Male Hormone Therapy

How is our Male Hormone Therapy Different?

Testosterone Optimization: Evidence, Context, and Choice.

The Process:

1st visit - "moderate" level (see price list), labs ordered (if needed).

2nd visit - when labs return (included in first visit fee) to decide best next steps. Rx sent (if needed).

Thereafter - "quick visit" (see price list) level visits with or without labs every 2-3 months until labs/dose are stable, then visits every 3-6 months.

Memberships are required for hormone therapy. This can be a basic hormone membership or a direct primary care membership.

Cost and frequency of labs depends on each individual's needs, insurance coverage, medications and prior lab results. Cash pay initial labs are ~$200, subsequent labs are $30-$120.

Hormone patients are rq

Testosterone therapy for men has become one of the most debated areas in modern medicine. Some clinics sell it as a cure for everything, while others dismiss it entirely. The truth lies in the middle: testosterone therapy is a legitimate and effective tool for certain men when used with precision and respect for physiology.

We don’t push testosterone as a miracle fix. We don’t use it as a sales pitch. And we don’t exaggerate what the research says. We offer clarity, choice, and individualized care for men who want to feel and function at their best.

We treat testosterone optimization like any other medical issue - your RX is sent to a pharmacy (cash pay is around $50 for a 2-3 month supply), pay for the labs that you need and need to see us ever 3-6 months. No upselling. No nonsense.

Why Consider Testosterone Optimization

Low testosterone (hypogonadism) can cause fatigue, loss of muscle, decreased libido, depressed mood, cognitive decline, and reduced drive. Replacement can restore well-being and performance in men who are truly deficient or functionally low.

There is no universal definition of “optimized.” Many men fall into a gray zone—within normal ranges but still symptomatic. The goal is not chasing a lab number but improving how a patient feels while maintaining safety and physiologic balance.

The Truth About the Data

The TRAVERSE trial (N Engl J Med, 2023) is the largest and most rigorous study on testosterone therapy in men with confirmed hypogonadism and cardiovascular risk factors. It found that physiologic testosterone replacement did not increase major cardiovascular events compared with placebo (Nissen et al., 2023).

However, the TRAVERSE trial did not evaluate optimization. Participants were treated only to mid-normal levels, not high-normal or individually tailored ranges.

The study supports safety for replacement but does not answer questions about symptom-driven or optimized dosing in otherwise healthy men.

That uncertainty is important. We acknowledge the limits of current data. We focus on informed decisions based on symptoms, goals, and overall health, not rigid population averages.

Estrogen in Men

Testosterone converts to estradiol in the body, and that conversion is critical for bone strength, sexual function, mood, and cardiovascular health (Finkelstein et al., 2013). Using aromatase inhibitors or “estrogen blockers” too aggressively can cause low bone density, irritability, joint pain, and may even raise heart risks (Snyder et al., 2016).

We do not automatically suppress estradiol unless there is a clear reason. The balance between testosterone and estrogen, not the elimination of one, is what supports long-term health.

What we do differently

Individualized protocols
We don’t have protocols. We do not rely on cookie-cutter dosing charts. We evaluate your baseline function, symptoms, and goals, then adjust carefully over time.
Transparent discussions
We outline real risks and benefits: erythrocytosis, fertility effects, possible prostate changes, acne, lipid shifts, and cardiovascular considerations. You’ll know what to expect before starting.
Evidence-guided treatment
The research isn’t perfect, but it provides a foundation. We use it responsibly and keep you part of the process.
Comprehensive hormone balance
Testosterone interacts with estradiol, DHEA, SHBG, thyroid, and cortisol. We look at the whole picture instead of treating one lab value in isolation.
Multiple delivery options
Testosterone can be given by injection, topical gel, or pellet. Each has trade-offs in consistency, convenience, and cost, which we explain clearly.
Ongoing monitoring
We track hematocrit, estradiol, PSA, lipids, and liver enzymes. True optimization requires active oversight, not a “set it and forget it” approach.

Practical considerations & monitoring

Start low, go slow.
Monitor symptoms but also lab values that matter (lipids, liver enzymes, etc.).
Reassess risk vs benefit periodically.
Use nonhormonal adjuncts when helpful (lifestyle changes, diet, exercise, sleep hygiene).
If you opt out or discontinue therapy, we support you through that transition.

Our promise to you

We help men make educated, self-directed choices for their health and performance. We emphasize safety, transparency, and honesty.
We won’t push “bioidentical hormones are always safer” as gospel
We won’t overtest just to generate billable results
We won’t hide the risks
We will show you what we actually believe will benefit you (even if that means recommending no therapy)
If you’re thinking about female hormone therapy, we offer clarity, safety, and integrity - no fluff, no spin.

References

Nissen, S. E., et al. (2023). Cardiovascular Safety of Testosterone-Replacement Therapy. New England Journal of Medicine, 389(9), 811–823.

Finkelstein, J. S., et al. (2013). Gonadal steroids and body composition, strength, and sexual function in men. New England Journal of Medicine, 369(11), 1011–1022.

Snyder, P. J., et al. (2016). Effects of testosterone treatment in older men. New England Journal of Medicine, 374(7), 611–624.