How to get TRT in 2025: A step-by-step guide to optimizing your testosterone levels

If you’ve been feeling a little low in more than one aspect of life, you’re not alone, and chances are you’re not going crazy, either.

You may be experiencing the symptoms of low testosterone. Testosterone is the sex hormone that is responsible for a range of important functions, from hair growth and bone density to sperm count and libido levels.

Low testosterone affects millions of men, and the symptoms can feel like a slow drag on daily life. Nearly 39% of men aged 45 years and older have low testosterone, also known as hypogonadism, according to the University of Washington’s School of Public Health.

The symptoms are not the same for everyone, which can make it more challenging for men to identify the root cause. Some notice their muscles looking a little less defined than they used to. Or, possibly, they’ve struggled to maintain energy throughout the day. Others feel that they’re sex drive is nearly non-existent.

Fortunately, there are treatment options for men with low testosterone: FDA-approved injections, creams, gels, tablets, and even natural supplements that are designed to support testosterone production.

“TRT stands for Testosterone Replacement Therapy,” explained Deep Patel, the co-founder of Ulo, a telehealth company that offers tailored TRT protocols. “It’s a way of bringing your testosterone levels back into a healthy range when your body isn’t producing enough. You’re not taking extra. You’re restoring what your system is missing.”

If you’re new to the TRT space, chances are you’re not too familiar with the process for getting a TRT prescription or what types of treatments are available. The good news is that Testosterone Replacement Therapy (TRT) has become much more accessible through legitimate telehealth clinics like Ulo.

The Post has consulted several men’s health experts and leaders in the hormone space to create a step-by-step guide to getting TRT in 2025.

1. Consider your symptoms

Low testosterone can manifest through various symptoms. These include low sex drive, trouble focusing, mood swings or irritability, loss of muscle or strength despite working out, constant fatigue (even when you’re sleeping enough), increased belly fat, and even depression or anxiety.

According to Patel, many guys suffering from ‘Low T’ feel like they’re hitting a wall when it comes to their physical health and overall well-being. “The most common things guys say are ‘I can’t focus like I used to,’ ‘I feel flat mentally, physically, sexually,’ ‘I’ve lost my drive,’ ‘I work out and eat clean but don’t see results,’ ‘I just don’t feel like me anymore,’” he shared.

Often they’ve tried everything else — better sleep, different diets, supplements, lifestyle changes. “TRT is rarely the first thing they try,” said Patel. “But for many with genuinely low levels, it’s the solution that finally works.”

2. Consult a men’s health expert or find a legitimate online TRT clinic

After identifying symptoms, the next step is to consider different providers. There are a few different options for men interested in learning more about TRT.

For anyone seeking medical advice, it’s important to consult your primary care physician, especially before starting a new healthcare or wellness routine. Primary care physicians are also able to access your medical history, which is important to consider when starting TRT.

Nowadays, there are more online clinics offering TRT services. The challenge is finding one that is legitimate, affordable, and provides services that are tailored to your specific needs. Sites like Hone, Ulo, Hims, and PeterMD offer well-regarded testosterone services, with different treatment plans available.

“There are plenty of clinics that advertise TRT online,” suggested Dr. Michael Aziz, an anti-aging internist and regenerative medicine specialist at Lenox Hill Hospital in New York City. “But, patients should only consider clinics that have physicians who are board-certified and are specialized in endocrinology, urology,  and internal medicine with anti-aging training.”

Aziz added that patients should also read the online reviews about the doctors’ experience, and look for positive feedback about ease of communication, as well as rapid response to issues and treatments. 

It’s also important to verify that the clinic is using legitimate U.S.-based pharmacies and is fully compliant with telehealth laws and DEA regulations for controlled substances.

3. Get your bloodwork done

To get a testosterone prescription, you’ll need to take a TRT blood test. TRT blood tests examine the amount of the male hormone present in the blood.

Some tests offer more detailed analyses than others, including additional health markers, such as free and total testosterone, sex hormone-binding globulin (SHBG), the prostate-specific antigen (PSA), and other hormones that could be affected by TRT. These tests are most accurate when administered in the morning, when testosterone levels peak.

The normal testosterone range is considered to be anywhere between 300 and 1,000 nanograms per deciliter. The FDA only approves TRT for specific conditions, such as hypogonadism or diminished functional activity of the gonads. Most clinics also only consider testosterone prescription for men who are experiencing symptoms and have levels under 300 ng/dl.

Today, TRT clinics can mail blood tests to your door. At-home tests require a simple finger prick that you can do yourself and send back to a laboratory for analysis.

4. Wait for a diagnosis and prescription

After a licensed health provider evaluates your blood work, it’s important to meet with them to discuss your symptoms and medical history.

“The clinic should require comprehensive labs, a detailed intake process, and a real conversation with a knowledgeable provider,” said Tomo Marjanovic, the owner of Aspire Rejuvenation Clinic, a wellness center specializing in personalized hormone therapy.

Marjanovic warned that if the only interaction is an automated signup form or a rushed consult, that is a red flag. Diagnosis should never rely on numbers alone — some men at his clinic experience serious symptoms, even when their testosterone levels are slightly over 300ng/dl.

In addition to clinical symptoms and hormone levels, Marjanovic considers a patient’s family history (specifically heart disease, prostate issues, and hormone disorders) and lifestyle factors (such as stress, diet, sleep, and substance use).

