Male Vitality
Provider-led hormone therapy for men's wellness.
TRT or Enclomiphene (lab-guided)Optional: PT-141Optional: NAD+
Hormone therapy · Schedule III
Testosterone replacement therapy, physician-led TRT for diagnosed hypogonadism.
Testosterone levels decline approximately 1 to 2 percent per year after age 30. For most men this is gradual and tolerable. For a meaningful subset, it crosses a clinical threshold, diagnosed hypogonadism, that produces measurable symptoms. Testosterone replacement therapy (TRT) is an FDA-approved, evidence-supported treatment for confirmed hypogonadism, not a wellness supplement or shortcut. At Genesis Longevity in Colorado Springs, TRT is offered only to men with diagnosed deficiency under ongoing physician supervision.
What it is
Testosterone replacement therapy (TRT) restores testosterone to physiologic levels in men with diagnosed hypogonadism, a condition characterized by consistently low testosterone with corresponding clinical symptoms. TRT is not indicated for the normal age-related decline in testosterone in the absence of confirmed deficiency.
At Genesis Longevity, TRT is preceded by a Good Faith Exam documenting symptoms and cardiovascular risk, and a clinical evaluation per Endocrine Society and AUA guidelines to confirm deficiency, characterize its cause, and rule out contraindications.
Common formulations include intramuscular testosterone cypionate or enanthate (injected weekly or biweekly) and topical gels. Each has a different pharmacokinetic profile; your provider selects the most appropriate route for your goals and lifestyle.
How it works
When testosterone cypionate or enanthate is administered intramuscularly, the ester bond is hydrolyzed post-injection, releasing free testosterone into circulation. Free testosterone binds androgen receptors directly, or is converted by two enzymatic pathways:
5α-reductase converts testosterone to dihydrotestosterone (DHT), which mediates effects on hair follicles, prostate, and libido.
Aromatase converts testosterone to estradiol, mediating effects on bone density, mood, and sexual function in men.
The net effect: gene transcription supporting muscle protein synthesis, erythropoiesis, bone mineralization, libido, and cognitive function.
The fertility trade-off. Exogenous testosterone suppresses LH and FSH via negative hypothalamic-pituitary feedback, which inhibits endogenous spermatogenesis. Men who want to preserve fertility should discuss enclomiphene or hCG-based alternatives before starting TRT.
Conditions and use cases
Who TRT is appropriate for.
- Men with diagnosed hypogonadism per Endocrine Society (2018) and AUA guidelines.
- Men with consistent symptoms: low libido, erectile dysfunction, fatigue, depressed mood, reduced muscle mass, increased body fat.
- Not indicated for age-related decline without confirmed deficiency or for athletic performance enhancement.
Expected timeline
What patients commonly observe.
Week 0 to 2
Stabilization
Levels begin to climb toward physiologic range.
Week 2 to 4
Libido and energy
Improved libido and erectile function commonly emerge in this window.
Month 1 to 3
Mood and motivation
Mood improvement, energy, and motivation. Body composition begins shifting.
Month 3 to 6
Body composition and bone
Improved muscle mass and strength. Bone density improvements continue with sustained therapy at 6 to 12 months.
Stacks that include this therapy
Testosterone replacement therapy appears in this stack.
Investment and access
Care plans, not menus.
Genesis Longevity therapies are dispensed only after a complimentary consultation and Good Faith Exam. Schedule yours to receive a personalized plan tailored to your biology and goals.
Side effects
What patients commonly report.
Common. Erythrocytosis (rising hematocrit, particularly with IM therapy), managed with dose adjustment or therapeutic phlebotomy. Acne and oily skin. Gynecomastia from estradiol elevation via aromatase, managed with dose adjustment or aromatase inhibitor. Testicular atrophy and reduced sperm production are expected consequences of HPG suppression.
Mood. Mood fluctuations, particularly with high peaks or rapid dose changes. Twice-weekly dosing reduces fluctuations.
