These ‘modest' changes are to blame for erectile dysfunction as you age, say doctors — it's not testosterone
Drops in testosterone have long been blamed for age-related declining erectile performance.
But a new study suggests something else may be at play.
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A new study suggests a metabolic marker is the culprit behind declining sexual health in men.
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'Although age and testosterone levels have long been considered an impetus for men's declining sexual health, our research indicates that these changes more closely correlate with modest increases in blood sugar and other metabolic changes,' Dr. Michael Zitzmann, a professor and doctor of medicine at University Hospital in Muenster, Germany, said in a press release.
'This means that men can take steps to preserve or revive their reproductive health with lifestyle choices and appropriate medical interventions.'
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The long-term study, which began in 2014 and wrapped in 2020, tracked 200 otherwise healthy men between the ages of 18 and 85.
By the end, 117 participants remained — all free of diabetes, heart disease or cancer — allowing researchers to isolate the effects of subtle metabolic changes on male reproductive health.
Despite aging, participants' hormone levels and semen quality mostly remained in the normal range.
But one thing did take a noticeable hit: erectile function, particularly among those whose blood sugar levels crept up just slightly, but still fell well below the threshold for diabetes.
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'Although age and testosterone levels have long been considered an impetus for men's declining sexual health, our research indicates that these changes more closely correlate with modest increases in blood sugar and other metabolic changes,' Dr. Michael Zitzmann said.
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Interestingly, testosterone levels were not linked to erectile function, but they did correspond to the sex drives of participants.
Zitzmann hopes their findings — which were presented Saturday at ENDO 2025, the Endocrine Society's annual meeting in San Francisco, California — will help men take charge of their sexual health as they age.
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'We're hopeful that the information gleaned from this study will help doctors and their patients formulate effective male sexual health maintenance plans,' he said.
'We now know that it's in our power to retain sexual and reproductive wellbeing in men, even as they age.'
The findings come amid public debate over testosterone replacement therapy (TRT), which has surged in popularity despite potential side effects.
A recent study found the male libido gets an astonishing boost from grape juice.
Meanwhile, experts say that — while sexual function unavoidably declines with age —men can improve their chances of staying reproductively healthy by avoiding smoking, excessive alcohol consumption and obesity.
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Medscape
7 hours ago
- Medscape
Adherence to Male Hypogonadism Treatment Guidelines Is Low
SAN FRANCISCO — Adherence to diagnostic and treatment guidelines for male hypogonadism is quite low, with significant differences among medical specialists, a new study found. Off-label use of testosterone replacement therapy (TRT) has risen in recent years, corresponding with the advent of direct-to-consumer (DTC) advertising for TRT and the emergence of 'low T' clinics, Petra Pederson, MD, PhD, chief resident in internal medicine at Scripps Clinic/Green Hospital, San Diego, said at the ENDO 2025: The Endocrine Society Annual Meeting. 'This led to our hypothesis that [DTC] advertising in the presence of online clinics creates patient expectations that make it challenging for clinicians to practice evidence- and guideline-based care,' she said. Pederson and colleagues conducted a two-part study of adherence to TRT prescribing guidelines at their institution. The first part involved a retrospective chart review of 269 men who were prescribed TRT from January 1, 2019, through June 30, 2023, examining adherence to the 2018 Endocrine Society clinical practice guideline (CPG). Of the 269 TRT prescriptions, 67.3% were from primary care providers (54% internal medicine and 13% family medicine) and 32.7% from specialists (25% urology and 8% endocrinology). The majority of patients (72.1%) stayed on treatment for at least 1 year, with an average treatment duration of 25 months. Criteria for adherence was defined as: Confirmation of the diagnosis of hypogonadism with two separate low (< 264 ng/dL) early morning total testosterone levels. Determination of the etiology of hypogonadism by measuring luteinizing hormone (LH) and follicle-stimulating hormone (FSH) with appropriate laboratory or imaging follow-up based on the results. On-treatment therapeutic monitoring with total testosterone levels drawn at 3-6 months and 12 months. On-treatment safety monitoring, with hematocrit at baseline and at 3-6 months, with dose reduction if necessary and discontinuation if > 54%. Overall, the proportion of clinicians, primary care, and specialists combined who followed all four criteria was just 5.9%. The difference between primary care (3.3%) and specialists (11.4%) was statistically significant ( P = .009). By individual criteria, 17.8% overall had no low testosterone level prior to treatment, 21% among the primary care group vs 10.2% for the specialists. This difference was also significant ( P = .023). Follow-up total testosterone measurement at 3-6 months was performed for only 50% overall, 44.1% by primary care, and 62.5% by the specialists. Hematocrit testing at 3-6 months was measured at 54% overall, 48.0% by the primary care, and 65.3% by specialists. Both specialty differences were again significant ( P = .01 and P = .06, respectively). Between the two specialties, endocrinologists were more likely than urologists to follow all four criteria, 23.8% vs 7.5%, respectively ( P = .054), and were much more likely to have LH and FSH drawn (85.7% vs 16.4% for LH; P < .001). 