Testosterone Replacement Therapy (TRT) in Tokyo – English-Speaking Clinic
Testosterone replacement therapy (TRT) is an established medical treatment for men with clinically low testosterone levels — a condition known as hypogonadism. Despite growing awareness worldwide, finding an English-speaking TRT clinic in Tokyo remains extremely difficult. Only a handful of physicians in the city offer testosterone therapy with full English consultation.
Last updated: March 2026. Content supervised by medical professionals at Tokyo Hub Clinic.
At Tokyo Hub Clinic, Dr. Ichiro Kamoshita, M.D., Ph.D., provides comprehensive testosterone evaluation and treatment for international patients and expats. Located inside Hotel New Otani Garden Court, 2F (Chiyoda-ku, Kioicho 4-1), our clinic offers a private, comfortable environment for this sensitive treatment.
What Is Testosterone Replacement Therapy?
TRT is a medically supervised treatment that restores testosterone to healthy levels in men whose bodies no longer produce sufficient amounts. Testosterone is the primary male sex hormone and plays crucial roles in:
- Maintaining muscle mass and bone density
- Regulating mood, energy, and cognitive function
- Supporting sexual desire and erectile function
- Influencing fat distribution and metabolism
- Contributing to red blood cell production
When testosterone drops below normal ranges, men may experience a constellation of symptoms that significantly impact quality of life. TRT aims to restore hormonal balance and alleviate these symptoms under careful medical supervision.
Symptoms of Low Testosterone
Low testosterone (hypogonadism) can manifest in numerous ways. If you recognize several of the following symptoms, a blood test measuring your testosterone levels is an important first step:
- Chronic fatigue and lack of energy despite adequate sleep
- Reduced libido — diminished interest in sexual activity
- Erectile dysfunction — difficulty achieving or sustaining erections
- Mood disturbances — depression, irritability, or anxiety
- Cognitive decline — poor concentration, memory issues, brain fog
- Decreased muscle strength and increased body fat
- Loss of body hair and changes in skin texture
- Sleep problems — insomnia or excessive sleepiness
- Decreased bone density — increased fracture risk
- Night sweats or unexplained temperature changes
TRT at Tokyo Hub Clinic
Dr. Kamoshita follows evidence-based protocols aligned with both Japanese Urological Association and international guidelines. Our approach combines rigorous diagnosis with individualized treatment planning.
Who Qualifies for TRT?
TRT is not appropriate for every patient. Candidacy is determined through:
- Clinical symptoms: Presence of hypogonadal symptoms as described above
- Blood testosterone levels: Total testosterone and free testosterone measurements taken in the morning (when levels peak). In Japan, a total testosterone level below approximately 11.8 nmol/L (340 ng/dL) or free testosterone below 8.5 pg/mL is generally considered low.
- Exclusion of contraindications: Including prostate cancer, severe sleep apnea, uncontrolled heart failure, or elevated red blood cell counts
Types of TRT Available in Japan
The TRT landscape in Japan differs from Western countries in several important ways:
Intramuscular Injection (Primary Method): Testosterone enanthate (Enarmon Depot) is the most widely used form of TRT in Japan. Injections are administered at the clinic every 2–4 weeks. This is the most established and commonly prescribed option, covered by National Health Insurance (NHI) when medically indicated.
Topical Testosterone Gel: Testosterone gel formulations are available in Japan, though they are less commonly prescribed than injections. Gel is applied daily and provides more stable hormone levels, but may not be covered by insurance in all cases.
Key Differences from Overseas: Unlike the United States and some European countries, testosterone pellet implants and certain long-acting injectables (such as testosterone undecanoate / Nebido) are not approved or widely available in Japan. If you were on a different TRT protocol abroad, Dr. Kamoshita can help you transition to an appropriate regimen available here.
The Treatment Process
Step 1: Book a Consultation
Call 03-6261-7070 or visit our appointment page to schedule. Our clinic is reservation-only, ensuring dedicated time for your evaluation. Mention that you are interested in hormone evaluation or TRT when booking.
Step 2: Comprehensive Blood Work
At your first visit, we draw blood to measure total testosterone, free testosterone, LH, FSH, prolactin, PSA (prostate-specific antigen), complete blood count, liver function, and lipid profile. Blood is ideally drawn in the morning when testosterone levels peak. Results are typically available within 3–5 business days.
Step 3: Diagnosis and Treatment Planning
Dr. Kamoshita reviews your results with you in English, explains whether TRT is appropriate, and discusses the expected benefits, timeline, and potential risks. If TRT is indicated, you will agree on a treatment schedule together.
