Testosterone Replacement Therapy
Physician-supervised TRT prescribed and monitored by a board-certified internist. Comprehensive hormone workup, ongoing safety labs, and a physician's judgment — not a testosterone mill.
Not Just a Number
Low testosterone affects an estimated 1 in 4 men over 30. The symptoms — fatigue, brain fog, low drive, stubborn weight gain, poor sleep — are real and measurable. But most primary care physicians check a single total testosterone level and call it a day.
At Private MD, we run the full picture: total and free testosterone, SHBG, estradiol, LH, FSH, metabolic markers, and safety labs. If your levels are genuinely low, we treat it. If something else is going on, we find it.
How the Program Works
1. Full Hormone Panel
Comprehensive lab workup: total & free testosterone, SHBG, estradiol, LH, FSH, DHEA-S, prolactin, PSA, CBC, lipids, metabolic panel. Two morning draws to confirm levels.
2. Physician Evaluation
Extended visit to review your labs, symptoms, medical history, and goals. We discuss whether TRT is appropriate, what to expect, and which formulation fits your lifestyle.
3. Treatment & Monitoring
If you qualify, we prescribe testosterone and monitor you closely — hematocrit, PSA, lipids, and hormone levels every 3–6 months. Dose adjustments based on labs and how you feel.
What We Prescribe
Testosterone Cypionate
Injectable — IM or subcutaneous
The gold standard. Most cost-effective option at ~$30–50/month. Weekly or biweekly injections. Stable levels, well-studied, decades of clinical data.
Testosterone Gel
Topical — daily application
Applied daily. No injections. Good option for patients who prefer topical application. Higher cost than injectable. Requires precautions around skin contact with others.
Your physician will recommend the best option based on your lifestyle, preferences, and medical history. We do not prescribe pellets, patches, or compounded formulations.
Who Qualifies
TRT is appropriate for men with clinically confirmed low testosterone. This means:
- Symptoms — fatigue, low libido, brain fog, decreased muscle mass, mood changes, poor sleep, weight gain
- Confirmed low levels — at least two morning testosterone draws below the normal range
- No contraindications — we screen for conditions where TRT may not be safe (active prostate cancer, uncontrolled polycythemia, untreated sleep apnea)
Important: TRT and fertility. Testosterone replacement suppresses sperm production and can significantly reduce fertility. If you are planning to have children or want to preserve that option, this must be discussed before starting treatment. We will review your fertility goals at your initial evaluation.
Known risks of TRT. Polycythemia (elevated red blood cell count) is the most common safety concern and is monitored with regular hematocrit checks. Other potential effects include acne, fluid retention, mood changes, and worsening of untreated sleep apnea. The TRAVERSE trial (2023) — the largest randomized TRT safety study to date — found no increased cardiovascular risk in hypogonadal men, though earlier studies were mixed. These risks are manageable with proper monitoring and dose adjustment — which is why we check labs every 3–6 months.
We do not prescribe testosterone for bodybuilding, performance enhancement, or to men with normal levels. This is evidence-based medicine, not a hormone optimization clinic. All patients complete a medical evaluation and informed consent before beginning treatment.
Pricing
TRT is included in both of our membership plans when clinically indicated. See full pricing →
Testosterone cypionate medication is typically $30–50/month at cash-pay pricing.
Why Private MD for TRT
- Board-certified internist — not a clinic staffed by NPs or PAs. Your testosterone is managed by a physician with 20+ years of internal medicine experience.
- Real diagnosis first — we confirm low testosterone with proper testing before prescribing anything. No questionnaire-only assessments.
- Safety monitoring — hematocrit, PSA, and metabolic labs every 3–6 months. TRT without monitoring is reckless. We don't do that.
- Whole-patient care — testosterone is one piece. We also manage your blood pressure, metabolic health, sleep, and everything else. That's the advantage of getting TRT from your primary care physician.
- Direct access — call or text your physician directly with questions about dosing, side effects, or labs. No waiting for callbacks.
- Hindi, Urdu, Punjabi spoken — care in the language you're most comfortable with.
Frequently Asked Questions
How do I know if I have low testosterone?
Common symptoms include persistent fatigue, low libido, brain fog, weight gain (especially around the midsection), decreased muscle mass, irritability, and poor sleep. However, symptoms alone aren't enough — diagnosis requires at least two morning blood tests confirming low levels. We start with a comprehensive hormone panel.
Is testosterone a controlled substance?
Yes. Testosterone is classified as a Schedule III controlled substance by the DEA. It requires a valid prescription and is only prescribed after confirmed clinical hypogonadism. All prescribing follows federal and California state guidelines.
What are the risks of TRT?
The most common concern is polycythemia (elevated red blood cell count), which is why we monitor hematocrit regularly. Other potential effects include acne, fluid retention, and changes in fertility. TRT can suppress sperm production — if fertility is a concern, we discuss this before starting treatment. Proper monitoring minimizes these risks significantly.
Can I do follow-ups virtually?
Yes. After your initial evaluation (telemedicine), most follow-up visits can be done via telemedicine. Lab work is done at local Quest Diagnostics sites in Folsom or El Dorado Hills and we review results together virtually.
How is this different from a testosterone clinic?
Testosterone clinics typically prescribe based on a questionnaire and a single lab draw, often staffed by mid-level providers. We require confirmed low levels on two separate morning draws, evaluate the underlying cause, monitor safety labs every 3–6 months, and manage your entire health — not just your testosterone. Your physician is board-certified in internal medicine with 20+ years of experience.
Join With Your Partner
Hormonal changes affect both men and women in their 40s and 50s. Many of our members join as a couple — one on TRT, the other on HRT for perimenopause or menopause. Having one physician who knows both of you makes coordination easier and ensures nothing falls through the cracks.
Mention your partner when you fill out the form below and we'll schedule you together.
Interested in Testosterone Therapy?
Ready to get started, or just have questions? Tell us where you are and we'll reach out.