TRT: Frequently Asked Questions
Pricing, lab kit, payment and cancellation questions: see the HeydayMD FAQ.
Answers to the most common questions about testosterone replacement therapy — safety, cost, timeline, fertility, and how to get started.
Quick answer: Testosterone replacement therapy is a prescribed medical treatment that restores testosterone levels in men diagnosed with hypogonadism. A blood test measuring total and free testosterone determines if levels are clinically low. Licensed telehealth providers can prescribe treatment after reviewing comprehensive lab work and conducting a virtual consultation. Administration methods include injections, gels, patches, or pellets under ongoing medical supervision.
Start here: testosterone therapy at HeydayMD · could it be low testosterone? · at-home testing
Testosterone replacement therapy (TRT) is a clinician-supervised treatment that restores testosterone levels in men with clinically low levels. At HeydayMD, TRT is prescribed online starting at $99 per month, with at-home lab testing, virtual provider consultations, and monthly medication delivery — no clinic visits required.
Testosterone Replacement Therapy is a prescribed medical treatment that restores testosterone to the normal range for adult men (lab reference ranges vary; targets are individual) in men diagnosed with hypogonadism. It is administered through injections, gels, patches, or pellets under ongoing medical supervision.
If you are experiencing persistent fatigue, low libido, reduced muscle mass or strength, weight gain, brain fog, or mood changes, a blood test measuring total and free testosterone can determine if your levels are clinically low (below 300 ng/dL on two separate morning tests).
The TRAVERSE trial (5,246 men) found no increased risk of heart attack, stroke, or prostate cancer with properly monitored TRT. In December 2025, an FDA expert panel recommended removing the prostate cancer warning from TRT labels.
Most men notice energy and mood improvements within 3-6 weeks. Sexual function improves within 3-6 weeks. Body composition changes become visible over 3-6 months. Full optimization typically occurs by 9-12 months.
Yes. Exogenous testosterone suppresses sperm production. This is usually reversible after stopping, but recovery can take 6-12 months. If fertility matters, discuss alternatives like clomiphene or HCG co-therapy with your provider before starting.
Heyday offers TRT starting at $99/month on the annual plan. All plans include provider consultations, medication, supplies, shipping and dose adjustments. The starter lab kit is included with the annual plan only; follow-up lab panels are $229 each.
Yes. Licensed telehealth providers can prescribe TRT after reviewing comprehensive lab work and conducting a virtual consultation. Heyday offers TRT in most states and Puerto Rico. TRT is not available in Arkansas, Connecticut, Hawaii, New Hampshire or Rhode Island, where state law restricts prescribing testosterone by telehealth, and is not yet available in Alaska, Mississippi or New Jersey. Confirm your state during intake.
The most common side effect is elevated red blood cells (polycythemia), occurring in 5-10% of patients. This is caught with regular CBC monitoring. Other possibilities include acne, fluid retention, and mood changes — all manageable with proper oversight.
TRT is a long-term treatment. Exogenous testosterone suppresses natural production, so stopping typically results in levels dropping back to or below pre-treatment levels. Most men continue indefinitely.
TRT restores testosterone to the normal range for adult men (lab reference ranges vary; targets are individual) under medical supervision. Anabolic steroid use involves supraphysiological doses (2-10x normal) without medical oversight. The goals, doses, and risk profiles are fundamentally different.
How providers decide if TRT is right for you
A diagnosis of low testosterone isn't based on a single number. A licensed clinician typically looks at your symptoms alongside more than one blood draw, since testosterone naturally fluctuates by time of day and from one day to the next. Other biomarkers — such as free testosterone, SHBG, and estradiol — help explain whether a low total testosterone reading reflects a true hormonal issue or something else, like a binding protein imbalance. A clinician will also review your medical history, including sleep, medications, and other conditions that can suppress testosterone, before deciding whether treatment is appropriate. If you want help understanding what each marker on your panel means, a guide like this one can be useful context before your consult.
What ongoing monitoring actually looks like
Once treatment starts, monitoring is not a one-time event. Most clinicians recheck labs periodically to track hematocrit, estradiol, and testosterone levels, and to adjust dosing if needed. This is also when side effects, if any, are caught early rather than after they become noticeable. Men sometimes assume that once a prescription is written, the work is done — but ongoing lab review is part of what makes supervised therapy different from self-directed use. If you're unsure what a reasonable monitoring schedule looks like, it's worth asking directly: how often are labs reviewed, who reviews them, and what triggers a dose change. See questions to ask a TRT provider for a fuller list.
Common mistakes men make when starting TRT
- Expecting a fixed timeline — individual response varies, and some changes may take longer to notice than others.
- Skipping follow-up labs because symptoms feel improved, which can mask issues like rising hematocrit.
- Not discussing fertility goals upfront, which can limit options later.
- Comparing providers only on convenience without asking how they handle dose adjustments or side effects.
Avoiding these mistakes usually comes down to treating TRT as an ongoing relationship with a clinician rather than a one-time prescription. Reading about what the first month typically involves can help set realistic expectations before you begin.
Frequently asked questions
Can lifestyle factors affect how TRT works for me?
Yes. Sleep quality, alcohol use, stress, and exercise habits can all influence how your body responds to therapy and how your labs look over time. A clinician may ask about these factors when reviewing your results, since addressing them alongside treatment is often part of a complete plan.
Do I need to stay with the same clinician the whole time?
Continuity can help, since a clinician familiar with your history and prior labs is better positioned to notice trends. If you switch providers, be prepared to share your lab history so monitoring isn't interrupted.
What should I bring to my first consultation?
Recent lab results if you have them, a list of current medications and supplements, and a clear description of your symptoms and how long you've noticed them. This helps the clinician reviewing your case make a more informed assessment.
Is it normal to have questions even after starting treatment?
Yes, and bringing them to your clinician is encouraged rather than making changes on your own. Treatment decisions, including any dose adjustments, should always be made in discussion with a licensed clinician familiar with your labs and history.
