Hormone therapy that starts with your labs, not a sales pitch.
Testosterone and hormone care under real physician oversight. Baseline bloodwork before anything is prescribed, honest thresholds, monitoring that doesn't stop after the first refill, and a straight answer about what your numbers mean, whichever way they point.
When something feels off.
Hormones change with age, and sometimes those changes cause real symptoms. Sometimes they don't. The honest first step is finding out which one is true for you.
For men
- + Fatigue that a good night's sleep doesn't fix
- + Low libido or changes in sexual function
- + Harder to build or keep muscle, even with training
- + Low mood, irritability, or a persistent mental fog
- + These symptoms, plus lab-confirmed low testosterone
For women
- + Hot flashes and night sweats in perimenopause or menopause
- + Sleep that keeps breaking, and the exhaustion that follows
- + Mood swings, anxiety, or brain fog that arrived with cycle changes
- + Vaginal dryness or discomfort
- + Irregular or changing periods in your 40s and 50s
One honest caveat before anything else: every symptom on those lists has more than one possible cause. Fatigue and low mood can come from depression, poor sleep, thyroid problems, or sleep apnea. Low energy often travels with weight gain, and each makes the other worse. Part of your doctor's job is ruling those in or out, not assuming hormones explain everything.
Labs first. Always.
You cannot practice good hormone medicine without bloodwork. So the doctors here don't try. Here's the promise:
- Baseline labs before anything is prescribed. No testosterone, no estrogen, no exceptions, and no guessing from a symptom questionnaire. Your doctor orders the panel that fits your situation: hormones plus the related markers that matter for safe treatment.
- Repeat testing to confirm. Testosterone in particular varies day to day and hour to hour. A single low reading isn't a diagnosis, so low results are confirmed with a second morning measurement before treatment starts, the standard set by the Endocrine Society.[1]
- Numbers and symptoms, together. A lab value without symptoms isn't a disease, and symptoms without supporting labs aren't a testosterone deficiency. An honest evaluation weighs both, never just one.
- Monitoring that continues. If you start treatment, labs are repeated on a schedule to check your response and your safety markers, and your dose is adjusted by your doctor from real data rather than from how a month happened to feel.
What your levels actually measure.
Most people are handed a number and a verdict. Here's what's behind the number, so you can follow the reasoning yourself.
Total testosterone
The headline number, and the most misread one. It measures all the testosterone in your blood, but most of it is bound to carrier proteins and isn't available to your tissues. A total that looks reassuring can sit on top of a genuine problem, and a total that looks low can be an artifact of a bad draw time or an ordinary illness. On its own, it settles less than people think.
Free testosterone and SHBG
SHBG (sex hormone binding globulin) is the protein that holds most of your testosterone in circulation. Free testosterone is the small fraction that isn't bound and can actually act on your tissues. This matters because SHBG moves: it rises with age and with thyroid overactivity, and falls with obesity and insulin resistance. When SHBG is unusual, the total becomes misleading and the free level is what tells the story. That's the difference between reading a lab and interpreting one.
Why morning, and why twice
Testosterone follows a daily rhythm (highest in the morning, drifting down through the day), so an afternoon draw can produce a "low" result in a man whose levels are entirely normal. It also fluctuates day to day, and a passing illness can push it down on its own. That's why a low morning result is confirmed with a second morning measurement before it means anything, exactly as the Endocrine Society guideline directs.[1] One number, drawn at lunchtime, is not a diagnosis. It's a reason to test properly.
The markers around it
A hormone panel rarely stops at hormones. LH and FSH help locate where a problem originates: the testicles themselves, or the pituitary signal upstream. That changes what the finding means and what should happen next. Thyroid function, prolactin, blood count, and metabolic markers are often part of the same draw, because the conditions that mimic low testosterone are common, treatable, and easy to miss if nobody looks. Sometimes the panel's real value is finding the thing that wasn't hormones at all.
Hematocrit and PSA
These two show up on hormone panels and deserve an explanation. Hematocrit is the percentage of your blood made up of red cells (essentially how thick your blood is), and it's followed over time because it can drift upward and because that drift is easy to catch early and act on. PSA is a prostate marker, tracked alongside age and history to make sure nothing gets missed. Neither is a formality. They're the reason this belongs under a physician rather than in an app.
What a number can't do
Hormones don't explain a life. A level in the normal range won't fix fatigue that comes from poor sleep, untreated depression, or a schedule no one could survive. Finding a number to blame can also quietly delay treating the thing that's actually wrong. And there is no version of this where higher is better: a level pushed above the normal range hasn't been shown to add benefit, only risk. Normal is the target, not a starting line.
TRT, minus the hype.
What treatment can do
For men with genuinely low testosterone confirmed on labs, treatment can meaningfully improve sexual desire and function, and mood. Combined with actual training, it can help with muscle mass and strength. The large Testosterone Trials showed clear benefits for sexual function and mood, with more modest effects on energy.[2] Benefits build over weeks to months, not days. That's the honest timeline, and anyone promising faster is selling something. Results vary between people, and nothing here is a guarantee.
