Testosterone Replacement Therapy (TRT) is a medically supervised treatment designed to restore healthy testosterone levels in men whose bodies are no longer producing adequate amounts naturally. Testosterone is the primary male sex hormone and plays a vital role in regulating energy, muscle mass, bone density, mood, libido, and cognitive function. When levels drop below the optimal range, men can experience a variety of symptoms, including fatigue, loss of muscle strength, decreased motivation, irritability, brain fog, and reduced sexual performance.

Low testosterone — sometimes called hypogonadism — can result from natural aging, medical conditions, lifestyle factors, injuries to the testes, or even certain medications. While mild fluctuations are normal, persistently low levels can significantly impact quality of life and overall health.

TRT works by supplementing the body's natural testosterone through medically approved methods such as injections, topical gels, or other delivery systems. The goal isn't to give "extra" testosterone but to restore levels to a healthy, balanced range so the body can function optimally. This is not the same as using anabolic steroids for bodybuilding, which often involves unsafe, supraphysiologic doses.

When used correctly under medical supervision, TRT can help improve energy levels, boost mood, increase lean muscle mass, support fat loss, improve sleep quality, and enhance sexual health. It may also contribute to better cardiovascular and metabolic health when combined with lifestyle improvements like proper nutrition and regular exercise.

The decision to start TRT should always be made in partnership with an experienced physician who will assess your symptoms, review your medical history, and confirm low testosterone levels through blood testing. This careful approach ensures treatment is both safe and effective, with regular monitoring to fine-tune dosing and avoid side effects.

Our TRT process is designed to be streamlined, thorough, and patient-friendly while maintaining the highest standard of medical oversight.

Step 1 – Initial Assessment You begin by completing a detailed online questionnaire covering your symptoms, health history, and lifestyle factors. This helps us determine whether further evaluation for TRT is appropriate.

Step 2 – Comprehensive Blood Work You'll be sent a requisition for a full hormone and metabolic panel. This lab work will check testosterone levels along with other key biomarkers like estradiol, hematocrit, PSA, liver and kidney function, and cholesterol. The goal is to get a complete picture of your hormonal health and identify any underlying conditions.

Step 3 – Virtual Consultation Once results are in, you'll meet with one of our licensed physicians via a secure video call. They'll review your lab results, discuss your symptoms and goals, and answer any questions you have. If TRT is recommended, your provider will create a customized treatment plan tailored to your needs.

Step 4 – Prescription & Delivery If you choose to move forward, your prescription will be sent to our partner pharmacies or your pharmacy of choice, who will contact you within 48 hours. Medications are shipped directly to your home, and certain shipments may require a signature.

Step 5 – Ongoing Monitoring Follow-up blood work and consultations are scheduled every three months to track your progress, adjust dosages if necessary, and ensure safety. This proactive approach helps prevent side effects and keeps your results on track.

From start to finish, you're never left on your own — your treatment is guided by physicians who specialize in men's health and are committed to optimizing your vitality.

Your initial blood panel is far more than just a testosterone test — it's a comprehensive assessment of your hormonal and overall health to ensure TRT is appropriate and safe.

Key markers typically include:

• Total Testosterone – Measures the overall level of testosterone in your blood.
• Free Testosterone – The active form of testosterone available for your body's use.
• Estradiol (E2) – Estrogen levels are important to monitor, as testosterone can convert to estrogen, and imbalances can cause side effects.
• Sex Hormone Binding Globulin (SHBG) – A protein that binds testosterone; high or low SHBG can impact free testosterone availability.
• Luteinizing Hormone (LH) & Follicle-Stimulating Hormone (FSH) – Help determine whether low testosterone is due to a testicular or pituitary cause.
• Prostate-Specific Antigen (PSA) – Screens for potential prostate health concerns.
• Complete Blood Count (CBC) – Monitors red blood cell count and hematocrit, as TRT can increase these levels.
• Liver & Kidney Function Tests – Ensure your organs can safely handle treatment.
• Lipid Profile – Assesses cholesterol and triglyceride levels.
• Fasting Glucose / HbA1c – Checks blood sugar control and metabolic health.

