Question 1

How is low testosterone diagnosed?

Accepted Answer

Low testosterone is diagnosed from laboratory testing interpreted alongside symptoms — not from symptoms alone. Guidelines generally call for total testosterone measured on at least two separate morning draws, since levels vary through the day. A provider will typically also review free testosterone, SHBG, LH and FSH to establish whether the cause is primary or secondary, and order a CBC and metabolic panel as a baseline.

Question 2

Do I need bloodwork before starting testosterone therapy?

Accepted Answer

Yes. A baseline hormone panel is required before a provider can determine whether testosterone therapy is appropriate. Prescribing testosterone without baseline laboratory work is not consistent with accepted practice. Baseline results also establish the reference point every later result is compared against.

Question 3

How often do I need labs while on testosterone therapy?

Accepted Answer

Monitoring intervals are set by the treating provider. A common pattern is follow-up bloodwork within the first few months of starting or changing a dose, then periodically thereafter. Haematocrit is monitored throughout because testosterone can raise it, and PSA is monitored where age-appropriate.

Question 4

Why is haematocrit monitored on testosterone therapy?

Accepted Answer

Testosterone can increase red blood cell production, which raises haematocrit — the proportion of blood made up of red cells. Because a rise can occur without symptoms, it is tracked with periodic bloodwork rather than by how you feel. If haematocrit rises beyond an acceptable range, a provider may adjust the dose, change the interval, or pause therapy.

Question 5

Is testosterone therapy lifelong?

Accepted Answer

Not necessarily, but it is generally an ongoing therapy rather than a short course. Because exogenous testosterone suppresses the body's own production, stopping usually means levels return toward — or briefly below — their pre-treatment baseline until the axis recovers. Any decision to stop should be made with your provider rather than abruptly.

Question 6

Does testosterone therapy affect fertility?

Accepted Answer

Yes. Exogenous testosterone suppresses the hormonal signals that drive sperm production, and this can reduce or halt spermatogenesis while on therapy. If you intend to conceive now or in future, raise it before starting. Providers may consider alternatives such as enclomiphene, which raises endogenous testosterone without the same suppressive effect, or adjunct protocols alongside testosterone.

Question 7

What is enclomiphene?

Accepted Answer

Enclomiphene is an oral selective estrogen receptor modulator that acts at the pituitary to increase LH and FSH, which in turn stimulate the testes to produce more testosterone. Because it works through the body's own axis rather than replacing testosterone from outside, it does not carry the same suppressive effect on sperm production. It is compounded, is not FDA-approved for this use, and is prescribed at provider discretion.

Question 8

How does enclomiphene differ from testosterone therapy?

Accepted Answer

Testosterone replaces the hormone directly and suppresses the body's own production. Enclomiphene stimulates the body to produce more of its own and does not carry the same suppressive effect on fertility. Enclomiphene depends on the testes being able to respond, so it is generally considered for secondary rather than primary hypogonadism. Which is appropriate is a clinical judgement based on your laboratory results and goals.

Question 9

How often do you inject testosterone cypionate?

Accepted Answer

Dosing schedules are set by the prescribing provider. Testosterone cypionate is long-acting, and weekly or twice-weekly administration are both common. Splitting a weekly dose across two injections is often used to reduce the peak-and-trough swing between doses.

Question 10

Subcutaneous or intramuscular testosterone injection?

Accepted Answer

Both routes are used. Subcutaneous injection uses a shorter, finer needle and is often reported as more comfortable and easier to self-administer; intramuscular is the longer-established route. Which is recommended depends on your provider's protocol, your dose and your own preference. Injection technique is covered as part of onboarding.

Question 11

Do I need an aromatase inhibitor on testosterone therapy?

Accepted Answer

Usually not. Aromatase inhibitors such as anastrozole are used selectively, where measured estradiol and symptoms together indicate it. Estradiol has necessary functions in men, including in bone density, lipids and libido, so over-suppression causes its own problems. Adjusting testosterone dose or interval is often considered before adding one.

Question 12

What is gonadorelin used for alongside TRT?

Accepted Answer

Gonadorelin is a synthetic gonadotropin-releasing hormone sometimes prescribed alongside testosterone with the intent of maintaining testicular signalling during therapy. It is compounded, not FDA-approved for this use, and protocols vary between prescribers. It requires frequent administration owing to its short half-life.

Question 13

What time of day should testosterone be tested?

Accepted Answer

Morning, generally before 10am, because testosterone follows a daily rhythm and is typically highest earlier in the day. Testing at a consistent time also makes results comparable between draws. Your lab order will specify the timing your provider wants.