What it can't do
Testosterone won't fix fatigue caused by poor sleep, untreated depression, or an overloaded life. It isn't an anti-aging cure. And treating a normal level is not a plan: if your numbers are fine, your doctor will say so rather than write something to keep you happy.
Monitoring, honestly
Testosterone therapy has real, manageable risks, and managing them is the whole point of physician oversight. It can raise your hematocrit, essentially the thickness of your blood, which your doctor checks regularly and acts on if it climbs. On the heart: the largest safety trial to date found testosterone did not increase major cardiovascular events in higher-risk men with low levels, though it did see somewhat more atrial fibrillation and blood clots.[3] Your doctor will walk through what's known against your personal risk factors rather than waving it away. Depending on your age and history, prostate-related monitoring may be part of your plan too.
In practice, that means a real panel rather than a single number. Expect baseline bloodwork and then repeat labs on a schedule: your testosterone level drawn at a consistent point in your dosing cycle, hematocrit every time, PSA where your age and history call for it, and the thyroid, metabolic, or estradiol markers your history makes relevant. If something drifts, the plan changes. That is what treatment under a real practice looks like, and it is the part the cheap protocols leave out.
Menopause, evaluated properly.
There is no single menopause protocol, because there is no single menopause. What's right depends on your symptoms, your age, how far you are from your last period, and your personal and family history. Those four things vary enormously between two women the same age.
A point worth knowing before you get your results: in perimenopause, hormone levels swing week to week, which is exactly why a single blood level rarely settles the question. The evaluation leans on your symptoms and your cycle history, with labs used to rule out the lookalikes, especially thyroid disease, which can imitate the whole picture and is straightforward to identify once someone checks.
Options your doctor may discuss center on estradiol and, if you have a uterus, progesterone to protect the uterine lining. For symptoms like vaginal dryness, low-dose local estrogen can help with very little absorption into the rest of the body. For hot flashes and night sweats, hormone therapy remains the most effective treatment available. That part isn't hype. It's the position of The North American Menopause Society.[4]
The rest is honest and individual. For most healthy women near the start of menopause, the benefits of treating significant symptoms generally outweigh the risks. Starting many years after menopause, or with a history of breast cancer, blood clots, or stroke, the calculation changes. Your doctor will walk you through it plainly rather than handing you a yes or a no without reasons. Some histories mean hormone therapy isn't the right tool at all, and you deserve to hear that directly.
The medicines, in plain terms.
What your doctor may discuss once your labs and symptoms point to treatment. Which one fits, if any, is a decision the two of you make from your results. It isn't a menu you order from.
Testosterone cypionate
A long-acting injectable testosterone, usually given weekly. It's the most-studied and often most cost-effective way to bring low levels back into a healthy range.
Testosterone gel
A gel applied to the skin each day for steadier levels and no needles. It calls for care to avoid transferring it to partners or children through skin contact.
Clomiphene / enclomiphene
Taken by mouth, these can prompt your body to raise its own testosterone while preserving sperm production, which is worth discussing if fertility matters to you. This is an off-label use your doctor will explain plainly.
Estradiol + progesterone
Estradiol eases hot flashes, night sweats, and other menopause symptoms. Progesterone is generally added to protect the uterine lining if you have a uterus. Form and dose are matched to you.
Examples patients ask about, not a menu and not a promise. Your doctor prescribes only what fits your labs and your history, and anything prescribed is dispensed and billed by an independent licensed pharmacy. everydaymd never handles or sells medication.
Important safety information
Testosterone is a Schedule III controlled substance. Therapy can raise red blood cell counts (polycythemia), suppresses sperm production and fertility while on treatment, can worsen untreated sleep apnea, and can cause acne or fluid retention. Responsible treatment includes baseline and ongoing monitoring of hematocrit and PSA, and individualized assessment of cardiovascular risk. Testosterone should not be used by men with prostate or breast cancer and has no place in pregnancy. This is not a complete list of risks. Treatment always follows labs and a physician evaluation, with monitoring throughout.
What your doctor will ask.
A little prep makes your first visit faster and more useful. Come ready to talk through:
Come prepared
- + Your main symptoms: when they started and how they affect your days
- + Everything you take, including supplements and anything hormonal
- + Past bloodwork and past treatment, and what did or didn't help
- + Personal and family history: heart, prostate or breast health, and blood clots
- + Whether having children, now or later, matters to you
- + What you're actually hoping treatment will change
Who this isn't for.
Good medicine includes knowing when to say no. Hormone therapy through everydaymd isn't the right fit if:
- You have a history of prostate cancer. Testosterone decisions in that setting belong in person, with your urologist or oncologist rather than a telehealth visit.
- You are pregnant, breastfeeding, or trying to conceive. Hormone therapy isn't appropriate in pregnancy, and TRT works against male fertility rather than for it.