'We postulate that these striking differences between endocrinology and urology could be related to the fact that urologists were seeing more patients who present with sexual dysfunction compared to endocrinologists, and perhaps they have more pressure to prescribe,' Pederson said. Barriers: DTC Advertising, Misinformation, Test Inaccuracy The second part of the study involved a survey to which 51 Scripps providers responded. Of those, 74% were primary care (41% internal medicine and 33% family medicine), 18% endocrinologists, and 8% urologists. All 51 reported having seen one or more patients in the last 6 months who requested TRT. The specialists were significantly more likely to report being comfortable with the guidelines than were the primary care providers and to prescribe TRT more often. A total of 74.5% overall felt that DTC advertising and testosterone 'clinics' were significant public health issues. A similar majority (76.5%) felt there was a need for more educational tools. Barriers to providing guideline-based care identified by the providers included misinformation through advertising or social media, for-profit 'low T' clinics that contradict evidence-based guidelines, patient dissatisfaction when guidelines don't align with their expectations, vague and subjective symptoms, and test inaccuracy and variability. 'We're planning to address this at our institution with a quality improvement initiative,' Pederson said. She acknowledged that the American Urological Association guidelines use a low testosterone cutoff of < 300 ng/dL, 'so we might underestimate guideline adherence with our criteria.' And she noted that a small number of primary care providers accounted for a disproportionate number of the prescriptions in their sample, which could limit generalizability. In response to a question from the audience about why the guideline adherence was so low even among specialists, Pederson responded, 'I think that they're experiencing some of the same challenges that PCPs are experiencing, which is the pressure from their patients, and also maybe issues related to tests and accuracy. And I just think the difficulty of getting patients to do all these follow-up tests when they're looking for a simple fix.' Improvements Are Underway, Patient Education Is Key Asked to comment, the Endocrine Society's CPG lead author Shalender Bhasin, MB, professor of medicine at Harvard Medical School and director of the Research Program in Men's Health: Aging and Metabolism at Brigham and Women's Hospital, Boston, told Medscape Medical News that these findings align with those of a study his group conducted a decade ago in the Veterans Administration (VA), but that the VA has since implemented system-wide improvements. 'I think it's gotten much better. In the VA, it was very low, and it has gotten substantially better because at the VA now there's one policy. Also, the assays have gotten better.' Bhasin also pointed out that the prescribing of testosterone has fluctuated over time, dropping in 2013 after an FDA advisory about cardiovascular risk but then rising again around 2017 following the TRAVERSE trial results showing cardiovascular safety. The subsequent rise has been slower, but, Bhasin noted, 'testosterone sales are growing, and at the same time, many men with testosterone deficiency remain undiagnosed, so it's both overuse and underuse.' Also asked to comment, session moderator Ismat Shafiq, MD, of the University of Rochester, Rochester, New York, told Medscape Medical News that patients will commonly have low total testosterone due to overweight or obesity and/or sleep apnea but will have normal free testosterone. 'If that's the case, we can properly educate our patients and work on managing their weight and sleep problems. That can reverse the hypogonadism and make them feel better, rather than giving them testosterone.' And if they have both low total and free testosterone, the cause could be something reversible, such as a prolactinoma or pituitary macroadenoma. 'If we check the prolactin level and we treat them, the hypogonadism will resolve. Primary hypothyroidism, too, if treated, can resolve the hypogonadism,' Shafiq said. 'Diagnosing the patient appropriately can identify causes that can be treatable and that can improve their quality of life and improve their testosterone level too, rather than jumping into giving them testosterone.' She also noted that many patients mistakenly believe that more testosterone is better. 'We need to educate them. In my experience, most of the patients listen and understand because nobody wants to take extra medicine all the time, unless it's really needed for them to improve their quality of life.' Pederson and Shafiq reported having no disclosures. Bhasin reported receiving research grant support from AbbVie and Metro International Biotech for investigator-initiated research, with the grants managed by Brigham and Women's Hospital. He has served as a consultant to Besins and Versanis and has an equity interest in XYone Therapeutics.
