Does Hims Prescribe Testosterone for Men?

Testosterone replacement therapy (TRT) has become more accessible with telehealth services, offering a solution for men with low testosterone. Companies like Hims provide online consultations and treatment options, simplifying the process. However, not all providers offer the same level of care or prescribe every form of TRT.

Understanding how companies like Hims operate, their consultation procedures, and the types of testosterone they prescribe is essential for those considering treatment.

Role Of Telehealth In Accessing Testosterone

Telehealth has reshaped how men seek treatment for low testosterone, removing barriers associated with in-person visits. Virtual platforms allow consultations with licensed professionals from home, reducing travel and wait times. This shift benefits those in rural or underserved areas with limited access to endocrinologists or urologists.

Online providers use screening tools like the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess symptoms before recommending further evaluation. If signs of low testosterone are present, patients must undergo lab testing, typically requiring morning blood draws to account for hormonal fluctuations. Many telehealth services partner with national labs, allowing patients to visit local centers or use at-home kits for sample collection.

Despite these advantages, telehealth-based TRT has limitations. State regulations affect whether online providers can prescribe testosterone without an in-person evaluation. The U.S. Drug Enforcement Administration (DEA) has historically required at least one face-to-face visit before prescribing testosterone, though temporary exceptions were made during the COVID-19 public health emergency. As regulations evolve, some providers may still require patients to establish care with a local physician. Additionally, virtual consultations may not fully capture underlying conditions like pituitary disorders or metabolic syndromes, which require comprehensive diagnostic workups.

Consultation And Evaluation Procedures

Determining whether a man is a candidate for TRT involves more than self-reported symptoms. Online providers like Hims streamline the process, but consultations assess multiple factors affecting testosterone levels to ensure safe and appropriate treatment. Licensed healthcare professionals use structured questionnaires and patient interviews to evaluate medical history, lifestyle, and symptom severity. These discussions help distinguish between primary hypogonadism, where the testes fail to produce testosterone, and secondary hypogonadism, caused by dysfunctions in the hypothalamic-pituitary axis. Identifying the cause is crucial, as some cases require interventions beyond hormone replacement.

Laboratory testing confirms testosterone deficiency. The Endocrine Society and American Urological Association recommend measuring total testosterone levels in the morning, between 7 a.m. and 10 a.m. A diagnosis is typically confirmed when blood tests show levels below 300 ng/dL on two separate occasions. Some providers also assess free testosterone in cases where total levels appear normal but symptoms persist. Additional tests, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH) measurements, help differentiate between testicular and pituitary causes. Hematocrit levels are monitored to mitigate the risk of polycythemia, a potential side effect of TRT that increases blood viscosity.

A thorough evaluation also considers contraindications to TRT. Men with a history of prostate cancer, untreated severe obstructive sleep apnea, or significant cardiovascular disease may not be suitable candidates due to potential risks. The American College of Physicians advises caution when prescribing TRT for age-related testosterone decline, as long-term benefits and risks remain under study. Some telehealth platforms include screenings like prostate-specific antigen (PSA) testing and cardiovascular risk assessments. If concerns arise, patients may be referred for in-person evaluations with endocrinologists or urologists.

Hims And Other Online Providers

Online healthcare platforms have made TRT more accessible. Hims, a well-known digital health provider, offers telemedicine consultations, allowing patients to undergo testosterone evaluation without in-person visits. Licensed healthcare providers determine whether TRT is appropriate based on symptoms and lab results. While convenient, the level of care varies among online providers, with some offering more comprehensive diagnostics than others.

Unlike traditional endocrinology or urology practices that investigate a broader range of hormonal imbalances, many telehealth platforms, including Hims, focus on testosterone deficiency without exploring other potential causes. This approach works for straightforward cases but may not be ideal for those with complex endocrine disorders requiring in-depth evaluation. Some providers offer advanced hormone panels or imaging studies, while others prioritize rapid prescription fulfillment. Follow-up care also differs, with some companies emphasizing long-term monitoring through periodic lab testing and others relying on patient-reported outcomes.

Pricing structures and treatment options vary. Hims operates on a subscription-based model, bundling consultations, medication, and support into a monthly fee. Other companies allow patients to pay separately for consultations, lab tests, and prescriptions. Medication availability also differs, with some platforms prescribing only topical formulations while others offer a wider range of options. Insurance coverage is another factor, as many online providers operate on a cash-pay basis, affecting affordability.

Types Of Administration

TRT is available in multiple forms, each with unique benefits and considerations. The choice of administration depends on patient preference, absorption rates, and potential side effects.

Injections

Injectable testosterone is a common and cost-effective TRT method. Administered as intramuscular (IM) or subcutaneous (SC) injections, formulations include testosterone enanthate, cypionate, and undecanoate, each with different half-lives. Enanthate and cypionate are typically injected every one to two weeks, while undecanoate, a longer-acting option, is administered every 10 to 14 weeks. Injections can cause fluctuating testosterone levels, leading to mood swings and energy variations. Some patients counteract this by using smaller, more frequent doses. Side effects include injection site pain, increased hematocrit levels, and, in rare cases, local infections. Proper administration techniques, such as rotating injection sites and using sterile needles, help reduce complications.

Patches

Transdermal testosterone patches provide a controlled release, maintaining more stable levels than injections. Applied once daily, they deliver testosterone through the skin into the bloodstream. Brands like Androderm offer dosages ranging from 2 mg to 4 mg per day. While convenient, patches can cause skin irritation, including redness and itching. Rotating application sites helps minimize irritation. Patches must remain in place for 24 hours, and sweating or friction from clothing may reduce effectiveness, making them less ideal for physically active individuals.

Topical Gels

Testosterone gels, such as AndroGel and Testim, offer ease of application and steady hormone delivery. Applied daily to areas like the shoulders, upper arms, or abdomen, they allow consistent absorption. Dosages typically range from 20 mg to 100 mg per day. Gels maintain stable testosterone levels, avoiding the peaks and troughs of injections. However, they pose a risk of transference—if the gel contacts another person, it can raise their testosterone levels. Patients must wash hands thoroughly after application and allow the gel to dry before dressing. Skin irritation and absorption variability due to sweating or bathing are additional considerations.

Implants

Testosterone implants, or subcutaneous pellets, provide long-term hormone replacement with minimal maintenance. These small pellets, containing 75 mg to 200 mg of testosterone each, are inserted under the skin, usually in the hip or buttocks. They release testosterone over three to six months, eliminating frequent dosing. Implants offer stable hormone levels without the daily or weekly administration required by other forms. However, the procedure carries risks such as infection, pellet extrusion, or local discomfort. Adjusting dosage can be difficult, as pellets cannot be easily removed. While implants provide convenience, they may not be suitable for those who prefer more flexibility in their treatment.