Cardiovascular. The TRAVERSE trial (Lincoff et al., NEJM 2023, n=5,246 hypogonadal men) found no increase in major adverse cardiovascular events compared with placebo in a monitored, appropriately selected population. Ongoing hematocrit monitoring and cardiovascular assessment remain essential.
Contraindications
Who should not use this therapy.
Show contraindications
Absolute. Prostate cancer or breast cancer. Severe untreated obstructive sleep apnea (OSA must be treated before initiation). Uncontrolled congestive heart failure. Polycythemia (hematocrit over 54 percent). Baseline PSA over 4 ng/mL or palpable prostate nodule without urology clearance.
Relative (require shared decision-making). Desire to maintain fertility (TRT suppresses spermatogenesis, consider enclomiphene or hCG). Thrombophilia or high VTE risk. Severe lower urinary tract symptoms (LUTS).
Pairs well with
Therapies that complement this protocol.
- FDA-approved
Tesamorelin
Visceral fat reduction via growth hormone axis support.
Strong evidence - FDA-approved
PT-141
CNS-level libido and arousal support for men and women.
Moderate evidence - Off-label
Enclomiphene
Fertility-preserving testosterone support.
Moderate evidence
Frequently asked
Frequently asked questions about Testosterone replacement therapy.
TRT delivers direct testosterone replacement: predictable, reliable, suitable for moderate-to-severe deficiency. Enclomiphene stimulates your body's own testosterone production via HPG axis stimulation and preserves fertility. The choice depends on the severity of your deficiency, fertility goals, and the cause (primary vs secondary hypogonadism).
TRT suppresses LH and FSH, which impairs spermatogenesis. Fertility can often be preserved with enclomiphene, hCG, or combination protocols. Discuss this explicitly with your provider before starting TRT if fertility is a current or future consideration.
The TRAVERSE trial (NEJM 2023) provides the most rigorous modern data. In n=5,246 hypogonadal men monitored appropriately, TRT did not increase major adverse cardiovascular events versus placebo. Baseline cardiovascular evaluation and ongoing hematocrit and PSA monitoring remain essential.
Hypogonadism is typically a chronic condition. Stopping TRT generally returns testosterone to pre-treatment levels. Some patients transition to enclomiphene to preserve some HPG axis function.
Current evidence does not support a causal link between TRT and prostate cancer in men without pre-existing disease. However, TRT can stimulate growth of an existing prostate cancer, which is why baseline DRE and PSA evaluation and ongoing monitoring are required.
Diagnosis combines consistent symptoms with confirmed deficiency per Endocrine Society and AUA criteria. Your provider characterizes the pattern (primary vs secondary hypogonadism) during the workup.
Sources
Citations & references
- [1]Saad F et al. J Clin Endocrinol Metab 2008; Traish AM et al. J Sex Med 2010; Lincoff AM et al. (TRAVERSE) NEJM 2023. Source
- [2]DrugBank, Testosterone Cypionate. Source
- [3]ChooseHealth, TRT monitoring requirements. Source
- [4]Vista Wellness, TRT/HRT evaluation and testing. Source
- [5]Pfizer, Testosterone Cypionate prescribing information. Source
- [6]Concierge MD, TRT vs Enclomiphene. Source
- [7]AUA Testosterone Deficiency Guideline (2018); Endocrine Society Guidelines (2018).
Status & disclosures
- FDA-approved · Schedule III controlled substance
- Testosterone cypionate and enanthate are FDA-approved Schedule III controlled substances indicated for confirmed male hypogonadism. A controlled-substance prescription and provider relationship are required.
- No fertility-improvement claims
- TRT suppresses spermatogenesis. We do not market TRT as a fertility treatment. Men with fertility goals should discuss enclomiphene or hCG protocols.
- Confirmed diagnosis required
- Diagnosed hypogonadism per Endocrine Society and AUA criteria, combined with consistent symptoms, is required before initiation. The TRAVERSE trial supports cardiovascular safety in monitored, appropriately selected men.
Next step
Talk to a Genesis provider about Testosterone replacement therapy.
Schedule a consultation. Physician-led, evidence-graded.
Or keep reading: See the Male Vitality stack