By looking at this broader range of biomarkers, we can detect underlying conditions, prevent complications, and create a treatment plan that addresses your whole health — not just your testosterone levels. This thorough approach is what separates medically supervised TRT from generic or unsafe online prescriptions.

Testosterone Replacement Therapy (TRT) can have a significant impact on fertility, and it's important to understand this before beginning treatment. In men, the production of testosterone is closely linked to sperm production. When you take external (exogenous) testosterone, your brain senses that testosterone levels are sufficient and reduces the signals (LH and FSH) that tell the testes to produce both testosterone and sperm.

As a result, many men on TRT will experience a decrease in sperm count — in some cases, it can drop to near zero while on therapy. This effect is typically reversible once TRT is discontinued, but recovery can take several months and, in rare cases, fertility may not fully return to pre-treatment levels.

If you are planning to have children in the near future, your doctor can discuss alternative strategies. Options might include:

• Using medications like hCG (human chorionic gonadotropin) alongside TRT to help stimulate the testes to keep producing sperm.
• Exploring other therapies to boost testosterone naturally before moving to full TRT.
• Sperm banking before starting treatment, as an extra precaution for future family planning.

The key takeaway is that TRT is not a form of birth control, but it does affect fertility for most men. This is why an open conversation with your provider about your family goals is essential before starting therapy. With the right plan, it's often possible to support both hormone optimization and future fertility goals.

The timing of your blood test is important because testosterone levels naturally fluctuate throughout the day. For most men, levels are highest in the morning and gradually decrease into the evening. This is why physicians typically recommend completing blood work between 7:00 a.m. and 10:00 a.m.

Testing in this window provides a more accurate baseline of your natural testosterone production, especially if you are being evaluated for low testosterone. Consistency is also crucial for follow-up testing once you're on TRT — ideally, you should have your blood drawn at the same time of day and at a consistent point in your treatment cycle (for example, midway between injections if you're using that method).

Other considerations for accurate results:

• Fasting: Some tests, such as glucose or lipid profiles, require you to fast for 8–12 hours beforehand.
• Avoid intense exercise before the test: Heavy workouts can temporarily alter hormone and metabolic markers.
• Hydration: Drink plenty of water to make the blood draw easier and more comfortable.

Following these guidelines ensures your results are reliable, which allows your physician to make precise adjustments to your treatment. Even small inconsistencies in testing time can influence lab values, so making it a routine is key for long-term monitoring.

The eligibility process is designed to be both thorough and efficient. Most patients can complete all the required steps and receive a decision within 48 -72 hours of completing labs, although the timeline can vary depending on how quickly blood work is completed and results are returned.

Here's how it typically works:

• Questionnaire Submission: You start by completing a detailed online intake form about your symptoms, medical history, and lifestyle. This is reviewed within 1–2 business days.
• Blood Work: Once approved for lab testing, you'll receive a requisition to take to a nearby lab. Turnaround for results is generally 2–3 business days, depending on the lab's workload.
• Consultation: As soon as results are in, we'll schedule a virtual consultation with a licensed physician to review your lab work and discuss your options.
• Eligibility Decision: During the consultation, the doctor will confirm whether you're a candidate for TRT and explain your treatment plan.

The most common delays occur when blood work is not completed promptly, so we recommend booking your lab appointment as soon as you receive your requisition. Our team also follows up to help keep the process moving.

By combining an efficient workflow with comprehensive evaluation, we ensure you get a clear answer quickly — without skipping any important safety checks.

At our clinic, transparency in pricing is a core value. We want every patient to know exactly what they are paying for and what is included in their program. In most cases, the cost of lab requisitions, physician consultations, and medication delivery is either built into your program fee or clearly itemized so there are no hidden surprises.

Lab requisitions When your physician orders your initial blood panel, the requisition itself does not usually incur a charge from us. However, whether or not the actual blood work is free depends on the lab and your provincial health coverage (see question 8 for details).

Consultations Your initial and follow-up virtual consultations with a licensed physician are included in your program subscription. This means you're not paying out-of-pocket for each appointment — instead, your monthly or quarterly fee covers your ongoing medical oversight.

Medication delivery Once your prescription is approved, our partner pharmacy ships your medication directly to your home. Delivery is included in your program unless you live in a remote location that requires a courier surcharge. Certain shipments may require a signature for verification purposes.