Question 14

Is TryGenesis covered by insurance?

Accepted Answer

No. TryGenesis operates on a cash-pay basis and does not bill insurance. Pricing is shown upfront and includes the clinician evaluation, ongoing support and medication where prescribed. Some patients use HSA or FSA funds; check with your plan administrator.

Question 15

Which states does TryGenesis serve?

Accepted Answer

Availability is determined by provider licensure and varies by treatment. Coverage is shown before you complete an evaluation, and eligibility is confirmed during intake. See the state legality page for current detail.

Question 16

How long until I speak to a provider?

Accepted Answer

After you complete intake, a licensed provider reviews your submission and laboratory results. Most reviews are asynchronous, meaning you do not need to schedule a call. Where a treatment requires a synchronous visit — testosterone therapy does, as a controlled substance — a video consultation is scheduled as part of the process.

Question 17

How does semaglutide work?

Accepted Answer

Semaglutide is a GLP-1 receptor agonist. It acts on receptors involved in appetite regulation and slows gastric emptying, which affects how full you feel and for how long. It is given as a once-weekly injection, started low and titrated upward over several weeks to manage tolerability. Whether it is appropriate depends on eligibility criteria and your medical history.

Question 18

Am I eligible for GLP-1 therapy?

Accepted Answer

Eligibility generally rests on BMI thresholds, with a lower threshold applying where weight-related comorbidities are present. There are also absolute contraindications: a personal or family history of medullary thyroid carcinoma or MEN2 rules the class out entirely, and a history of pancreatitis requires careful consideration. A provider determines eligibility after reviewing your intake and laboratory results, and not everyone qualifies.

Question 19

What side effects does semaglutide have?

Accepted Answer

Gastrointestinal effects are the most commonly reported — nausea, constipation, diarrhoea and reflux — and are most pronounced during dose escalation. This is why titration is gradual. The class carries a boxed warning regarding thyroid C-cell tumours based on rodent studies. Pancreatitis and gallbladder disease are less common but require prompt attention. Report anything unexpected to your provider rather than waiting for a scheduled review.

Question 20

What happens if I stop GLP-1 therapy?

Accepted Answer

Appetite regulation generally returns toward its previous state once the medication is cleared, and weight regain is commonly observed. This is a recognised feature of the therapy rather than a failure, and it is why providers discuss the longer-term plan at the outset rather than treating it as a short course. Any decision to stop should be made with your provider.

Question 21

Do you offer compounded semaglutide or tirzepatide?

Accepted Answer

Not as a general offering. The FDA declared the semaglutide and tirzepatide shortages resolved, which ended the basis on which pharmacies could compound copies of them, and enforcement discretion for outsourcing facilities ended in March 2025. What remains available is the FDA-approved branded product, and genuine patient-specific compounding only where a prescriber documents a clinical need the approved product cannot meet. Any provider offering compounded copies as a routine low-cost alternative is operating outside that framework.

Question 22

Is metformin a weight-loss medication?

Accepted Answer

Metformin is not approved for weight management. It is a metabolic medication used primarily in type 2 diabetes and insulin resistance, and providers sometimes use it in metabolic care where the laboratory picture supports it. Any effect on weight is modest compared with GLP-1 therapy. Whether it has a role for you depends on your metabolic markers.

Question 23

What is the difference between semaglutide and tirzepatide?

Accepted Answer

Semaglutide acts at the GLP-1 receptor. Tirzepatide is a dual agonist acting at both GIP and GLP-1 receptors. Both are given as weekly injections with a stepwise titration and both carry the same boxed warning regarding thyroid C-cell tumours. Which is appropriate depends on your history, tolerability, contraindications and availability — that is a clinical judgement, not a preference.

Question 24

Are peptides FDA-approved?

Accepted Answer

The peptides discussed in this category are not FDA-approved and have no approved indication. They are compounded preparations prescribed at the discretion of a licensed provider. There is no USP monograph for them, human clinical evidence is limited, and dosing protocols are not standardised between prescribers. Anyone presenting them as proven therapies is overstating what is known.

Question 25

What is the current regulatory status of BPC-157?

Accepted Answer

In late 2023 the FDA placed BPC-157 into 503A Category 2, which effectively prohibited compounding it. In April 2026 it was removed from Category 2, but it was not added to the 503A positive list — the list of substances affirmatively permitted — so it became neither prohibited nor authorised. In July 2026 the Pharmacy Compounding Advisory Committee voted 8–6 to recommend adding it to that list. That vote is a recommendation rather than a rule: the FDA has not acted on it, and doing so requires formal rulemaking that ordinarily takes a year or more. As things stand it remains without FDA approval and without an approved indication.

