How to choose a men's hormone clinic

Start with the diagnosis

The American Urological Association suggests a total testosterone below 300 ng/dL as a reasonable cutoff for low testosterone and asks that it be confirmed with two early-morning measurements on separate days, together with symptoms or signs. A clinic that prescribes after a single afternoon test, or with no test at all, is skipping the most important step.

A careful clinic also looks for why testosterone is low. Measuring LH helps separate testicular causes from signaling problems, and prolactin is checked when LH is low or low-normal. Obesity, sleep apnea, opioids, heavy drinking and some other medications can all lower testosterone and may be treatable.

What good looks like

• Two properly timed total testosterone results before diagnosis
• LH, and prolactin when indicated, to identify the cause
• Hemoglobin and hematocrit before treatment, and PSA for men over 40
• A direct question about whether you might want children, and a plan that protects fertility if so
• A choice of approaches explained, including replacement and, where appropriate, options that stimulate your own production
• Clear monitoring: testosterone levels after starting, then every 6 to 12 months, with hematocrit and PSA
• A checkpoint at three to six months to decide whether symptoms have actually improved

Red flags

• Testosterone prescribed without confirmed low levels
• No mention that testosterone therapy suppresses sperm production
• Routine add-on drugs prescribed to everyone without a clear reason
• Targets far above the normal range, framed as optimal
• Hematocrit or PSA never checked after starting
• Claims that testosterone will fix erectile dysfunction, depression or weight on its own
• Contracts that make it hard to pause or stop

Fertility should come up early

Testosterone from outside the body tells the brain to stop sending the signals that drive sperm production. The AUA advises against prescribing testosterone to men who are trying to conceive and recommends discussing long-term effects on fertility with anyone who may want children. If that applies to you, a good clinic will suggest a semen analysis and discuss alternatives such as clomiphene or enclomiphene, which can raise your own testosterone in secondary hypogonadism. Enclomiphene is available only as a compounded product in the U.S. and is not FDA-approved.

Heart and blood safety

The TRAVERSE trial found that testosterone therapy did not increase major cardiac events in men aged 45 to 80 with low testosterone and elevated cardiovascular risk. It did find more atrial fibrillation, clot-related problems and acute kidney injury. A good clinic will ask about clot history and heart rhythm problems and will watch hematocrit, since testosterone raises red blood cell production.

Delivery forms and practical trade-offs

Testosterone can be given as injections, skin gels, patches, pellets and, more recently, oral capsules. Injections are inexpensive and flexible but can produce peaks and troughs. Gels give steadier levels but can transfer to partners or children through skin contact. Pellets last months but cannot be adjusted once placed. A good clinic explains these differences and lets your preferences and lab responses guide the choice.

It should also explain what to do if a dose is missed, how injections are stored, and which symptoms, such as headaches, swelling, breathing pauses at night or breast tenderness, should prompt a call.

Questions to ask

• How many testosterone tests do you require before diagnosis, and at what time of day?
• Will you check LH, prolactin, hematocrit and PSA?
• How will treatment affect my fertility, and what are my alternatives?
• Is the product FDA-approved or compounded?
• What will you monitor, how often and who reviews it?
• At what point will we decide whether treatment is working?

Price comparisons that make sense

Monthly prices are hard to compare unless you know what each one includes. Ask whether the price covers the medication, clinician visits, follow-up messaging and lab work, or whether labs, supplies and add-on medicines are billed separately. A lower headline price can end up costing more once required labs and extras are added, and a higher price may include monitoring that you would otherwise pay for elsewhere.

Also check how easy it is to pause, change or cancel, and whether a first-month price differs from later months.

Applying this to HealifyMD

We encourage you to use these criteria with us as with any provider. HealifyMD clinicians review properly timed labs before discussing treatment, and options include testosterone therapy, listed at $249 for the first month and then $149 per month, or a compounded enclomiphene-based product from $129 per month. TRT's first month includes the lab panel; otherwise labs are priced separately, and prices are confirmed during your eligibility review.