Men's health after 40: measure first, then decide

What we help men with

• Low testosterone: proper testing, and TRT or alternatives when appropriate
• Weight and metabolic health, including GLP-1 medicines for men who qualify
• Erectile dysfunction and sexual health, including daily tadalafil
• Hair loss
• Energy, sleep and fatigue workups, including sleep apnea screening
• Fertility-related testing, such as semen analysis
• Heart and metabolic labs: lipids with apoB and Lp(a), HbA1c, liver and kidney function, PSA where appropriate

Is this you?

Maybe you are tired by mid-afternoon, recovering more slowly from workouts, and less interested in sex. Maybe your waist has grown while your weight barely moved. Maybe you have read that all of this is low testosterone and want to know if that is true.

Sometimes it is. Often it is part of the story alongside sleep, weight, alcohol, stress or medications. Measuring properly helps you avoid both missing a real deficiency and treating a number that was never the problem.

Testing testosterone the right way

Both the American Urological Association and the Endocrine Society say testosterone deficiency should be diagnosed only when you have symptoms or signs and consistently low levels. The AUA uses a total testosterone cut-off of 300 ng/dL, confirmed with two early-morning tests on separate days. Your clinician may also check free testosterone, SHBG, LH and FSH to understand the cause.

If deficiency is confirmed and treatment is appropriate, TRT can relieve symptoms. It requires monitoring of hematocrit, because testosterone can thicken the blood, and PSA, because of prostate considerations. TRT also suppresses sperm production, so men who want children in the near future need a different approach. For some men, options that support the body's own production may be discussed.

Hormones first, then the rest

When hormones are a real part of the picture, addressing them can make everything else easier. But treatment is only one piece. Losing excess weight, treating sleep apnea and cutting back on alcohol can raise testosterone on their own in some men, and they protect your heart either way.

Other services can complement hormone care or stand alone: medical weight programs, sexual health treatment, hair loss treatment, and lab panels to track heart and metabolic risk. Peptides and NAD+ are also offered after evaluation, though human evidence for many of them is limited and some are prohibited in sport.

Who should not start testosterone

TRT is not right for everyone. The Endocrine Society advises against it for men planning fertility soon and for men with breast or prostate cancer, an elevated hematocrit, untreated severe sleep apnea, severe urinary symptoms, uncontrolled heart failure, a recent heart attack or stroke, or a clotting disorder. A raised PSA needs urologic evaluation first.

If any of these apply to you, it does not mean you are out of options. It means your clinician will look for the underlying cause and safer approaches, and may refer you for specialist care.

Our physicians

HealifyMD physicians include Dr. Benjamin H. Krasne, M.D., who is board certified by the American Board of Anesthesiology and focuses on longevity and metabolic health. He earned his M.D. at the University of Miami Miller School of Medicine. Care itself is provided by independently licensed clinicians in your state.

How it works

Start with a free online eligibility check. A licensed clinician reviews your answers and, if needed, orders labs at a local service center. You review results by video, agree on a plan, and any prescription ships from a licensed U.S. pharmacy, often a compounding pharmacy. Compounded medications are not FDA-approved and are not equivalent to branded products. Prices are confirmed at your eligibility review, there is no membership fee, and services are available only in states where our clinicians are licensed.