Question 26

Tadalafil or sildenafil — what is the difference?

Accepted Answer

Both are PDE5 inhibitors. Tadalafil has a much longer half-life, which allows either on-demand use or a lower daily dose; sildenafil is shorter-acting and taken on demand roughly an hour beforehand, with onset delayed by a heavy meal. Side-effect profiles differ slightly. Neither may be combined with nitrates under any circumstances. Which suits you is a clinical decision based on frequency of use, other medications and tolerance.

Question 27

Can erectile dysfunction be a sign of something else?

Accepted Answer

Yes, and this is the reason evaluation matters. Erectile dysfunction is frequently an early marker of vascular disease, and can also reflect diabetes, low testosterone, medication side effects, sleep apnoea or psychological factors. Treating the symptom without assessing the cause can mean missing something more consequential. A provider will review cardiovascular risk factors and relevant laboratory work as part of the evaluation.

Question 28

Finasteride or minoxidil for hair loss?

Accepted Answer

They work differently and are often used together. Finasteride reduces conversion of testosterone to DHT, addressing the hormonal driver of pattern hair loss. Minoxidil is a vasodilator applied topically or, off-label, taken at low oral doses. Finasteride carries considerations around fertility and mood; oral minoxidil requires blood-pressure monitoring. Benefit from either is maintained only while treatment continues.

Question 29

How long before hair-loss treatment shows any change?

Accepted Answer

Hair grows slowly and cycles over months, so assessment of response is measured in months rather than weeks. Providers generally review at defined intervals rather than expecting early change. An initial increase in shedding after starting minoxidil is a recognised phase and is not a sign the treatment has failed. Photographic tracking at consistent intervals is more reliable than impression.

Question 30

What is NAD+ therapy?

Accepted Answer

NAD+ is a coenzyme central to cellular energy metabolism and DNA repair, and its levels decline with age. It is offered as a compounded preparation by subcutaneous injection or intravenous infusion. It is not FDA-approved for this use, clinical evidence for longevity outcomes in humans is limited, and protocols are not standardised. Infusion is commonly associated with flushing and discomfort, which is rate-dependent.

Question 31

Which biomarkers matter most in longevity care?

Accepted Answer

The most informative markers tend to be metabolic and cardiovascular rather than exotic. ApoB gives a better picture of atherogenic risk than total cholesterol. Fasting insulin and HbA1c describe glycaemic control before overt disease. hs-CRP captures inflammatory burden. Beyond those, hormonal markers appropriate to your age and sex, and liver and kidney function to establish a baseline. What matters is tracking the same markers over time.

Question 32

Why screen for sleep apnoea before treating poor sleep?

Accepted Answer

Obstructive sleep apnoea is common, frequently undiagnosed, and presents as unrefreshing sleep and daytime fatigue — the same complaint that prompts most requests for a sleep medication. Sedating medication can worsen it. It also carries cardiovascular and metabolic consequences that treating the symptom would leave unaddressed. Screening first is why a proper evaluation is worth more than a prescription.

Question 33

Can you prescribe sleeping tablets?

Accepted Answer

Sedative-hypnotics are controlled substances and are generally not appropriate for routine telehealth prescribing, particularly before underlying causes have been excluded. The evaluation focuses on identifying what is driving the sleep problem — apnoea, thyroid disease, iron deficiency, mood, or behavioural factors — and addressing that. Cognitive behavioural therapy for insomnia has better long-term evidence than medication for chronic insomnia.

Question 34

Is shipping discreet?

Accepted Answer

Medications ship from a licensed pharmacy in plain packaging without any indication of the contents on the exterior. Tracking is provided, and temperature-controlled shipping is used where a medication requires it.

Question 35

Can I use an HSA or FSA?

Accepted Answer

Many patients do. TryGenesis is cash-pay and does not bill insurance, but charges for evaluation, laboratory work and prescribed medication are commonly HSA and FSA eligible. Check with your plan administrator, since rules vary between plans.

Question 36

What is a GLP-1 medication?

Accepted Answer

GLP-1 receptor agonists are medications that mimic glucagon-like peptide-1, a hormone the gut releases after eating. They act on receptors involved in appetite regulation, gastric emptying and insulin release. Semaglutide and tirzepatide are the two most widely prescribed in this class, though tirzepatide also acts on the GIP receptor. Whether one is appropriate for you is a clinical decision made after evaluation.

Question 37

Who is eligible for GLP-1 treatment?

