Question 1

How much does TRT cost per month?

Accepted Answer

$149 per month, flat. That covers the TRT program: provider visits, your medication, delivery to your door, and initial labs. Your initial video consult is free. Enclomiphene, tadalafil, sermorelin, hCG, and tirzepatide are separate standalone products priced on their own — you are never billed for them without choosing them.

Question 2

What states do you serve?

Accepted Answer

Arizona and Utah. Arizona is live and booking now. Utah is not yet accepting patients — you can join the list to be notified the day we open.

Question 3

How long does TRT take to work?

Accepted Answer

It varies from person to person. Some men notice changes in energy, mood, or sleep within the first few weeks. Other changes — body composition, libido — tend to come on more gradually over the first few months. Your provider checks your levels at follow-up to confirm the dose is doing what it should. No clinical outcome is guaranteed, and your provider tells you honestly if your symptoms are not improving.

Question 4

Is TRT safe?

Accepted Answer

TRT is generally safe for men with confirmed low testosterone and no contraindications, when it is monitored. Certain existing conditions make it unsafe — untreated severe sleep apnea, uncontrolled heart failure, a recent history of hormone-sensitive cancer, or markedly elevated hematocrit. That is why a provider reviews your full history and labs before prescribing, and monitors you during treatment. The long-term effects of TRT over decades are not fully characterized, which is why ongoing follow-up is standard.

Question 5

What are the side effects of TRT?

Accepted Answer

Common side effects include acne or oily skin, mild fluid retention, breast tenderness, and mood changes — most appear early and often improve as your dose stabilizes. More serious risks include elevated hematocrit (thickened blood), which is why it is monitored, and suppression of natural testosterone and sperm production. Side effects vary by individual and delivery method. Your provider adjusts your protocol based on your labs and how you feel.

Question 6

Does TRT cause hair loss?

Accepted Answer

Testosterone therapy can accelerate pattern (androgenic) hair loss in men who are genetically predisposed to it. It does not cause hair loss in men who are not. If hair loss is a concern, raise it with your provider — it is one of the factors weighed when building your protocol.

Question 7

Will TRT shrink my testicles?

Accepted Answer

Direct testosterone can reduce natural testicular production, which for some men means some reduction in testicular size. This is not guaranteed and varies. If preserving testicular size and function matters to you, options like hCG (a separate standalone product) exist to maintain that pathway alongside TRT. Your provider walks through this with you.

Question 8

Does TRT affect fertility?

Accepted Answer

Yes. Direct testosterone signals your body to reduce its own production, which can lower sperm count — sometimes significantly. Fertility typically recovers after stopping, but the timeline is unpredictable and full recovery is not guaranteed. If you plan to conceive, fertility-sparing options like enclomiphene, or hCG as a separate standalone product, exist. Discuss your plans with your provider before starting.

Question 9

Do I have to do bloodwork before starting?

Accepted Answer

Yes, always. We never prescribe without laboratory validation. Your baseline panel evaluates Total and Free Testosterone, SHBG, Estradiol, CBC with Hematocrit, and PSA for men over 40.

Question 10

Where do I get my blood drawn?

Accepted Answer

Your provider orders labs to a local draw site — typically a national laboratory patient service center near you. There is no clinic to visit. Testing prefers an early-morning fasting draw, so plan accordingly if you work non-traditional hours.

Question 11

How is the medication delivered?

Accepted Answer

Your medication is shipped to your door in discreet packaging. Injection supplies (syringes, needles, pads) are included when applicable. In extreme heat or freezing cold, bring it indoors immediately on delivery.

Question 12

Do you bill insurance?

Accepted Answer

No. We do not bill insurance. The $149/month is paid directly by you. Many patients use HSA or FSA funds for eligible expenses — check with your plan administrator. See the insurance page for what that means for you.

Question 13

Will I see the same provider every visit?

Accepted Answer

Yes. You are assigned a licensed provider in your state and see that provider throughout your care.

Question 14

Is TRT guaranteed to work?

Accepted Answer

No clinical outcome is guaranteed. TRT is intended to address symptoms in men with low testosterone confirmed by labs. Individual results vary, and your provider tells you honestly if TRT is not the right answer.

Question 15

Can I get TRT if my testosterone is normal?

