Suffering from sore joints, scrambled thoughts, lagging libido, a receding hairline — or perhaps, all of the above?
According to a growing community of endocrinologists, such unwelcome signs may not simply mean that you’re starting to “slow down”. These symptoms could also be due to lowered testosterone levels.
A 2023 study in the Journal of Clinical Endocrinology revealed that testosterone levels in American men have plummeted about 1% per year since the 1980s. There are several potential causes that have been explored, including lifestyle, diet, and environmental factors.
However, the decline in testosterone can not be attributed to aging alone. Business leaders, like Deep Patel, are working to raise more awareness around what he has described as the “male version of menopause,” and bring men a safe, accessible solution — Testosterone Replacement Therapy (TRT).
Find Out About Our Top TRT Pick
Feeling low on energy? Ulo offers a personalized approach to testosterone replacement therapy (TRT), starting with an at-home lab test and virtual consultation with a licensed provider. If TRT is recommended, treatment options — including injections, gels, and oral medications — are delivered straight to your door. Plans start at $159/month. You’ll only be charged if a provider determines treatment is appropriate and writes a prescription. Treatment is currently available in select states and includes ongoing support throughout your plan. Learn more about how it works and if it’s available in your state at Ulo’s website.
“TRT stands for Testosterone Replacement Therapy. It’s a way of bringing your testosterone levels back into a healthy range when your body isn’t producing enough. You’re not taking extra. You’re restoring what your system is missing,” Patel, who co-founded telehealth startup Ulo, explained.
Patel says that when TRT is done right, it can give you your life back. A 2019 study on prescription testosterone found that 52% of men claimed testosterone improved their energy, 42% saw improvements in their libido, and 29% reported muscle growth.
While TRT has exhibited a range of benefits, Patel is also open about some of the potential risks. He explained that some of the more common side effects include acne, water retention, or elevated red blood cell counts, which can thicken your blood. Some men experience testicular shrinkage or reduced fertility.
Currently, TRT is only FDA-approved for specific conditions, such as a testosterone deficiency (also called hypogonadism) or diminished functional activity of the gonads. In order to start TRT, men will need to get a prescription for testosterone, which requires a blood test.
There are a few important steps, but getting an online testosterone prescription is actually much easier than it might appear, thanks to modern telemedicine.
Today, those interested in starting TRT can get evaluated, tested, and prescribed TRT right from their laptops, through online TRT clinics like Ulo.
How do you get a testosterone prescription online?
To piece together the steps needed to get a testosterone prescription online, the Post consulted several medical experts and leaders in the TRT space. Below, find our expert-backed, step-by-step guide.
1. Research reputable online TRT clinics
Tomo Marjanovic is the owner of Aspire Rejuvenation Clinic, a wellness center specializing in personalized hormone therapy and holistic wellness solutions.
Before starting your search, it’s important to make note of regulations. In the U.S., a provider must be licensed in the patient’s state to legally prescribe testosterone.
Finding a reputable clinic doesn’t stop at that. Marjanovic explained that it’s important to look for a TRT clinic that connects patients with licensed medical providers and offers a multi-step process to ensure clients have the information they need before making a decision.
“The clinic should require comprehensive labs, a detailed intake process, and a real conversation with a knowledgeable provider,” explained Marjanovic. “If the only interaction is an automated signup form or a rushed consult, that’s a big red flag.”
There are a few other red flags to look out for, according Marjanovic. He recommends skipping any sites that don’t require bloodwork and consultations before providing. Clinics should always create individualized plans for treatement and monitor symptoms along the way.
A telehealth platform that focuses more on marketing than medicine is also best avoided: “If it feels more like ordering supplements than receiving medical treatment, it’s a problem,” he added.
Most reputable telehealth clinics will offer testosterone treatment in the form of injections, tablets, creams, or all of the above.
2. Complete the intake form, considering all symptoms and medical history
Before you take a blood test, most reputable online TRT clinics will ask for detailed background information through a medical intake form. Patients should expect several questions about their symptoms, medical history, and lifestyle habits, such as exercise, diet, and drug use.
Deep Patel, who is the co-founder of Ulo, emphasized that patients may experience a range of different symptoms. It’s important to flag any internal signals, as well as external signs of a hormone deficiency.
“Common symptoms include constant fatigue even when you’re sleeping enough, low sex drive, trouble focusing, mood swings or irritability, loss of muscle or strength despite working out, increased belly fat, and even depression or anxiety,” Patel described.
At Ulo, the intake form is pretty straightforward. Patients are asked about medical issues, conditions, or previous diagnoses, such as elevated blood pressure or a history of cancer. There are also some questions regarding fertility, which Patel points out is important to consider. TRT significantly suppresses natural testosterone production, which can also reduce sperm production.