New York Post
9 hours ago
- New York Post
7 best sites to buy testosterone online in 2025
New York Post may receive revenue from affiliate and advertising partnerships for sharing this content and/or when you make a purchase. Whether you've searched the internet far and wide for the best TRT clinics, can't seem to escape posts about 'Low T' on social media, or just so happened to stumble upon this guide, you likely have more questions than answers when it comes to accessing online testosterone therapy. Most people are familiar with the physical and emotional changes associated with menopause, but the hormonal changes that men face in their late forties and fifties have also come into the conversation. Now, more experts are raising awareness about plummeting testosterone levels in men — a phenomenon often referred to as 'Andropause.' While it's natural for men's testosterone levels to fall as they age, the gap appears to be widening over time, and some experts have expressed concern. A 2023 study in the Journal of Clinical Endocrinology revealed that testosterone levels in American men have dropped at a rate of roughly 1% per year. Advertisement 'It's not just guys over 50,' explained Deep Patel, the co-founder of Ulo, a telehealth clinic that has recently expanded into the TRT space. 'More and more men in their 20s, 30s, and 40s are dealing with low T. A lot of it comes from stress, lack of sleep, diet, or genetics. And then there's the stuff you can't really control, like microplastic exposure.' post wanted picks Best TRT Clinic Overall: Ulo Ulo Best Alternative TRT Clinic: Hims Hims Best Holistic TRT Clinic: Hone Hone Best Quick Online TRT Clinic: PeterMD PeterMD Best TRT Prescription Alternative: Ro Patel and many other experts in the field have seen a growing demand for TRT services. But what is TRT, exactly? Testosterone Replacement Therapy is a treatement used to restore the male hormone to normal, healthy levels. There are a few forms of testosterone treatment available: injections, gels, and tablets. Advertisement There are several potential benefits of TRT, according to Patel: 'More energy, better workouts and faster recovery, higher libido, clearer thinking and focus, emotional stability, and a sense of drive and confidence that returns,' Patel shared. The efficacy of this type of treatment is well-documented for men with low testosterone, yet it can still be challenging for people less familiar with TRT to find sites to buy testosterone online that are reputable, transparent, and safe. To evaluate the best TRT clinics, The Post consulted several experts in the men's hormone space and vetted offerings across a number of telehealth sites, finding options that meet a range of needs, including clinics with personalized TRT programs, TRT alternatives, and the most affordable options for every man. Read on for our expert-backed guide to the best TRT clinics. Advertisement Best TRT Clinic Overall: Ulo Ulo Pros: The treatement is tailored to each person's needs and goals No charges until the prescription is approved by the provider Men can consider different forms of treatment, including injections, gels, and oral medication Cons: Service availability may vary by state due to different telehealth regulations After developing a telehealth platform that supports men's daily struggles (including hair loss and regrowth), Ulo expanded into the TRT space with personalized care for men at every stage of life. To get a TRT prescription at Ulo, patients must first complete a simple, at-home blood test. Then, a licensed physician will look at your lab work, discuss your history, and together, you can work out an appropriate course of treatment. Nobody is charged until they're prescription is approved by the provider. Ulo's founders have worked to create a platform that is user-friendly, highly responsive, and tailored to individuals' needs. It's not just about treating a problem, but looking at the whole picture — and this is the type of care you'll receive at Ulo. Price: $50 per blood test. Starts at $159/month for testosterone injections, $169/month for testosterone topical gel, and $189/month for oral medication. Best Alternative TRT Clinic: Hims Hims Pros: Hims offers a full suite of healthcare services, so you can access more than testosterone treatment Pricing starts at just $39/month with flexible plans available Dual-action treatments are available to target multiple health goals at once Cons: Hims does not offer testosterone injections Designed to support men every step of the way, Hims is among the most popular telehealth sites offering a range of healthcare solutions. The site is not just for men seeking TRT, but also offers weight loss support, anxiety medication, erectile dysfunction treatement, and more. Getting started is simple. Users will be directed to answer some basic health questions, and then they're connected with a provider who can review their information and create a personalized plan. While the brand does not offer testosterone injections, patients can still access