“If clinical symptoms align with hormone deficiencies confirmed by lab results, the provider may prescribe TRT. This isn’t something you should get from a simple online form because it’s a medical therapy that needs real evaluation, not checkbox medicine,” he explained.

5. Consider the cost and check with your insurance for coverage options

Be sure to check with your insurance provider to see if TRT is covered. Most providers require patients to meet certain thresholds and provide medical documentation that indicates their testosterone has fallen below the normal levels, in addition to recorded symptoms.

The cost of TRT will depend on the type of treatment you are interested in. Most testosterone injections cost between $50 and $150, oral tablets around $300, and patches can reach $400.

There are certain telehealth companies that offer broader health services, which may include TRT. Subscription plans can range from $100 to $300 per month.

6. Consider the potential benefits and risks

TRT comes with a number of benefits; everything from increased energy at the gym to better sleep at night, enhanced mood, and improved intimate performance.

“When done right, TRT can give you your life back,” Patel pointed out. “The benefits people report most often are way more energy, better workouts and faster recovery, higher libido, clearer thinking and focus, emotional stability, and a sense of drive and confidence that returns.”

A 2019 study on prescription testosterone found that 52% of men claimed testosterone improved their energy, 42% saw improvements in their libido, and 29% reported muscle growth. While there are several benefits, Patel and many other experts are very transparent about the potential risks associated with TRT.

“The most common side effects include acne, water retention, or elevated red blood cell counts, which can thicken your blood. Some men experience testicular shrinkage or reduced fertility. There are also concerns about cardiovascular risks in certain populations, particularly men with existing heart conditions,” he explained.

It’s important to consider that TRT significantly suppresses natural testosterone production, which can also reduce sperm production. If fertility is important to you, Patel mentions there are medications like HCG or clomiphene that can be taken alongside TRT to preserve it.

In a 2021 study, over 90% of men maintained normal sperm counts when using these fertility-preserving medications with TRT.

7. Discuss treatment plans

There are a few different forms of TRT available, and most reputable online TRT clinics offer different types of TRT to cover individuals’ needs and preferences.

“The clinic’s approach to TRT should be comprehensive rather than just giving a script for testosterone treatment,” Aziz stressed. “The delivery method of TRT is best chosen by both the doctor and the patient based on the patient’s lifestyle and symptoms.”

Aziz says that different gels, creams, tablets, and injections are well-researched and vetted. However, some differences must be observed: “Gels are used daily but can be transferred to sexual partners and children. Injections can be self-injected once to twice a week, or administered by the doctor every 10 weeks.”

Most experts agree that injections consistently offer the most predictable results. An article in The Journal For Nurse Practitioners outlines the most viable treatment options, citing that Depo-Testosterone is the most cost-efficient TRT option and Androderm is the most efficacious TRT medication, with up to 92% of patients reaching normal testosterone levels with consistent use.

8. Start treatment and wait for the results

Many online TRT clinics can ship treatment to your front door as soon as the prescription is in place. But that’s just the beginning of the process; it takes some time to feel and see the benefits, and the timeline can also depend on the form of treatment you’re using.

“As for results, most guys feel a difference within four to six weeks. More energy, better mood, stronger libido,’ Patel explained.

He said that body composition changes — like more muscle and less fat — usually take a bit longer to notice. Some physical changes can be expected around two to three months.

“I remember one person telling us he knew it was working when he woke up one morning and actually wanted to go to the gym for the first time in years,” Patel exclaimed.

It’s not just changes in performance or appearance, but how men view themselves. “More energy, stronger sex drive, better workouts, and a sense of confidence they hadn’t felt in years,” he added.

9. Monitor progress and adjust protocols if necessary

Once you begin your treatment, it’s very important to monitor your results, watch for any potential side effects, and communicate openly with your providers.

“TRT isn’t a one-and-done therapy because hormones are dynamic, and treatment should evolve based on regular lab monitoring and patient feedback,” Marjanovic explained. Without proper diagnosis and ongoing tracking, you risk underdosing, overdosing (a lot of people don’t think this can happen, but it can), or ignoring other hormonal imbalances like estrogen dominance or thyroid dysfunction that can derail progress.”

Marjanovic recommends that TRT providers repeat labs every 8 to 12 weeks early in therapy, check symptoms regularly, and make any adjustments necessary. It’s important to address any markers that could signify side effects, including elevated hematocrit, estrogen imbalances, or libido issues.

“Personalized plan means tailoring dosage, delivery method, ancillary meds (like enclomiphene and hCG if needed), and lifestyle support based on individual needs. This is all crucial…” he explained. “TRT without follow-up isn’t therapy — it’s gambling.”

This article was written by Miska Salemann, New York Post Commerce Writer/Reporter. As a health-forward member of Gen Z, Miska seeks out experts to weigh in on the benefits, safety and designs of both trending and tried-and-true fitness equipment, workout clothing, dietary supplements and more. Taking matters into her own hands, Miska intrepidly tests wellness products, ranging from Bryan Johnson’s Blueprint Longevity Mix to home gym elliptical machines to Jennifer Aniston’s favorite workout platform – often with her adorable one-year old daughter by her side. Before joining The Post, Miska covered lifestyle and consumer topics for the U.S. Sun and The Cannon Beach Gazette.