Accepted Answer

Eligibility is determined by a licensed provider after reviewing your medical history, current medications, laboratory results and measurements. Providers generally consider body mass index alongside weight-related conditions, and screen for contraindications including personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia type 2, and pancreatitis. Completing an intake does not mean a prescription will be issued.

Question 38

What would disqualify me from GLP-1 treatment?

Accepted Answer

Providers screen for a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2, a history of pancreatitis, current pregnancy or breastfeeding, and certain gastrointestinal conditions. Some medications interact and need review. This is not an exhaustive list — the evaluation exists precisely to work through your individual history.

Question 39

What does titration mean?

Accepted Answer

Titration is the process of starting at a low dose and increasing it in steps over time. With GLP-1 medications this is standard practice: it gives the body time to adjust and is how gastrointestinal side effects are managed. Your provider sets the schedule and may hold a dose longer, or step it back, depending on how you tolerate it.

Question 40

What side effects are associated with GLP-1 medications?

Accepted Answer

The most commonly reported are gastrointestinal — nausea, vomiting, diarrhoea, constipation and abdominal discomfort — and are most often noted when starting or increasing a dose. Serious risks described in the prescribing information for approved products in this class include pancreatitis, gallbladder disease and thyroid C-cell tumours in rodent studies. Discuss the full risk profile with your provider, and report any severe or persistent symptoms.

Question 41

What is compounded semaglutide?

Accepted Answer

A compounded preparation is made by a licensed compounding pharmacy for an individual patient pursuant to a prescription. Compounded preparations are not FDA-approved products and are not reviewed by the FDA for safety, efficacy or manufacturing quality in the way approved drugs are. Whether a compounded preparation is appropriate, and whether it is available in your state, are matters for your provider and the dispensing pharmacy.

Question 42

What is a 503A compounding pharmacy?

Accepted Answer

503A refers to the section of the Federal Food, Drug, and Cosmetic Act covering traditional compounding pharmacies, which prepare medications for identified individual patients against a prescription. 503B outsourcing facilities are a separate category, registered with the FDA and permitted to compound in larger batches under stricter manufacturing standards. Both are distinct from the manufacturers of FDA-approved drug products.

Question 43

Why would a provider prescribe a compounded preparation?

Accepted Answer

Reasons vary and are clinical. A patient may need a dose or formulation that is not commercially available, or may have an allergy or intolerance to an inactive ingredient in an approved product. The decision rests with the prescribing provider, who is required to determine that compounding is appropriate for that individual patient.

Question 44

Do I still need to change my diet on a GLP-1?

Accepted Answer

Yes. These medications are prescribed as part of a programme that includes nutrition and activity, not as a replacement for it. Adequate protein intake matters particularly, because weight reduction from any cause can include loss of lean mass. Your provider will discuss what is appropriate for you.

Question 45

What happens if I stop taking a GLP-1?

Accepted Answer

Appetite effects diminish once the medication clears, and the published literature on approved products in this class describes weight regain after discontinuation in many patients. Stopping should be discussed with your provider rather than done abruptly on your own, so that a plan for what follows is in place.

Question 46

How long does GLP-1 treatment last?

Accepted Answer

There is no fixed duration. Obesity is generally treated as a chronic condition, and treatment length is a decision made between you and your provider based on response, tolerance and your goals. Some people continue long term, others taper under supervision.

Question 47

How are GLP-1 medications administered?

Accepted Answer

They are given as a subcutaneous injection — into the fat layer just under the skin of the abdomen, thigh or upper arm — usually once weekly. The needles are short and fine. Your care team provides instruction on technique, site rotation and sharps disposal before you start.

Question 48

Can I drink alcohol on a GLP-1?

Accepted Answer

Discuss this with your provider. Alcohol can worsen the gastrointestinal side effects associated with this class, and it affects blood sugar, which matters more if you also take medication for diabetes. There is no single answer that applies to everyone.

Question 49

Will I lose muscle as well as fat?

Accepted Answer

Weight reduction from any cause typically includes some loss of lean mass, and this is discussed in the literature on GLP-1 medications. It is the reason programmes emphasise adequate protein intake and resistance training. Your provider can advise on what is appropriate given your history.

Question 50

What are the differences between testosterone injections, creams and pellets?

Accepted Answer

Injections are typically given weekly or twice weekly and produce a peak-and-trough pattern that depends on the interval. Transdermal creams and gels are applied daily and carry a risk of transferring to others through skin contact. Pellets are implanted and release over months but cannot be adjusted once placed. Route is chosen with your provider based on your history, preferences and how you respond.

Question 51

How do providers decide between testosterone and enclomiphene?