We designed our program to remove financial guesswork and keep the process as seamless as possible. You'll know up front what is included and what isn't, so you can focus on your treatment and results rather than worrying about extra charges showing up unexpectedly.

Whether you need to pay for blood work depends largely on your location, the lab used, and your provincial or private health coverage.

In provinces with full coverage for medically necessary lab testing (such as BC, Alberta, and Ontario), your initial and follow-up blood work is typically free when ordered by a licensed physician.

In provinces or territories with partial coverage, some tests — particularly specialized hormone or advanced metabolic markers — may not be covered in full. The lab will inform you of any out-of-pocket fees before proceeding.

If you choose to use a private lab for faster results or additional markers, you may be responsible for the cost, which can range from $50 to $250 depending on the panel.

For patients outside Canada, or for those whose insurance plans require specific labs, our team will help guide you to the most cost-effective and convenient option available. We always aim to minimize out-of-pocket expenses while still ensuring you get a complete and medically appropriate assessment.

The bottom line: in most cases, standard TRT-related blood work will be covered, but you should confirm with the lab and your insurance provider to avoid surprises.

Coverage for TRT medication depends on your insurance provider and plan details. In Canada, testosterone replacement medications are not typically covered under public health plans unless prescribed for certain medical conditions like primary hypogonadism confirmed by lab tests. However, many private or employer-sponsored insurance plans do include coverage for hormone therapy.

Here's what you should do before starting:

• Check your plan's drug formulary — This list shows which medications are covered, under what conditions, and whether prior authorization is needed.
• Ask about preferred brands or forms — Some plans only cover specific formulations (e.g., injections vs gels) or require you to try a certain option first.
• Find out about coverage limits — Plans may cap the amount they will reimburse per year or per prescription.
• Ask if you can use a Health Spending Account (HSA) — Even if medication isn't directly covered, HSAs can often be used to pay for it tax-free.

Our administrative team is happy to provide the drug identification number (DIN) and supporting documentation your insurer might require. In many cases, we've been able to help patients secure partial or full coverage simply by submitting the right paperwork.

For those paying out-of-pocket, our partner pharmacy offers competitive pricing and discreet home delivery. We also work to find the most cost-effective formulation without compromising your treatment plan.

Testosterone Replacement Therapy can be delivered in several different ways, and the best method for you depends on your medical profile, personal preference, and lifestyle.

Most common TRT delivery methods include:

• Intramuscular injections – Typically administered every 1–2 weeks (or more frequently in smaller doses to maintain stable levels). Injections are one of the most cost-effective and reliable methods, and many patients learn to self-administer at home after initial guidance.
• Subcutaneous injections – Delivered into the fatty tissue just under the skin, usually with smaller needles and less discomfort. Some patients prefer this method for convenience and ease.
• Topical gels or creams – Applied daily to the skin, allowing testosterone to be absorbed transdermally. These can be effective but require daily application and care to avoid transferring the medication to others through skin contact.
• Testosterone pellets – Implanted under the skin by a physician, releasing testosterone gradually over several months. This option offers convenience but requires a minor procedure for insertion and replacement.
• Oral or buccal formulations – Less common due to potential liver strain with some older oral versions, though newer options are available in certain cases.

During your consultation, your doctor will discuss the pros and cons of each option, considering factors like dosing stability, convenience, cost, and your comfort with self-administration. No matter the method, consistent monitoring is critical to ensure you're achieving optimal testosterone levels without side effects.

When prescribed and monitored by an experienced physician, TRT is generally safe and well tolerated. However, like any medical treatment, it can have side effects — especially if dosages are too high or if proper monitoring is not in place.

Possible side effects include:

• Increased red blood cell count (polycythemia)
• Acne or oily skin
• Mood changes or irritability
• Swelling in ankles or feet (fluid retention)
• Breast tissue changes (gynecomastia) due to estrogen conversion
• Changes in cholesterol levels
• Worsening of sleep apnea in predisposed individuals
• Fertility reduction (see FAQ #4)

Regular blood work and follow-up consultations are essential to detect these changes early and adjust treatment as needed. Your doctor will also monitor prostate health, liver function, and cardiovascular markers to ensure ongoing safety.