other types of TRT as well as some treatments with dual-action benefits, so you can take care of hormone support in addition to other needs at the same time. Price: The price of medications varies, with Sex Rx + Testosterone Support starting at $39/month. Best Holistic TRT Clinic: Hone Hone Health Pros: Hone considers more than just testosterone with its in-depth biomarker testing Completely personalized TRT protocols based on individual hormone levels and symptoms Hone offers naturual supplements in addition to injections, gels, and tablets Cons: Service availability may vary by state due to different telehealth regulations For a more holistic approach to testosterone testing and treatement, consider Hone. This online clinic starts patients off with Doctor-designed blood tests, which evaluate 50 biomarkers, looking beyond testosterone to see the whole picture. It's more detailed and in-depth than some other blood tests, which could potentially flag other issues affecting hormone levels. After considering health history and individual goals, Hone formulates a plan to help patients optimize their healthspan. Treatment options include injections, gels, and tablets, as well as naturual supplements for testosterone and thyroid support. Price: $60 per Biomarker Test. Starts at $25/month for discounted access to a limited number of medications that don't require lab testing, and $149/month for everything Hone offers: regular lab testing, physician consults, and full access to our medications. Best Quick Online TRT Clinic: PeterMD PeterMD Pros: Patients can submit recent lab work to skip blood testing and get a prescription/treatement faster User-friendly website, simple to navigate different treatement options, and get signed up fast In-depth blood panels look beyond testosterone levels Cons: PeterMD offers tablets and injections, but no testosterone creams or gels Whether you're looking to up your libido, get more out of your workouts, or fight hair loss, PeterMD offers the support you need to find a solution. For men interested in TRT, PeterMD has a few paths to getting started. Men who have had their lab work done in the past six months can skip the blood-testing step and send their results right to PeterMD for evaluation. If you haven't had the necessary tests done, PeterMD will take care of that, too. There are a few different panels to select from, including a simple testosterone assessment panel, an optimization panel, a comprehensive panel, and a diagnostics panel that offers deeper insights into things like tumor markers, brain health, heavy metal exposure, and more. While this TRT clinic does not offer gels or creams, patients can still choose between oral treatement or injections. Pricing: Testosterone Assessment Panel starts at $95, and testosterone treatment starts at $99/month Advertisement Best TRT Prescription Alternative: Ro Testosterone Support Supplements Ro Pros: Ro offers a dietary supplement that supports testosterone production without hormones (a good alternative for those seeking natural solutions) All of the ingredients in Ro's Roman Tesosterone support have been researched and vetted by Doctors This formulation is said to be fast-working; ingredients are absorbed into the body in hours Cons: May not be suitable for those seeking medication Requires four tablets daily, not ideal for people who struggle with swallowing pills Not everyone is ready to jump into TRT headfirst. If you're more interested in natural testosterone support (or prefer not to wait for a blood test or prescription), head right to Ro. Ro's physicians have designed a hormone-free supplement that helps support hormone production naturally, while also delivering a dose of key ingredients: magnesium for muscular health, maca for emotional stress, and ashwagandha to help with testosterone production. This is not the same as TRT, but it's a wonderful alternative for those interested in whole-body health, and it starts at just $35 a month. Pricing: $35/mo and save $72/year when you choose a quarterly plan Best TRT Oral Treatement: MangoRX MangoRX Pros: MangoRX offers Kyzatrex, an FDA-approved oral tablet that has shown high efficacy Patients can choose between a 30-day or 60-day supply, which requires fewer frequent refills Cons: This site only offers oral tablets, no injections, creams, or gels Pricier than some other options MangoRX is an innovative men's health clinic that makes it easy to take care of all your needs in one place. The site doesn't offer as many testosterone treatments as some competitors, but the process is simple: jump on a call with a board-certified physician, request a blood kit shipped to your front door, receive a prescription, and start with a simple, FDA-approved once-a-day pill. They're single option — Kyzatrex — has shown high efficacy in restoring testosterone levels to normal ranges. Oral tablets are also a great alternative for people who struggle with injections. Patients can also pick between a 30-day or 60-day supply, which requires fewer frequent refills. Pricing: An initial visit and 60-day supply start at $249/month (first month free) Best Online TRT Clinics FAQs The Post consulted three men's health experts to answer some frequently asked questions about the best sites to buy testosterone online. How do you get a TRT prescription? To get a TRT prescription, telehealth clinics typically require a blood test. Testosterone blood tests measure the amount of the male hormone in the blood. The normal range is considered to be anywhere between 300 and 1,000 nanograms per deciliter, but physicians also consider symptoms, as well as medical history, before writing up a prescription. 