Testosterone Replacement Therapy (TRT)

Testosterone replacement therapy (TRT) treats clinically diagnosed hypogonadism — low testosterone confirmed by blood tests plus symptoms. Clinical practice guidelines from the Endocrine Society and the American Urological Association (AUA) require two separate morning testosterone measurements before starting treatment, and ongoing monitoring of blood counts and prostate markers while on it.

Testosterone Replacement Therapy (TRT)

We track 562 verified clinics offering Testosterone Replacement Therapy (TRT) across our directory. Across 23 clinics with published pricing, cash-pay TRT programs report a median range around $199-$399/mo. Nationally, year-one injectable TRT runs $800–$5,110 cash-pay (typical midpoint $2,299/yr) covering labs, consults, and medication. Average public Google rating across 524 rated clinics: 4.7★ from 33,265 reviews.

Updated 2026-08-15. Cost figures are estimates, not quotes. See the full year-one cost breakdown.

Diagnostic Biomarker & Clinical Prerequisite Summary

How many clinics offer Testosterone Replacement Therapy (TRT)?

Our directory currently tracks 562 verified clinics offering Testosterone Replacement Therapy (TRT). Testosterone replacement therapy (TRT) treats clinically diagnosed hypogonadism — low testosterone confirmed by blood tests plus symptoms. Clinical practice guidelines from the Endocrine Society and the American Urological Association (AUA) require two separate morning testosterone measurements before starting treatment, and ongoing monitoring of blood counts and prostate markers while on it.

What TRT is and who it's for

TRT restores testosterone to normal physiologic levels in men with hypogonadism. The Endocrine Society and the American Urological Association (AUA) both require a confirmed biochemical diagnosis — at least two morning blood draws showing low total testosterone (the AUA uses below 300 ng/dL as a reasonable cutoff) — together with symptoms such as low libido, erectile dysfunction, fatigue, or loss of muscle mass.

FDA-approved testosterone products are indicated for men with hypogonadism caused by identified medical conditions. The U.S. Food & Drug Administration (FDA) has cautioned that the benefit and safety of testosterone solely for age-related decline have not been established, which is why reputable clinics test first and treat a diagnosis — not an age.

Delivery methods

• Injections (testosterone cypionate or enanthate, weekly or twice-weekly, IM or subcutaneous) — least expensive, most common in cash-pay clinics
• Topical gels and creams — steady levels, transfer risk to partners and children
• Pellets implanted under the skin every 3–6 months — convenient but hard to adjust once placed
• Oral formulations and nasal gel — newer FDA-approved options, typically more expensive

Risks, side effects, and who should not take it

The most common laboratory side effect is erythrocytosis (elevated red blood cell count), which is why clinical guidelines from the Endocrine Society require monitoring hematocrit. TRT suppresses sperm production — men who want children soon should discuss fertility-preserving alternatives before starting. Other possible effects include acne, fluid retention, breast tenderness, testicular shrinkage, and worsening of untreated sleep apnea.

On cardiovascular safety: the landmark TRAVERSE trial (New England Journal of Medicine, 2023) found testosterone therapy non-inferior to placebo for major adverse cardiac events in middle-aged and older men with hypogonadism and elevated cardiovascular risk, though the treated group had higher rates of atrial fibrillation, pulmonary embolism, and acute kidney injury. AUA guidelines recommend avoiding TRT in men with active prostate or breast cancer, a hematocrit above ~54%, severe untreated sleep apnea, or a recent heart attack or stroke.

What TRT typically costs

Across the clinics in this directory, cash-pay injection programs commonly run $99–$250 per month including provider oversight and follow-up labs. Pellet programs typically cost $600–$1,000 per insertion (3–4 per year). Insurance sometimes covers testosterone when a documented deficiency exists, but many longevity clinics are cash-pay only. Ask any clinic for its all-in monthly price — medication, visits, and lab work — before enrolling.

How much does Testosterone Replacement Therapy (TRT) cost?

Across 23 clinics with cited published pricing, reported cash prices for TRT median at $199-$399/mo. Across the clinics in this directory, cash-pay injection programs commonly run $99–$250 per month including provider oversight and follow-up labs. Pellet programs typically cost $600–$1,000 per insertion (3–4 per year). Insurance sometimes covers testosterone when a documented deficiency exists, but many longevity clinics are cash-pay only. Ask any clinic for its all-in monthly price — medication, visits, and lab work — before enrolling.

Which clinics offer Testosterone Replacement Therapy (TRT)?

What clinical guidelines and risks govern Testosterone Replacement Therapy (TRT)?