“If fertility matters to you, there are medications like HCG or enclomiphene that can be taken alongside TRT to preserve it,” Patel explained. “Just make sure your provider knows that’s a priority from the beginning.”
It might be tempting to rush through an intake form, but it’s quite important to pay attention to these questions as your responses will dictate the type of treatement that is best for you.
3. Get your bloodwork done, measuring total and free testosterone
Prior to getting a prescription for testosterone, patients are required to submit bloodwork for analysis. Online clinics have simplified the process by offering at-home test kits that can be delivered straight to your door and mailed back to the lab for review.
At-home tests typically require a quick finger prick, but each kit has different instructions, so it’s important to read them carefully. If at-home testing is not for you, it’s also possible to take a blood test through local lab partnerships, such as Quest or Labcorp.
Blood tests can measure different hormone levels, but for a TRT prescription, the primary indicators and total testosterone in your blood. Most testosterone is bound to different proteins, like sex hormone-binding globulin and albumin. However, some testosterone remains unbound, also called “free testosterone.” Other hormones to consider testing for include estradiol, thyroid, are cortisone.
The majority of TRT clinics consider normal testosterone levels to land anywhere between 300 to 1,000 nanograms per deciliter. However, this is just a baseline, and the experts we spoke to have pointed out that the numbers alone don’t tell the whole story.
“Some men experience symptoms at 400 or 500 ng/dL if their free testosterone or androgen sensitivity is off. Diagnosis should never rely on numbers alone,” explained Marjanovic.
4. Meet with a licensed provider to discuss your background, ask questions, and clarify risks
Receiving an online testosterone prescription should not happen without a conversation. Speaking to a board-certified Doctor is crucial, according to Michael Aziz, the author of “The Ageless Revolution” and a regenerative physician specialist at Lenox Hill Hospital in NYC.
Patients should always confirm their doctor’s expertise and education as it relates to testosterone therapy. Perferably, the physician on the call should specialize in endocrinology, urology, and internal medicine with anti-aging training.
“To have an accurate diagnosis, a detailed medical history and exam should be conducted. A Zoom call or telemedicine should be conducted,” Aziz explained. “The doctor should take into consideration a complete review of symptoms… The clinic’s approach to TRT should be comprehensive rather than just giving a script for testosterone treatment.”
This consultation provides an opportunity for patients to discuss their goals and ask any questions they might have, but Doctors should also clarify any issues raised through the intake form or bloodwork. It’s also a good time to discuss the risks and benefits of different forms of treatement.
“The delivery method of TRT is best chosen by both the doctor and the patient based on the patient’s lifestyle and symptoms,” Aziz suggested. “Gels are used daily, but can be transferred to sexual partners and children. Injections can be self-injected once to twice a week, or administered by the doctor every 10 weeks.”
After weighing all the options, the provider will create a personalized treatement plan for the patient.
5. Get your testosterone prescription and begin treatment; follow-up to report progress and side effects
At companies like Ulo, the process for starting TRT is straightforward and streamlined. Once a patient receives their prescription, treatement can be sent to their door in as little as a week. However, the one-on-one care doesn’t stop when they start taking it.
“We rely on data and feedback from the patient. Your physician will examine your blood work and any changes in symptoms, and will ask how you’re feeling in general,” Patel shared.
At Ulo, the first lab takes place before your initial consultation with the doctor. A second lab is done 30 days after treatment begins to help prepare for your 45-day follow-up. After that, labs are required every quarter and are paired with a live consultation to make sure your treatment stays safe, effective, and personalized.
“If something seems off or if you’re not progressing as expected, the team at Ulo will make adjustments to dosage, frequency, or support meds. Everything can be fine-tuned. The goal is to ensure you feel your best,” Patel explained.
As with any treatement plan, it’s possible that your tesosterone prescription will need to be altered over time. Be sure to report any progress, concerns, or questions to your provider.
This article was written by Miska Salemann, New York Post Commerce Writer/Reporter. As a health-forward member of Gen Z, Miska seeks out experts to weigh in on the benefits, safety and designs of both trending and tried-and-true fitness equipment, workout clothing, dietary supplements and more. Taking matters into her own hands, Miska intrepidly tests wellness products, ranging from Bryan Johnson’s Blueprint Longevity Mix to home gym elliptical machines to Jennifer Aniston’s favorite workout platform – often with her adorable one-year old daughter by her side. Before joining The Post, Miska covered lifestyle and consumer topics for the U.S. Sun and The Cannon Beach Gazette.