'Legally, it starts with comprehensive bloodwork, followed by a consultation with a licensed medical provider. If clinical symptoms align with hormone deficiencies confirmed by lab results, the provider may prescribe TRT,' explained Tomo Marjanovic, the owner of Aspire Rejuvenation Clinic, a wellness center specializing in personalized hormone therapy. Marjanovic has warned that a TRT prescription is not something that you should be able to get from a simple online form because it's a medical therapy that needs real evaluation, not 'checkbox medicine.' How do you choose the best site to buy testosterone online? Thousands of online men's health clinics offer TRT online, but finding a credible and affordable option can be more challenging. Experts recommend buying testosterone from sites that are transparent with their process, offer a tailored approach for each patient, and maintain an open line of communication between people and Doctors. 'Search for a company that emphasizes medical care rather than product. TRT usage requires lab testing, the involvement of a physician, and thorough follow-up based on data,' Patel, the co-founder of Ulo, suggested. 'If those elements are not prominently indicated on the company's website, step away and search for another option.' What are the risks and side effects of TRT? Advertisement While TRT is generally considered safe for long-term use, TRT clinics should always outline potential risks and coordinate follow-up appointments to discuss any potential side effects. 'TRT does come with risks that need to be taken seriously,' shared Patel, who explained that the most common side effects include acne, water retention, or elevated red blood cell counts, which can thicken your blood. 'Some men experience testicular shrinkage or reduced fertility, ' he added. 'There are also concerns about cardiovascular risks in certain populations, particularly men with existing heart conditions.' Earlier this year, the FDA also issued class-wide labeling changes for TRT. The label language on all testosterone products must now include the risk of adverse cardiovascular outcomes and increased blood pressure. What form of testosterone offers the best results? Advertisement Currently, testosterone injections are the most popular form of treatment for low testosterone, but gels, creams, and oral tablets are also available. 'Injections, particularly shallow daily intramuscular or subcutaneous dosing, consistently offer the most predictable and stable results. Gels can work for some, but are inconsistent in absorption. Pellets are convenient but make dose adjustments difficult and can cause hormone spikes or crashes,' Marjanovic explained. 'I always say it's more about the patient's physiology and lifestyle, which delivery method to use, and not just 'convenience'.' An article in The Journal For Nurse Practitioners found that Depo-Testosterone was the most cost-efficient TRT option, and Androderm was the most efficacious TRT medication, with up to 92% of patients reaching normal testosterone levels with consistent use. Are there any online TRT clinics that accept insurance? There are some TRT clinics that accept insurance, but details vary on the type of treatement and specific diagnoses. Most insurance providers require TRT candidates to provide documentation of symptoms and lab work that indicates their testosterone has fallen below the normal levels. What's the cheapest online TRT clinic? Advertisement Many online TRT clinics offer competitive pricing options. PeterMD, for example, gives patients the option to submit previous lab work, which can save money up front. Ulo does not charge patients until their prescription is approved by the provider, so you can get started at no risk. This article was written by Miska Salemann, New York Post Commerce Writer/Reporter. As a health-forward member of Gen Z, Miska seeks out experts to weigh in on the benefits, safety and designs of both trending and tried-and-true fitness equipment, workout clothing, dietary supplements and more. Taking matters into her own hands, Miska intrepidly tests wellness products, ranging from Bryan Johnson's Blueprint Longevity Mix to home gym elliptical machines to Jennifer Aniston's favorite workout platform – often with her adorable one-year old daughter by her side. Before joining The Post, Miska covered lifestyle and consumer topics for the U.S. Sun and The Cannon Beach Gazette.