Step 4: Treatment Initiation
For injection-based TRT, your first dose is administered at the clinic. Typical dosing is 125–250 mg of testosterone enanthate every 2–4 weeks, adjusted based on your individual response and blood levels.
Step 5: Regular Monitoring
Ongoing blood work is essential for safe TRT. We monitor testosterone levels, hematocrit (red blood cell count), PSA, liver function, and lipid levels at regular intervals — typically every 3 months initially, then every 6–12 months once stable. This ensures therapy remains safe and effective.
Side Effects and Safety
TRT is generally safe when properly administered and monitored. However, potential side effects include:
- Polycythemia (elevated red blood cell count) — the most common side effect, monitored through regular blood tests
- Acne or oily skin — usually mild and manageable
- Fluid retention — typically temporary
- Sleep apnea worsening — in patients with pre-existing sleep apnea
- Reduced sperm production — TRT suppresses natural sperm production; an important consideration for men planning to father children
- Mood changes — both positive (improved mood) and occasionally negative (irritability) during dose adjustments
Dr. Kamoshita carefully screens for contraindications before starting therapy and provides thorough monitoring throughout treatment. The goal is always the minimum effective dose that relieves symptoms while maintaining safety.
For Expats and International Residents
If you have been receiving TRT in your home country and have relocated to Japan, you may be concerned about continuity of care. Here are the key points to know:
- You cannot import testosterone into Japan for personal use without prior approval from the Ministry of Health. Attempting to do so can result in confiscation at customs.
- Prescriptions from overseas are not valid in Japan. You will need a new evaluation and prescription from a Japanese-licensed physician.
- Dr. Kamoshita can review your previous medical records and bloodwork to facilitate a smooth transition to a Japan-approved TRT regimen.
- Bring documentation of your previous treatment (dosage, frequency, last blood results) to your first appointment.
Our clinic is one of the very few in Tokyo where you can discuss TRT in English with a knowledgeable physician. There is no need for interpreters or translation services.
Insurance & Pricing
TRT for medically diagnosed hypogonadism is covered by Japan’s National Health Insurance (NHI). With insurance, your costs are typically:
- First visit (consultation + blood tests): Approximately ¥10,000–¥15,000
- Follow-up visits (injection + monitoring): Approximately ¥5,000–¥8,000
- Testosterone injection (NHI-covered): A fraction of the cost compared to self-pay clinics
If you do not have Japanese health insurance, self-pay rates are available. We provide detailed English-language receipts for insurance claims with your home country insurer. Visit our Pricing page for more information.
Frequently Asked Questions
How quickly will I notice results from TRT?
Most men begin to notice improvements in energy and mood within 2–4 weeks. Sexual function improvements may take 4–8 weeks. Changes in body composition (increased muscle, decreased fat) typically become noticeable after 3–6 months of consistent therapy. Full effects generally develop over 6–12 months.
Is TRT a lifelong commitment?
Not necessarily. Some men use TRT for a defined period and then taper off, depending on the underlying cause. However, if your body’s testosterone production has permanently declined (common with aging), long-term therapy may be recommended. Dr. Kamoshita will discuss the expected duration based on your individual situation.
Will TRT affect my fertility?
Yes, TRT can suppress sperm production, potentially leading to temporary infertility. If you are planning to father children, this must be discussed before starting therapy. Alternative treatments such as hCG (human chorionic gonadotropin) may be considered to maintain fertility while addressing low testosterone symptoms.
Can I bring my testosterone medication from abroad?
Importing testosterone into Japan requires advance approval from the Ministry of Health, Labour and Welfare through the Yakkan Shomei process. Without this approval, testosterone products will be confiscated at customs. We recommend starting a new prescription in Japan instead. Bring your medical records and previous blood results to facilitate a smooth transition.
Does TRT increase the risk of prostate cancer?
Current medical evidence does not support a direct causal link between TRT and prostate cancer. However, TRT is contraindicated in men with known or suspected prostate cancer. We screen for prostate health (PSA blood test) before starting therapy and monitor regularly throughout treatment as a safety precaution.
Call 03-6261-7070 — Reservation required. One of the few English-speaking TRT clinics in Tokyo.
Related Pages
- Men’s Health Clinic in Tokyo
- Andropause (Male Menopause) Treatment
- ED Treatment in Tokyo
- Men’s Health Checkup & Hormone Testing
- About Dr. Kamoshita
- Pricing Information