You can get a testosterone prescription from several types of doctors, including your primary care physician, a urologist, or an endocrinologist. Online telehealth clinics are also an option. The path you choose affects how thoroughly you’re evaluated, how quickly you start treatment, and what you pay out of pocket.
Which Doctors Prescribe Testosterone
Any licensed physician can technically prescribe testosterone, but three types of providers handle most prescriptions: primary care doctors, urologists, and endocrinologists. Each brings a different level of focus to the process.
Primary care doctors are the most accessible starting point. They can order blood work, diagnose low testosterone, and write a prescription. However, they tend to be less thorough in the workup. In one comparative study, 77% of primary care patients started testosterone without a second confirmatory blood test, compared to just 45% of patients seen by urologists. Primary care providers also screened for secondary causes of low testosterone (problems with the pituitary gland, for example) only about 27% of the time, versus 78% for urologists and 75% for endocrinologists.
Urologists specialize in male reproductive health and are particularly careful about prostate screening before starting treatment. In the same study, every urology patient had a PSA (prostate-specific antigen) check before beginning therapy. Urologists are a strong choice if you want a specialist who understands both the hormonal and reproductive side of things.
Endocrinologists are hormone specialists. They’re the best option if your doctor suspects your low testosterone stems from a pituitary or brain-related issue. Endocrinologists ordered brain imaging 75% of the time for hypogonadism patients, and they identified 40% of the pituitary tumors found in one multi-specialty analysis. If your initial blood work shows unusual results, particularly very low testosterone combined with low levels of the hormones that signal the brain to produce testosterone, an endocrinologist can dig deeper.
Online Telehealth Clinics
A growing number of men get testosterone through telehealth platforms that handle the entire process remotely: lab orders, video consultations, prescriptions, and medication delivery. These clinics have expanded significantly since the COVID-19 pandemic, when the DEA relaxed rules around prescribing controlled substances via telemedicine. Those flexibilities have been extended through December 31, 2025, meaning providers can currently prescribe testosterone after a video visit without requiring an in-person exam.
The convenience is real. Most telehealth TRT clinics send you to a local lab for blood work, then schedule a video appointment within days. If you qualify, a prescription can ship to your door. The trade-off is that online clinics vary widely in quality. Some follow the same diagnostic standards as in-person specialists. Others are more willing to prescribe quickly with less thorough screening. Before choosing a telehealth provider, check whether they require two separate blood tests on different mornings, screen for underlying causes, and monitor your health with follow-up labs, all standard practices in a careful clinical setting.
What Qualifies You for a Prescription
Testosterone therapy isn’t prescribed based on symptoms alone. You need blood work confirming low levels. The American Urological Association defines the diagnostic threshold as a total testosterone level consistently below 300 ng/dL on at least two separate blood draws. Both samples should be taken in the early morning, ideally before 10 a.m., because testosterone peaks during those hours and drops throughout the day. Most insurance companies require these same two morning tests before they’ll approve coverage.
Total testosterone is the primary measurement, but it doesn’t always tell the full story. Most testosterone in your blood is bound to a protein called sex hormone-binding globulin (SHBG), which makes it unavailable for your body to use. If your total testosterone is borderline or your SHBG levels are abnormal due to medications, obesity, or other conditions, your doctor may also check free testosterone or bioavailable testosterone to get a clearer picture.
The Full Workup Before Treatment
A responsible provider won’t just check your testosterone level and hand you a prescription. Clinical guidelines recommend a broader evaluation before starting therapy:
- Baseline hematocrit: This measures the percentage of red blood cells in your blood. Testosterone stimulates red blood cell production, so if your level is already above 50%, your provider needs to investigate why before adding testosterone to the mix.
- PSA screening: Men over 40 should have a baseline PSA level checked, since testosterone is contraindicated in men with untreated prostate cancer.
- LH and FSH levels: These hormones, produced by the pituitary gland, tell your body to make testosterone. If they’re low alongside low testosterone, it suggests the problem originates in the brain rather than the testes, which changes both diagnosis and treatment options.
- Prolactin levels: When LH is low or borderline, checking prolactin helps rule out a pituitary tumor (prolactinoma) that could be causing the hormone disruption.
- Fertility discussion: Testosterone therapy suppresses sperm production, sometimes severely. If you want children in the future, your provider should discuss this upfront, because alternative treatments exist that can raise testosterone without shutting down fertility.
This full workup is one of the biggest differences between a thorough provider and a rushed one. Skipping these steps can mean missing a treatable underlying cause or starting therapy that creates new problems.
Who Should Not Take Testosterone
Testosterone replacement is contraindicated in men with untreated prostate cancer or breast cancer. Men considered high-risk for prostate cancer, including those with a first-degree relative who had prostate cancer and African American men with a PSA above 3 ng/dL, also need careful evaluation before starting treatment. If you’re actively trying to conceive, exogenous testosterone will work against you by suppressing your body’s natural sperm production.
How Testosterone Is Prescribed
Once you qualify, you and your provider choose a delivery method. Each has practical differences in cost, convenience, and how steady your hormone levels stay.
- Injections (testosterone cypionate): The most common and least expensive option. Typically administered weekly or every two weeks. Many men learn to self-inject at home. This is what most urologists and online clinics prescribe first.
- Topical gels: Applied daily to the skin, usually on the shoulders or upper arms. Gels keep testosterone levels more stable day to day but cost more and carry a risk of transferring the medication to partners or children through skin contact. Starting doses range from 40 to 50 mg daily depending on the formulation.
- Transdermal patches: Applied to the skin each evening, delivering a steady dose overnight. The starting dose is typically 4 mg per day. Skin irritation at the application site is common.
- Nasal gel: Applied inside the nostrils three times daily, at least six to eight hours apart. It avoids the skin-transfer risk of topical gels but requires the most frequent dosing of any option.
- Implantable pellets: Small pellets are inserted under the skin by a provider every few months. This is the most hands-off option but requires an in-office procedure each time.
Cost and Where to Fill Your Prescription
If your insurance covers testosterone, you’ll typically fill your prescription at a regular retail pharmacy. Coverage usually requires documentation of two low morning blood tests and a confirmed diagnosis. Even with insurance, copays vary. Generic testosterone cypionate for injection is the most affordable form of therapy, often costing $30 to $50 per month at a retail pharmacy. Brand-name gels can run several hundred dollars monthly without insurance.
Compounding pharmacies are another option, particularly for patients using telehealth clinics. These pharmacies custom-mix medications and can sometimes offer different concentrations or combinations. Compounded prescriptions tend to cost more on average than standard retail prescriptions, and insurance coverage for compounded medications is less predictable.
What Happens After You Start
Getting the prescription is not the end of the process. Guidelines recommend checking your hematocrit level at least every six months while on therapy, because testosterone can push red blood cell counts high enough to increase the risk of blood clots. Your provider should also recheck your testosterone levels within the first few weeks to make sure the dose is putting you in the target range and adjust up or down accordingly. PSA monitoring continues for men over 40.
Most men notice changes gradually. Energy and mood improvements often come within the first few weeks, while changes in body composition and sexual function may take three to six months to fully develop. Testosterone therapy is generally a long-term commitment. Stopping abruptly can cause your levels to drop below where they started, since exogenous testosterone suppresses your body’s own production over time.