New York Post
a day ago
- New York Post
How to get TRT in 2025: A step-by-step guide to optimizing your testosterone levels
New York Post may receive revenue from affiliate and advertising partnerships for sharing this content and/or when you make a purchase. If you've been feeling a little low in more than one aspect of life, you're not alone, and chances are you're not going crazy, either. You may be experiencing the symptoms of low testosterone. Testosterone is the sex hormone that is responsible for a range of important functions, from hair growth and bone density to sperm count and libido levels. Low testosterone affects millions of men, and the symptoms can feel like a slow drag on daily life. Nearly 39% of men aged 45 years and older have low testosterone, also known as hypogonadism, according to the University of Washington's School of Public Health. Advertisement The symptoms are not the same for everyone, which can make it more challenging for men to identify the root cause. Some notice their muscles looking a little less defined than they used to. Or, possibly, they've struggled to maintain energy throughout the day. Others feel that they're sex drive is nearly non-existent. Fortunately, there are treatment options for men with low testosterone: FDA-approved injections, creams, gels, tablets, and even natural supplements that are designed to support testosterone production. Find Out About Our Top TRT Pick Ulo Ulo Feeling low on energy? Ulo offers a personalized approach to testosterone replacement therapy (TRT), starting with an at-home lab test and virtual consultation with a licensed provider. If TRT is recommended, treatment options — including injections, gels, and oral medications — are delivered straight to your door. Plans start at $159/month. You'll only be charged if a provider determines treatment is appropriate and writes a prescription. Treatment is currently available in select states and includes ongoing support throughout your plan. Learn more about how it works and if it's available in your state at Ulo's website. LEARN MORE Advertisement 'TRT stands for Testosterone Replacement Therapy,' explained Deep Patel, the co-founder of Ulo, a telehealth company that offers tailored TRT protocols. 'It's a way of bringing your testosterone levels back into a healthy range when your body isn't producing enough. You're not taking extra. You're restoring what your system is missing.' If you're new to the TRT space, chances are you're not too familiar with the process for getting a TRT prescription or what types of treatments are available. The good news is that Testosterone Replacement Therapy (TRT) has become much more accessible through legitimate telehealth clinics like Ulo. The Post has consulted several men's health experts and leaders in the hormone space to create a step-by-step guide to getting TRT in 2025. 1. Consider your symptoms Advertisement Low testosterone can manifest through various symptoms. These include low sex drive, trouble focusing, mood swings or irritability, loss of muscle or strength despite working out, constant fatigue (even when you're sleeping enough), increased belly fat, and even depression or anxiety. According to Patel, many guys suffering from 'Low T' feel like they're hitting a wall when it comes to their physical health and overall well-being. 'The most common things guys say are 'I can't focus like I used to,' 'I feel flat mentally, physically, sexually,' 'I've lost my drive,' 'I work out and eat clean but don't see results,' 'I just don't feel like me anymore,'' he shared. Often they've tried everything else — better sleep, different diets, supplements, lifestyle changes. 'TRT is rarely the first thing they try,' said Patel. 'But for many with genuinely low levels, it's the solution that finally works.' 2. Consult a men's health expert or find a legitimate online TRT clinic After identifying symptoms, the next step is to consider different providers. There are a few different options for men interested in learning more about TRT. Advertisement For anyone seeking medical advice, it's important to consult your primary care physician, especially before starting a new healthcare or wellness routine. Primary care physicians are also able to access your medical history, which is important to consider when starting TRT. Nowadays, there are more online clinics offering TRT services. The challenge is finding one that is legitimate, affordable, and provides services that are tailored to your specific needs. Sites like Hone, Ulo, Hims, and PeterMD offer well-regarded testosterone services, with different treatment plans available. 