Accepted Answer

The distinction usually turns on whether the cause is primary — the testes — or secondary — the signalling from the pituitary — and on whether fertility is a consideration. Laboratory results including LH, FSH and SHBG inform that picture, alongside your history and goals. It is not a preference question; it is a diagnostic one.

Question 52

Will I need to give blood on testosterone therapy?

Accepted Answer

Some patients on testosterone are advised to donate blood or undergo therapeutic phlebotomy if haematocrit rises. Whether that applies to you is determined by your monitoring bloodwork and your provider's judgement, not by a blanket rule. This is one of the reasons regular monitoring is part of the programme.

Question 53

What is an aromatase inhibitor and would I need one?

Accepted Answer

Aromatase inhibitors reduce the conversion of testosterone into oestradiol. They are sometimes discussed in the context of testosterone therapy, but they are not routinely required, and suppressing oestradiol too far carries its own problems including effects on bone and lipids. Whether one has any place in your care is entirely a provider decision informed by symptoms and laboratory values.

Question 54

Is testosterone a controlled substance?

Accepted Answer

Yes. Testosterone is a Schedule III controlled substance in the United States. That has practical consequences for telehealth: prescribing requires a synchronous consultation — a live video visit — rather than an asynchronous questionnaire, and it is subject to federal rules that have been operating under temporary flexibilities. Refills and quantities are also governed differently from non-controlled medications.

Question 55

Can I travel with my testosterone prescription?

Accepted Answer

Keep medication in its original labelled pharmacy container and carry documentation of the prescription. Controlled substances are regulated differently across international borders, and some countries restrict or prohibit importing them regardless of a valid US prescription. Check the rules of your destination well before you travel.

Question 56

What are peptides?

Accepted Answer

Peptides are short chains of amino acids — the same building blocks that make up proteins, but in much shorter sequences. Many hormones the body makes are peptides. In a clinical setting, a small number of peptide medications hold FDA approval for specific indications; many other peptides discussed publicly do not, and are the subject of ongoing research rather than established therapy.

Question 57

Why can't I get a peptide I have read about?

Accepted Answer

Compounding pharmacies may only prepare substances that meet defined regulatory criteria, and the FDA maintains categories of bulk substances that are not eligible. Several peptides widely discussed online fall outside what a licensed pharmacy may dispense. A provider will not prescribe outside those limits, and a service that offers to is worth treating with caution.

Question 58

How is a prescribed peptide different from one sold online?

Accepted Answer

A prescribed preparation is dispensed by a licensed pharmacy against a prescription written by a licensed provider, for a named patient, after an evaluation. Material sold online without a prescription is not dispensed under that framework, is not intended for administration to people, and carries no assurance about identity, purity or sterility. The distinction is regulatory and it is substantive.

Question 59

How are peptide medications given?

Accepted Answer

Most are given by subcutaneous injection, because peptides are broken down in the digestive tract and generally cannot be taken orally in a useful form. Some are formulated for nasal or topical administration. Your provider and pharmacy will supply specific instructions for anything prescribed to you.

Question 60

Is bloodwork required for peptide therapy?

Accepted Answer

Baseline laboratory work is part of the evaluation, and monitoring intervals are set by the treating provider based on what has been prescribed and your individual history. Peptides that act on hormonal pathways generally warrant closer monitoring than those that do not.

Question 61

What causes erectile dysfunction?

Accepted Answer

Causes are frequently vascular, and erectile dysfunction can be an early indicator of cardiovascular disease — which is one reason evaluation matters rather than simply obtaining a medication. Other contributors include diabetes, hormonal factors, neurological conditions, medication side effects, sleep disorders, and psychological factors. A provider works through these during your evaluation.

Question 62

What tests are involved in an erectile dysfunction evaluation?

Accepted Answer

A provider will typically review a metabolic panel, lipids, HbA1c and morning total testosterone, alongside blood pressure and your medical and medication history. The purpose is to identify treatable contributors and to screen for cardiovascular risk, not simply to confirm a symptom you have already reported.

Question 63

What medications are used for erectile dysfunction?

Accepted Answer

PDE5 inhibitors — sildenafil and tadalafil among them — are the most commonly prescribed class, and both are available as FDA-approved products. They differ in onset and duration. They are contraindicated with nitrates, and interact with certain other medications, which is why the medication history taken at evaluation matters.

Question 64

Why do providers ask about nitrates?

Accepted Answer

PDE5 inhibitors taken with nitrate medications can cause a severe drop in blood pressure. Nitrates are prescribed for chest pain and heart conditions, and some recreational substances also contain them. This is an absolute contraindication, and it is one of the specific reasons an evaluation is required before a prescription.

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