The majority of men on well-managed TRT experience more benefits than drawbacks, including increased energy, improved mood, enhanced libido, better muscle tone, and greater overall vitality. Side effects are far more likely when testosterone is taken without medical supervision, which is why doctor-led programs are considered the gold standard.

In most cases, TRT can be safely combined with other medications or supplements, but it requires careful medical oversight to avoid interactions. During your intake process, you'll provide a full list of prescriptions, over-the-counter drugs, and supplements you're currently using. Your physician will review these to ensure there are no contraindications.

Potential considerations include:

• Blood thinners – TRT can increase red blood cell count, so careful monitoring is needed to avoid complications.
• Medications affecting the liver – Since testosterone is metabolized partly in the liver, other drugs that impact liver function may require dosage adjustments.
• Diabetes medications – TRT can influence insulin sensitivity, so diabetic patients may need closer monitoring of blood sugar levels.
• Sleep aids or sedatives – If TRT improves energy and mood, you may find you need less of these over time, but changes should be guided by your doctor.
• Herbal supplements – Some over-the-counter "test boosters" or hormone-related supplements may be redundant or interfere with your treatment.

The safest approach is open communication with your healthcare provider. Many men on TRT also take targeted supplements like vitamin D, zinc, magnesium, and omega-3s to support their results — but these are best tailored to your specific blood work and health goals.

The first step in determining candidacy for testosterone replacement therapy is understanding your symptoms and confirming them with accurate blood testing. Common signs of low testosterone include persistent fatigue, reduced libido, erectile dysfunction, decreased muscle mass, increased body fat, mood swings, irritability, difficulty concentrating, and poor sleep quality.

However, symptoms alone aren't enough to confirm low testosterone — many of these can be caused by other health issues such as thyroid imbalances, nutrient deficiencies, chronic stress, or poor sleep. That's why our approach combines a symptom assessment with comprehensive hormone testing to confirm whether low testosterone is the underlying cause.

To be considered for TRT, most patients must:

• Have clinically low total and/or free testosterone levels on lab testing.
• Experience symptoms consistent with testosterone deficiency.
• Not have certain medical conditions that make TRT unsafe (e.g., untreated prostate or breast cancer, severe untreated sleep apnea, uncontrolled heart failure).

Your physician will also review your medical history, current medications, and long-term health goals. In some cases, lifestyle changes or alternative treatments may be recommended before starting TRT. The goal is to ensure that therapy is both medically necessary and safe — and that it addresses the root cause of your symptoms.

TRT is not an instant fix — it's a gradual process that restores hormone balance and allows your body to respond over time. Most men begin to notice improvements within 3–6 weeks, but the timeline varies depending on factors like age, baseline testosterone levels, treatment method, and overall health.

Typical timeline of benefits:

• Weeks 3–4: Many men report improved energy, better mood, and reduced brain fog.
• Weeks 6–8: Noticeable increases in libido, sexual performance, and motivation.
• Months 3–4: Visible changes in body composition — more muscle tone, reduced fat mass, and enhanced workout recovery.
• Months 6–12: Continued improvements in bone density, strength, and cardiovascular health markers.

Consistency is key. Regular follow-up appointments and lab monitoring ensure your dosage is optimized for steady progress. While some benefits — like better sleep and mental clarity — may come quickly, others (like muscle gain or fat loss) take longer and are best supported with proper nutrition and exercise.

Whether TRT is lifelong depends on why you started it in the first place.

For men whose low testosterone is caused by age-related decline or irreversible conditions (like primary hypogonadism), TRT is typically a long-term or lifelong therapy — stopping treatment will usually cause testosterone levels and symptoms to return to their pre-treatment state.

However, in cases where low testosterone is caused by reversible factors (such as obesity, poor sleep, chronic stress, or certain medications), addressing these root causes may allow you to reduce or discontinue TRT over time. This requires careful planning and medical supervision.

It's important to understand that stopping TRT abruptly can cause your body to experience a temporary hormone imbalance, leading to fatigue, low mood, and other symptoms. If you and your physician decide to stop therapy, a tapered discontinuation plan or medications to help restart natural testosterone production may be used.

For most men who feel significantly better on TRT and tolerate it well, continuing long-term is the preferred choice — especially when it's monitored closely to ensure safety and effectiveness.