TRT and Hormone Therapy for Men in Scarsdale, NY

Testosterone replacement therapy restores testosterone in men whose bodies no longer make enough of it, a condition doctors call hypogonadism and most people call low T. At Protocol Health, TRT starts with a diagnosis, not a prescription. The Endocrine Society guideline recommends treating only men with consistent symptoms and unequivocally low total testosterone confirmed on two separate early-morning tests, because testosterone peaks in the morning and a single afternoon draw can make a normal level look low.

Fatigue, low libido and low mood have many causes, so symptoms alone are not enough. Fewer morning erections is one of the more specific signs. If these sound familiar, the next step is morning labs, not a prescription.

• Low sex drive or fewer morning erections
• Fatigue or low motivation
• Loss of muscle or strength, more body fat
• Low mood or poor concentration
• Men planning children should say so at the first visit

TRT is a long-term treatment, and monitoring is what keeps it safe. These are the questions to ask before you start.

Fertility. Testosterone from outside the body suppresses sperm production, often to very low levels. Men who want children in the near term are usually better served by enclomiphene or hCG.

Hematocrit. Testosterone raises red blood cell production. A hematocrit above 54% means the dose is paused or reduced.

PSA. TRT is not started in men with prostate cancer, and a raised or rising PSA gets a urology evaluation first.

The heart. In the 2023 TRAVERSE trial of 5,246 men at high cardiovascular risk, testosterone was noninferior to placebo for heart attack, stroke and cardiovascular death (7.0% vs 7.3%), but showed higher rates of atrial fibrillation, acute kidney injury and pulmonary embolism.

Sexual function. In men with confirmed low testosterone, the evidence is strongest for sexual function. In the Testosterone Trials, a year of testosterone gel moderately improved sexual function and slightly improved mood.

Body composition and bone. TRT increases lean mass, reduces fat mass and supports bone density in men with low testosterone.

Energy is less certain. The same trials did not show a significant improvement in vitality or energy. TRT is not a treatment for normal age-related tiredness in men whose testosterone is normal.

The options. Testosterone cypionate injections, testosterone gel or cream, enclomiphene and hCG. Your labs, goals and fertility plans decide which fits.

Four steps, in the clinic or by telehealth.

1. Evaluation. A provider reviews your symptoms, history, medications and fertility plans.
2. Morning labs, twice. Total and free testosterone, estradiol, LH and FSH, PSA and a CBC (including hematocrit), drawn early in the morning at the clinic and repeated to confirm.
3. A plan that fits your labs. If you have hypogonadism, your provider recommends testosterone, enclomiphene, hCG or a combination. If you do not, you hear that too.
4. Monitoring. Labs a few months after starting or changing a dose, then at least yearly once stable.

Protocol Health's TRT clinic is at 700 White Plains Rd #30 in Scarsdale, with morning testosterone labs drawn on site. Patients come from across Westchester County, including Scarsdale, White Plains, Eastchester, New Rochelle and Yonkers, and eligible patients in NY, NJ, CT, FL and CA can be seen by telehealth.

At Protocol Health, 700 White Plains Rd #30, Scarsdale, NY 10583. Providers diagnose low testosterone with morning labs drawn on site and prescribe TRT after an evaluation. Eligible patients can also be treated by telehealth in New York, New Jersey, Connecticut, Florida and California.

Low T is diagnosed from symptoms plus consistently low total testosterone on two separate early-morning blood tests. A single low reading or symptoms alone are not enough.

Yes. Testosterone therapy suppresses sperm production. Sperm production usually recovers after stopping, but recovery can take many months and is not guaranteed, so tell your provider at the first visit if children are in your plans.

In the TRAVERSE trial, testosterone was noninferior to placebo for major heart events in men at high cardiovascular risk, but showed higher rates of atrial fibrillation, acute kidney injury and pulmonary embolism. That is why monitoring is part of every plan.

The Male Hormone & Longevity Assessment is $349 at the clinic and includes bloodwork, a SECA body composition scan and a grip strength test. The Telehealth Hormone & Longevity Assessment is $249.

Protocol Health is a direct-care practice. We can provide documentation you may submit for eligible out-of-network benefits, and HSA and FSA cards are accepted for eligible services.