Our clinical standards

A diagnosis needs both symptoms and lab results that are consistently low. The Endocrine Society recommends diagnosing low testosterone only in men with symptoms and signs of deficiency and "unequivocally and consistently low" testosterone, measured in a fasting, early-morning blood sample and confirmed with a repeat morning test.

• Symptoms alone are not enough. The Endocrine Society's 2026 statement notes that low energy, libido and mood are common and have many causes, and that providers should first rule out reversible contributors such as obesity or certain medications.
• The approach is the same at any age. Age by itself is not a diagnosis.
• Your provider reviews your results against this guidance and orders a repeat morning test when one is needed.
• When total testosterone is borderline, or a condition affects the protein that carries testosterone in the blood, the guideline recommends also measuring free testosterone.
• If deficiency is confirmed, the guideline recommends looking for its cause.

There is no population screening. The Endocrine Society says there is not enough evidence to test men who have no symptoms.

Before starting, your provider checks the things that would make testosterone a poor choice for you.

• Red blood cell levels (hematocrit), because testosterone can raise them.
• Prostate cancer risk, including a PSA test where the guideline calls for one.
• Blood pressure, because testosterone can raise it.
• Your health history, medications, and any heart, liver, kidney or sleep problems.
• Whether you plan to have children.

Your provider does not start testosterone when the guidelines or the label advise against it. The Endocrine Society recommends against starting testosterone in men who plan to have children in the near term or who have:

• breast or prostate cancer;
• a prostate nodule, or a raised PSA that has not had further urological evaluation;
• elevated hematocrit;
• untreated severe obstructive sleep apnea;
• severe lower urinary tract symptoms;
• uncontrolled heart failure;
• a heart attack or stroke within the last 6 months;
• a clotting disorder (thrombophilia).

The prescribing information also lists conditions where testosterone must not be used. If your labs don't show deficiency, nothing is prescribed, and your provider explains what else may be worth looking at.

Testosterone therapy can reduce sperm production and fertility, so your provider asks about plans for children before anything is decided. The guidelines advise against starting testosterone in men planning fertility in the near term. If that applies to you, tell your provider at your first visit so you can talk through the options before any decision.

Monitoring follows a set plan while you're on treatment. The Endocrine Society recommends a standardized plan that checks symptoms, side effects and how you're taking your medication, measures testosterone and hematocrit levels, and evaluates prostate cancer risk during the first year of treatment.

• Follow-up labs and provider reviews are scheduled periodically. Your coordinator books them.
• Hematocrit, testosterone levels and prostate markers are re-checked, along with blood pressure readings you share with your provider.
• If a result moves outside the range your provider is comfortable with, your provider can change the dose, pause treatment or stop it.
• Each new medication supply needs your provider's prescription and your OK.

The goal the guideline sets is testosterone levels in the mid-normal range during treatment. It does not set a promise about symptoms, and neither do we.

Your provider chooses the medication that fits your labs, history and preferences, and explains why. Some prescribed medications may be compounded. Compounded medications are not FDA-approved, and FDA does not review them for safety, effectiveness, or quality before they are marketed. Your provider tells you which applies to you.

Women's hormone care, medical weight management and erectile dysfunction care also start with your history and lab work, and a licensed provider decides what fits. Each has its own safety page:

• Important Safety Information: hormone therapy
• Important Safety Information: GLP-1 weight-loss medications
• Important Safety Information: ED medications

FDA labels and guidance on testosterone are changing, and this standard follows the current approved labels. In June 2026 FDA requested updates to testosterone prescribing information, including removing the limitation of use about low testosterone due to aging. Those changes are requested, not yet approved in the labels this page relies on. We review this page when the labels change.

Testosterone is FDA-approved for men with low testosterone caused by certain medical conditions. Its safety and effectiveness for low testosterone due to aging alone have not been established. Testosterone can raise blood pressure and red blood cell count, reduce sperm production and fertility, and requires monitoring of the prostate and blood levels. Your provider will review the benefits and risks and monitor you with regular labs.

Testosterone is a controlled substance because it can be misused. Abuse and dependence have been reported, mostly at doses above those prescribed. Take it only as your provider directs.

Testosterone is a Schedule III controlled substance. Depending on your state, and on federal telemedicine rules that are currently set to change after December 31, 2026, an in-person exam may be required before or during treatment.

Read the full Important Safety Information for testosterone

Prescription treatment requires an evaluation by a licensed healthcare provider, who decides whether treatment is appropriate for you. Not everyone qualifies. Completing an assessment, booking a visit, or paying a fee does not guarantee a prescription.

1. Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715. PubMed
2. Endocrine Society. Statement on Testosterone Replacement Therapy. July 16, 2026. endocrine.org
3. Mulhall JP, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018;200(2):423. PubMed
4. Depo-Testosterone (testosterone cypionate) prescribing information, revised August 2026. DailyMed
5. U.S. Food and Drug Administration. Testosterone Information. fda.gov