Testosterone Replacement Therapy
Confirm the diagnosis, then treat with care and monitoring.

Low libido, erectile changes, fatigue, low mood, loss of muscle and strength, more body fat and lower bone density. Symptoms overlap with sleep problems, stress, medications and other conditions, so testing matters.

Two separate early-morning total testosterone tests, plus free testosterone, LH, FSH and other labs when needed to find the cause. We also review sleep (including sleep apnea), weight, medications and fertility plans.

• Lifestyle and sleep first where they are driving low levels.
• FDA-approved testosterone when it is indicated: injections (testosterone cypionate or enanthate), gels, oral capsules or pellets. FDA-approved patches have been discontinued in the US.
• Monitoring of testosterone levels, hematocrit, PSA when appropriate, blood pressure and symptoms.
• Testosterone lowers sperm production. If you want children now or later, we discuss fertility-sparing options first; clomiphene is used off-label for this purpose, while hCG use depends on the product, diagnosis and approved indication.

In 2025 the FDA updated testosterone labeling after the TRAVERSE trial found no increase in major heart events compared with placebo. Labels still include a blood pressure warning. In June 2026 the FDA asked manufacturers for further class-wide label updates, including on age-related low testosterone and prostate cancer language; those updates are in progress. Testosterone is a controlled substance (Schedule III) and is prescribed only after an in-person or approved assessment.