop modest systolic blood pressure increases from fluid shifts and higher blood viscosity. Here’s how dose, baseline metabolic health, and careful monitoring help “optimize” testosterone without pushing blood pressure ...

High estrogen on trt symptoms: What happens when your balance shifts

Dr. Alexander Grant, MD, PhD: Urologist & Men's Health Advocate

Dec 13, 2025 · 11 min read

On TRT, a portion of injected testosterone is converted by the aromatase enzyme into estradiol, and about 15–20% of men develop elevated estrogen levels that can cause symptoms like water retention, nipple/breast tenderness, mood changes, and sexual dysfunction. Here’s how to recognize the pattern, why it can mimic low‑T, and what to adjust so your ...

Does masturbating lower testosterone? The science behind the myths

Dr. Alexander Grant, MD, PhD: Urologist & Men's Health Advocate

Dec 12, 2025 · 10 min read

Masturbation does not permanently lower baseline testosterone because the hypothalamus‑pituitary‑gonadal (HPG) axis maintains homeostatic hormone production, and clinical studies show no statistically significant change in systemic testosterone after orgasm. The real story is short‑term fluctuation—like the often‑misread ~145% spike on day 7 of abstinence—and what that means (and doesn’t) for muscle, mood, and long‑term health. ...

What happens if we release sperm daily? What science says about testosterone, muscle, and men’s health

Dr. Alexander Grant, MD, PhD: Urologist & Men's Health Advocate

Dec 11, 2025 · 13 min read

Wondering what happens if we release sperm daily? For most healthy men, frequent ejaculation is safe and does not drain testosterone, kill muscle gains, or wreck long-term health — but there are a few important exceptions you should know about. “For the average healthy man, ejaculating every day is more of a lifestyle choice than ...

How to lower hematocrit on trt safely and effectively

Dr. Alexander Grant, MD, PhD: Urologist & Men's Health Advocate

Dec 11, 2025 · 10 min read

The safest way to lower hematocrit on TRT is to reduce testosterone peaks—by lowering the dose and/or switching from infrequent injections to more frequent micro-dosing or a steadier transdermal method—because testosterone increases red blood cell production through kidney-driven erythropoietin (EPO) signaling. Since elevated hematocrit affects roughly 5% to 66% of men on therapy, the goal ...