'There are plenty of clinics that advertise TRT online,' suggested Dr. Michael Aziz, an anti-aging internist and regenerative medicine specialist at Lenox Hill Hospital in New York City. 'But, patients should only consider clinics that have physicians who are board-certified and are specialized in endocrinology, urology, and internal medicine with anti-aging training.' Aziz added that patients should also read the online reviews about the doctors' experience, and look for positive feedback about ease of communication, as well as rapid response to issues and treatments. It's also important to verify that the clinic is using legitimate U.S.-based pharmacies and is fully compliant with telehealth laws and DEA regulations for controlled substances. 3. Get your bloodwork done To get a testosterone prescription, you'll need to take a TRT blood test. TRT blood tests examine the amount of the male hormone present in the blood. Some tests offer more detailed analyses than others, including additional health markers, such as free and total testosterone, sex hormone-binding globulin (SHBG), the prostate-specific antigen (PSA), and other hormones that could be affected by TRT. These tests are most accurate when administered in the morning, when testosterone levels peak. Advertisement The normal testosterone range is considered to be anywhere between 300 and 1,000 nanograms per deciliter. The FDA only approves TRT for specific conditions, such as hypogonadism or diminished functional activity of the gonads. Most clinics also only consider testosterone prescription for men who are experiencing symptoms and have levels under 300 ng/dl. Today, TRT clinics can mail blood tests to your door. At-home tests require a simple finger prick that you can do yourself and send back to a laboratory for analysis. 4. Wait for a diagnosis and prescription After a licensed health provider evaluates your blood work, it's important to meet with them to discuss your symptoms and medical history. 'The clinic should require comprehensive labs, a detailed intake process, and a real conversation with a knowledgeable provider,' said Tomo Marjanovic, the owner of Aspire Rejuvenation Clinic, a wellness center specializing in personalized hormone therapy. Advertisement Marjanovic warned that if the only interaction is an automated signup form or a rushed consult, that is a red flag. Diagnosis should never rely on numbers alone — some men at his clinic experience serious symptoms, even when their testosterone levels are slightly over 300ng/dl. In addition to clinical symptoms and hormone levels, Marjanovic considers a patient's family history (specifically heart disease, prostate issues, and hormone disorders) and lifestyle factors (such as stress, diet, sleep, and substance use). 'If clinical symptoms align with hormone deficiencies confirmed by lab results, the provider may prescribe TRT. This isn't something you should get from a simple online form because it's a medical therapy that needs real evaluation, not checkbox medicine,' he explained. 5. Consider the cost and check with your insurance for coverage options Be sure to check with your insurance provider to see if TRT is covered. Most providers require patients to meet certain thresholds and provide medical documentation that indicates their testosterone has fallen below the normal levels, in addition to recorded symptoms. Advertisement The cost of TRT will depend on the type of treatment you are interested in. Most testosterone injections cost between $50 and $150, oral tablets around $300, and patches can reach $400. There are certain telehealth companies that offer broader health services, which may include TRT. Subscription plans can range from $100 to $300 per month. 6. Consider the potential benefits and risks TRT comes with a number of benefits; everything from increased energy at the gym to better sleep at night, enhanced mood, and improved intimate performance. Advertisement 'When done right, TRT can give you your life back,' Patel pointed out. 'The benefits people report most often are way more energy, better workouts and faster recovery, higher libido, clearer thinking and focus, emotional stability, and a sense of drive and confidence that returns.' A 2019 study on prescription testosterone found that 52% of men claimed testosterone improved their energy, 42% saw improvements in their libido, and 29% reported muscle growth. While there are several benefits, Patel and many other experts are very transparent about the potential risks associated with TRT. 