Important: Testosterone is a Schedule III controlled substance. FDA-approved testosterone products are indicated for diagnosed hypogonadism — not for age-related decline alone. Any clinic that prescribes without confirmed morning labs, or ships medication without a clinical evaluation, is operating outside guideline-based care from the Endocrine Society and AUA. The most common laboratory side effect is erythrocytosis (elevated red blood cell count), which is why clinical guidelines from the Endocrine Society require monitoring hematocrit. TRT suppresses sperm production — men who want children soon should discuss fertility-preserving alternatives before starting. Other possible effects include acne, fluid retention, breast tenderness, testicular shrinkage, and worsening of untreated sleep apnea. On cardiovascular safety: the landmark TRAVERSE trial (New England Journal of Medicine, 2023) found testosterone therapy non-inferior to placebo for major adverse cardiac events in middle-aged and older men with hypogonadism and elevated cardiovascular risk, though the treated group had higher rates of atrial fibrillation, pulmonary embolism, and acute kidney injury. AUA guidelines recommend avoiding TRT in men with active prostate or breast cancer, a hematocrit above ~54%, severe untreated sleep apnea, or a recent heart attack or stroke.

Frequently Asked Questions

What testosterone level qualifies for TRT?

Endocrine Society and AUA guidelines commonly use a total testosterone below roughly 300 ng/dL, confirmed on two separate morning blood draws, plus consistent symptoms. A single low reading is not enough — levels vary day to day and drop when tested later in the day.

How much does TRT cost per month?

Typical cash-pay clinic programs run $99–$250/month for injectable protocols including oversight and periodic labs. Gels and oral formulations cost more. Pellet therapy runs $600–$1,000 per insertion every 3–6 months.

How long until TRT works?

Libido and energy changes are usually noticed within 3–6 weeks. Body-composition changes (muscle, fat) develop over 3–6 months of consistent therapy alongside training and diet.

Is TRT safe for the heart?

The 2023 TRAVERSE trial (New England Journal of Medicine) found no increase in major adverse cardiac events versus placebo in men with diagnosed hypogonadism, but did observe more atrial fibrillation, pulmonary embolism, and kidney injury in the treated group. Men with recent heart attack or stroke are typically not candidates per AUA guidelines. Discuss your cardiac history with the prescribing clinician.

Does TRT cause infertility?

TRT suppresses the hormonal signals that drive sperm production, often dramatically. Men planning to have children should tell the clinic up front — alternatives such as clomiphene or hCG-based protocols can raise testosterone while preserving fertility.

Will I be on TRT for life?

Usually, yes — TRT treats the symptom, not the cause, and natural production is suppressed while on therapy. Stopping typically returns levels (and symptoms) to baseline over several months. Treat it as a long-term commitment with ongoing monitoring.

What lab tests are required before starting Testosterone Replacement Therapy (TRT)?

Required diagnostic labs include Total & Free Testosterone, SHBG, Estradiol, Comprehensive Metabolic Panel (CMP), Lipid Panel, PSA (for men), and Complete Blood Count (CBC) to check hematocrit levels.

What labs should a legitimate TRT clinic order first?

Per Endocrine Society and AUA guidelines: two morning total testosterone levels, LH and FSH (to distinguish testicular from pituitary causes), CBC for hematocrit, PSA for men of screening age, estradiol, and a metabolic panel. A clinic that prescribes without baseline labs is a red flag.

Can I get TRT through telehealth?

Yes — many clinics in this directory operate telehealth models with local lab draws. Testosterone is a Schedule III controlled substance under federal law (21 U.S.C. § 812), so federal and state telehealth prescribing rules apply and change periodically; legitimate telehealth clinics will still require labs and a real clinical evaluation.

Browse all TRT clinics

References & Recognized Medical Board Citations

Directory clinical prerequisites, baseline bloodwork guidelines, and treatment protocols listed on VerifiedAntiAgingClinics.com align with published clinical practice guidelines established by recognized national medical boards and professional societies, including the American Board of Obesity Medicine (ABOM), American Board of Urology (ABU), American Board of Internal Medicine - Endocrinology (ABIM), The Endocrine Society, The Menopause Society, and the American Urological Association (AUA).

1. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline (Bhasin et al., 2018) — Journal of Clinical Endocrinology & Metabolism
2. Evaluation and Management of Testosterone Deficiency: AUA Guideline — American Urological Association
3. Cardiovascular Safety of Testosterone-Replacement Therapy (TRAVERSE trial, Lincoff et al., 2023) — New England Journal of Medicine
4. Testosterone Information: Safety Communications and Labeling Requirements — U.S. Food & Drug Administration

Page updated 2026-08-15. Ratings and review counts are aggregated from public Google Business Profiles and are not our own reviews.