- You're under 18. everydaymd serves adults only.
- You want supraphysiologic "optimization." The doctors here treat to health, not to bodybuilding numbers. If you're looking for a doctor who will push your levels above the normal range, that isn't the medicine practiced here. No amount of asking will change the answer.
If your doctor can't treat you safely, we'll say so at your visit and point you toward care that can. And if care isn't available in your state at all, your visit fee is fully refunded. See our refund policy.
Five steps, none skipped.
Most patients have their first visit within 24 to 48 hours. Visit hours run roughly Monday through Friday, 10 AM to 4 PM Eastern.
Meet your doctor
A private, HIPAA-secure video visit. Your history, your symptoms, your goals. A real conversation, not a checkout form. You'll review our telehealth consent before care begins.
Get your baseline labs
Your doctor orders bloodwork drawn locally near you, timed properly: morning draws where timing matters. Your care team arranges the specifics after your visit. Nothing is prescribed before results are in.
Review the results together
Your doctor walks through your numbers in plain English: what supports treatment, what doesn't, and what else the labs might be pointing at. This is the visit that most people have never actually had.
Start a plan, if it's right
If labs and symptoms both support treatment, you'll get a plan built for you. Any prescription your doctor writes goes to an independent licensed pharmacy, which sets its own price, quotes it before anything is filled, and ships it to you or holds it for pickup. everydaymd never handles or sells medication.
Monitor and adjust
Repeat labs on a schedule, dose changes your doctor makes from real data, and a care team you can message. Hormone care is ongoing by design. That's exactly what the $99/month membership is built for. It covers your visits and your messaging, never medication.
Numbers and symptoms, together. Never one without the other.
Hormone questions, straight answers.
Yes, always. Your first visit is a conversation and an evaluation, not a prescription. Your doctor then orders baseline bloodwork, confirms low results on repeat testing where that's the standard (as it is for testosterone), and only then discusses treatment. Anyone offering hormones without labs is guessing with your health, and charging you for the guess.
Then your doctor will tell you, plainly, and won't prescribe hormone therapy. That's not a loophole in our model. It is our model. You'll go over what your labs do show and what's more likely behind your symptoms, whether that's sleep, thyroid, mood, weight, or something that needs in-person care. A real answer that isn't the one you wanted still beats a comfortable answer that's wrong.
Not on its own. Testosterone peaks in the morning and drifts down through the day, so an afternoon draw can read low in someone perfectly normal. It also moves day to day, and a recent illness can drag it down by itself. That's why a low morning result gets confirmed with a second morning measurement.[1] It's also worth asking whether the number you were given was a total or a free level. With unusual SHBG, those two can tell opposite stories.
Yes. Testosterone is a Schedule III controlled substance under federal law. That means a physician prescribes it only when it's clinically appropriate and permitted by state and federal law, and doing so may require extra identity verification, or in some cases an in-person evaluation. If it can't be prescribed for you safely and legally, your doctor will tell you plainly rather than bend the rules.
Some clinics are built so that nearly every man who walks in walks out with testosterone. We're built differently: the decision is made after your labs, not before your credit card. Your visit fee pays for a physician's judgment and nothing else. If testosterone is prescribed, the pharmacy that dispenses it sets its own price and bills you directly, so there's no product at the end of the funnel that anyone here does better if you take. If your labs don't support treatment, you'll hear exactly that.
Your doctor sends the lab order, and you complete the draw locally. Your care team arranges the specifics with you after your visit, including timing, since morning draws matter for some of these numbers. Lab work is separate from your visit fee, and your care team will go over the details before you commit to anything.
Honestly: weeks to months, not days. On TRT, libido and mood often shift within the first several weeks, while energy, body composition, and strength take longer and depend on what you do alongside treatment. For menopause symptoms, hot flashes and night sweats often improve within a few weeks of the right dose. Your follow-up labs and visits are where you and your doctor confirm it's working, and adjust if it isn't. Results vary, and nothing is guaranteed.
Then finding that out is the most valuable thing your visit does. Thyroid disease, sleep apnea, depression, and insulin resistance all produce the same tired, foggy, low-libido picture, and all of them are treatable once identified. A hormone workup that ends in a different diagnosis isn't a wasted visit. It's the one that finally got the question right.
Sources
- Bhasin S, Brito JP, Cunningham GR, et al. "Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline." J Clin Endocrinol Metab. 2018;103(5):1715–1744. PubMed
- Snyder PJ, Bhasin S, Cunningham GR, et al. "Effects of Testosterone Treatment in Older Men." N Engl J Med. 2016;374(7):611–624. PubMed
- Lincoff AM, Bhasin S, Flevaris P, et al. "Cardiovascular Safety of Testosterone-Replacement Therapy." N Engl J Med. 2023;389(2):107–117. PubMed
- "The 2022 Hormone Therapy Position Statement of The North American Menopause Society." Menopause. 2022;29(7):767–794. PubMed
Ready when you are.
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