What if low testosterone is holding you back?

Testosterone replacement therapy, or TRT, replaces testosterone your body is no longer making enough of. Testosterone affects energy, muscle, body composition, mood, concentration, bone density and sexual function, and levels decline with age. For some men the decline is steep enough to change how they feel day to day.

A blood test. Symptoms point toward it, but they overlap with a lot of other things, so we do not diagnose from symptoms alone. Common ones are persistent fatigue that sleep does not fix, lower sex drive, weaker erections, losing strength or muscle, gaining fat around the middle, low mood or irritability, and trouble concentrating.

Men 30 and over whose blood work shows underoptimized testosterone, and whose health history does not rule treatment out. Your provider makes that call after reviewing your labs and your intake answers together.

No upper limit. Older men are prescribed on the same basis as everyone else.

We are in limited states at this time but will be adding more very soon!

In California, treatment is cream only. We cannot ship injections to California.

A provider reviews your labs alongside your intake answers and you will be prompted to schedule a video call. If approved, your prescription goes to the compounding pharmacy and ships to you. In the event that you are not approved, you will not be charged.

Every shipment is a three-month supply.

We have partnered with Quest and Labcorp. We email you a requisition and you take it to a local draw site. Results typically come back in 5-7 business days.

Fasting is not required. If you are not on TRT currently, there is no special timing. Once you are on TRT the timing of your draw matters a great deal, and we will tell you exactly when to go (see the monitoring section).

Two: a daily cream or a twice-weekly subcutaneous injection. We do not offer patches, pellets or oral testosterone.

A metered pump bottle with your personalized prescriptions and instructions printed on the label. You will also be given a postcard that will contain a link to full instructions. Cream is available everywhere we currently offer TRT.

A small subcutaneous injection twice a week: under the skin, not into muscle, with a short fine needle. It ships with the vial, syringes, needles, alcohol wipes and a postcard with link to full instructions. Injections not available in California.

Both work great! Cream tends to offer more noticeable libido support with daily application. Injections are only 2 days a week instead of a daily routine. Each man is different and you can switch modalities at your renewal intervals if you choose.

• DHEA/Pregnenolone: An oral capsule that helps support healthy hormone balance, energy, mood, mental clarity, and overall vitality in men.
• Tadalafil: 5 mg tablets daily to support erectile function.

Each add-on has its own safety screening, so your offerings may be unique to you based on your medical history and symptoms.

By how you feel combined with your labs to ensure safety parameters. If the symptoms that brought you in are not improving, your provider can raise your dose, as long as your levels are in a safe range.

Your first lab recheck will be 12 weeks after your first dose. Every dose adjustment includes a video visit with a provider for at least the first year on treatment.

Timing of blood draw matters more than people expect, because a draw at the wrong point in the cycle reads artificially high or low.

• On cream: go for your draw 8 hours after that morning’s application.
• On injection: go on injection day, before you inject.

In men with low testosterone, energy, mood and libido are usually the first things to shift, often within a few weeks. Changes in muscle, strength and body composition take longer, months rather than weeks, and they depend on training and diet as much as on the hormone.

Yes, you can stop at any time. Talk to your care team first so they can walk you through what to expect, because your own testosterone production takes time to recover and some of the benefits will fade.

For the right candidate, with the right monitoring, it is well established. That is why the screening questions are strict, why labs come before a prescription rather than after, and why monitoring continues the whole time you are on therapy.

Testosterone therapy is not risk-free, and you should know what you are taking on before you start.

We check your PSA before you start and once a year after that. A PSA above the normal range means we want a urologist to clear you; often the cause turns out to be benign. Prostate cancer, or an active evaluation for suspected prostate cancer, rules testosterone out.

Message your Kiaora care team at anytime. If it is an emergency, call 911 or go to an emergency room. Do not wait for a reply.

Yes, and this is the part to read twice. Testosterone signals your body to slow its own production, and that includes sperm. Fertility usually returns after stopping, but it may not, and it may not return fully. We cannot promise it will.

Tell us on the intake and you may be offered an alternative such as enclomiphene instead. It raises your own testosterone rather than replacing it, so your fertility stays intact. It is not a testosterone prescription but can help raise testosterone to help with symptoms.

Men land here for three reasons: they live in one of the states where we cannot prescribe testosterone, their labs do not show low testosterone, or something in their health history rules it out.

• Enclomiphene. Rather than replacing testosterone, it prompts your body to make more of its own, so fertility is preserved.
• DHEA/Pregnenolone. A combined capsule helps support healthy hormone balance, energy, mood, mental clarity, and overall vitality in men. These naturally occurring hormone precursors play important roles in the body’s production of key hormones, including testosterone, and may help promote overall well-being as hormone levels change with age.
• Tadalafil. Daily 5 mg tablets for erectile function.