'The most common side effects include acne, water retention, or elevated red blood cell counts, which can thicken your blood. Some men experience testicular shrinkage or reduced fertility. There are also concerns about cardiovascular risks in certain populations, particularly men with existing heart conditions,' he explained. It's important to consider that TRT significantly suppresses natural testosterone production, which can also reduce sperm production. If fertility is important to you, Patel mentions there are medications like HCG or clomiphene that can be taken alongside TRT to preserve it. In a 2021 study, over 90% of men maintained normal sperm counts when using these fertility-preserving medications with TRT. 7. Discuss treatment plans There are a few different forms of TRT available, and most reputable online TRT clinics offer different types of TRT to cover individuals' needs and preferences. 'The clinic's approach to TRT should be comprehensive rather than just giving a script for testosterone treatment,' Aziz stressed. 'The delivery method of TRT is best chosen by both the doctor and the patient based on the patient's lifestyle and symptoms.' Aziz says that different gels, creams, tablets, and injections are well-researched and vetted. However, some differences must be observed: 'Gels are used daily but can be transferred to sexual partners and children. Injections can be self-injected once to twice a week, or administered by the doctor every 10 weeks.' Most experts agree that injections consistently offer the most predictable results. An article in The Journal For Nurse Practitioners outlines the most viable treatment options, citing that Depo-Testosterone is the most cost-efficient TRT option and Androderm is the most efficacious TRT medication, with up to 92% of patients reaching normal testosterone levels with consistent use. 8. Start treatment and wait for the results Many online TRT clinics can ship treatment to your front door as soon as the prescription is in place. But that's just the beginning of the process; it takes some time to feel and see the benefits, and the timeline can also depend on the form of treatment you're using. 'As for results, most guys feel a difference within four to six weeks. More energy, better mood, stronger libido,' Patel explained. He said that body composition changes — like more muscle and less fat — usually take a bit longer to notice. Some physical changes can be expected around two to three months. 'I remember one person telling us he knew it was working when he woke up one morning and actually wanted to go to the gym for the first time in years,' Patel exclaimed. It's not just changes in performance or appearance, but how men view themselves. 'More energy, stronger sex drive, better workouts, and a sense of confidence they hadn't felt in years,' he added. 9. Monitor progress and adjust protocols if necessary Once you begin your treatment, it's very important to monitor your results, watch for any potential side effects, and communicate openly with your providers. 'TRT isn't a one-and-done therapy because hormones are dynamic, and treatment should evolve based on regular lab monitoring and patient feedback,' Marjanovic explained. Without proper diagnosis and ongoing tracking, you risk underdosing, overdosing (a lot of people don't think this can happen, but it can), or ignoring other hormonal imbalances like estrogen dominance or thyroid dysfunction that can derail progress.' Marjanovic recommends that TRT providers repeat labs every 8 to 12 weeks early in therapy, check symptoms regularly, and make any adjustments necessary. It's important to address any markers that could signify side effects, including elevated hematocrit, estrogen imbalances, or libido issues. 'Personalized plan means tailoring dosage, delivery method, ancillary meds (like enclomiphene and hCG if needed), and lifestyle support based on individual needs. This is all crucial…' he explained. 'TRT without follow-up isn't therapy — it's gambling.' This article was written by Miska Salemann, New York Post Commerce Writer/Reporter. As a health-forward member of Gen Z, Miska seeks out experts to weigh in on the benefits, safety and designs of both trending and tried-and-true fitness equipment, workout clothing, dietary supplements and more. Taking matters into her own hands, Miska intrepidly tests wellness products, ranging from Bryan Johnson's Blueprint Longevity Mix to home gym elliptical machines to Jennifer Aniston's favorite workout platform – often with her adorable one-year old daughter by her side. Before joining The Post, Miska covered lifestyle and consumer topics for the U.S. Sun and The Cannon Beach Gazette.