Accepted Answer

TRT is not prescribed for men with normal levels. It is not a performance enhancer. A provider reviews your labs and symptoms and only prescribes when clinically indicated.

Question 16

What if TRT isn't right for me?

Accepted Answer

Your provider tells you honestly. If your labs or history do not support TRT, they will say so and discuss alternatives or no treatment. You are never pressured to start.

Question 17

What are the symptoms of low testosterone?

Accepted Answer

Common symptoms include persistent fatigue, low drive or motivation, reduced libido, difficulty with body composition despite diet and training, poor recovery, brain fog, and low mood. These symptoms have many causes — which is why symptoms alone are not a diagnosis. A comprehensive lab panel read against your symptoms is how a provider decides whether low testosterone is the issue.

Question 18

What is a normal testosterone level?

Accepted Answer

The lab reference range is a statistical spread of the population tested — it includes men with symptoms of low testosterone. It is not a statement about what is optimal for you. What matters clinically is the combination of your number and your symptoms. A man near the bottom of the range with persistent symptoms has a different conversation with his provider than a man at the same number feeling completely well.

Question 19

Does TRT increase the risk of heart attack or stroke?

Accepted Answer

The evidence is mixed. Some earlier studies raised concern; the 2023 TRAVERSE trial found no significant increase in major adverse cardiovascular events among men with hypogonadism and pre-existing or elevated cardiovascular risk. The FDA still requires a cardiovascular risk warning on testosterone products. Your provider considers your individual cardiovascular risk profile before prescribing.

Question 20

What if I live at high elevation?

Accepted Answer

Elevation can raise hematocrit, and so can testosterone. Your provider monitors hematocrit before and during treatment, as the AUA Testosterone Deficiency Guideline directs. This is standard monitoring, not a reason to avoid treatment. See our TRT and elevation guide for a city-by-city breakdown across Arizona and Utah.

Question 21

How often are follow-up labs done?

Accepted Answer

At intervals your provider sets based on your protocol and response — not a fixed schedule. A follow-up is typically done within the first few months, then periodically once your levels are stable. Follow-up labs are how your dose is titrated.

Question 22

What's the difference between TRT and enclomiphene?

Accepted Answer

TRT directly replaces testosterone. Enclomiphene is an oral therapy that stimulates your body to produce more of its own testosterone while preserving fertility and sperm production. TRT produces more predictable replacement; enclomiphene preserves the natural production pathway. The right choice depends on your labs, symptoms, and whether fertility matters to you. Both are separate products — enclomiphene is not part of the $149/mo TRT program.

Question 23

What's the difference between hCG and enclomiphene?

Accepted Answer

Both can help preserve fertility, but they work differently. Enclomiphene is oral and acts centrally on the pituitary to raise both LH and FSH. hCG is injected and acts directly on the testes as an LH analog. hCG is often used alongside TRT to maintain testicular function; enclomiphene is often used as a standalone fertility-sparing option. Your provider decides based on your situation. Both are separate standalone products.

Question 24

Is A2Z a medical practice?

Accepted Answer

No. A2Z is a management services organization. Licensed providers practice independently and make all clinical decisions. A2Z does not practice medicine or provide medical advice.

Question 25

Who is the provider?

Accepted Answer

In Arizona, your care is overseen by Lauren Orta, FNP-C — a Family Nurse Practitioner with 20 years in patient care, certified by AANP, DEA registered, with full practice authority in Arizona. In Utah, a licensed Utah provider will be confirmed before the state opens; until then, Utah is waitlist only.

Question 26

How do I start in Arizona?

Accepted Answer

Book a free video consult with a licensed Arizona provider. You must be physically located in Arizona during your appointment.

Question 27

How do I start in Utah?

Accepted Answer

A2Z is not yet accepting patients in Utah. Join the list and we will tell you the day we open. No payment or commitment is required to join.

Question 28

Do I have to stop TRT once I start?

Accepted Answer

Not necessarily. Many men stay on TRT long-term with ongoing monitoring. You can stop if you have bothersome side effects, if it is not helping, or if you develop a condition that makes it unsafe — but you should do that with your provider, not on your own, because stopping can cause your levels to drop. If you plan to conceive, stopping or switching to a fertility-sparing approach is part of that conversation.

Frequently Asked Questions