Hormone Therapy for Men and Women

Hormone therapy is one option people explore when they have questions about their hormones. For men, that usually means testosterone therapy, often called TRT. For women, it usually means hormone therapy for perimenopause and menopause, often called HRT. The Vitality Collective offers hormone therapy for men and women through independent licensed clinicians.

I’m Charles Chancio III, the founder. I’m not a clinician, so this page is general education, not medical advice. Whether hormone therapy makes sense for you is a conversation to have with a licensed clinician. In most cases, labs come first. We don’t promise results.

Testosterone therapy for men (TRT)

Testosterone is the main male sex hormone, made mostly by the testes. Levels naturally drift lower with age, and they change through the day, usually highest in the morning.^[1]

Symptoms people often link to low testosterone include a lower sex drive, erection problems, reduced energy, low mood or irritability, and loss of muscle mass.^[1][4] These symptoms aren’t specific to low testosterone. They can also come from other things, such as chronic stress, fatigue, depression or other health conditions, so symptoms on their own don’t tell you much.^[2][3]

How low testosterone is diagnosed. Whoever you see, guidelines call for symptoms plus consistently low levels, confirmed by repeat early-morning tests, before a diagnosis.^[2][3] Some causes of low testosterone can be reversible, and guidelines say those should be looked at first.^[1]

Rules that apply. Testosterone is a controlled substance, so extra federal and state prescribing rules apply, and federal telehealth rules for controlled substances are temporary and may change.

Hormone therapy for perimenopause and menopause (HRT)

Menopause is when your periods stop for good. You’ve reached it once you’ve gone 12 months in a row without a period.^[6][7] The years before that are called perimenopause. Estrogen rises and falls during this time, and it often starts in your 40s, though some women notice changes earlier or later.^[7][8]

Common symptoms include irregular periods, hot flashes and night sweats, trouble sleeping, vaginal dryness and pain during sex, and mood changes.^[6][7][8] Some women have few or no symptoms, and symptoms can last for several years.^[6]

What menopausal hormone therapy is. Hormone therapy is a medical treatment that can help relieve the symptoms of menopause and perimenopause, according to ACOG. Estrogen is the main hormone used. Women who still have a uterus are usually given a progestin along with it, because estrogen alone raises the risk of cancer of the uterine lining.^[9] The Menopause Society says that for many women, hormone therapy is the most effective treatment for hot flashes, with benefits and risks that depend on age, timing and health history.^[10] Non-hormonal options exist too.^[9]

Risks, and who hormone therapy may not be right for

Hormone therapy is a prescription treatment with real risks, for men and for women. Here’s what public medical sources highlight.

Testosterone therapy

Testosterone therapy has real risks. It can raise red blood cell counts, so guidelines call for checking them before and during treatment, along with prostate health (often including a PSA test). It can lower sperm production and fertility, and recovery after stopping varies from person to person and isn’t certain. In a large 2023 trial, men on testosterone had more blood clots in the lungs, atrial fibrillation (an irregular heart rhythm) and acute kidney injury than men on placebo. Gels and creams can transfer to partners and children through skin contact. Other possible effects include acne, breast tenderness or enlargement, fluid retention and worsening sleep apnea.^[2][3][5]

The Endocrine Society recommends against testosterone therapy for men who are planning to have children in the near term, and for men with:^[2]

• breast or prostate cancer
• an elevated PSA level, or a prostate lump or hardness found on exam, that hasn’t been evaluated by a urologist
• a high red blood cell count (elevated hematocrit)
• untreated severe obstructive sleep apnea
• severe urinary symptoms
• uncontrolled heart failure
• a heart attack or stroke in the last six months
• a blood-clotting disorder (thrombophilia)

Testosterone is also misused at high doses for muscle building. That’s not a medical use.

Menopausal hormone therapy

Hormone therapy also has risks, which depend on the type, dose, route, how long it’s used, age and timing, and health history. They can include blood clots and stroke and, with some types and longer use, a higher risk of breast cancer.^[9][10][11] For women who start hormone therapy after age 60, or more than 10 years after menopause begins, the balance of benefits and risks appears less favorable, because of greater risks of heart disease, stroke, blood clots and dementia.^[10]

According to ACOG, systemic hormone therapy usually isn’t recommended if you’ve ever had:^[9]

• breast or endometrial cancer
• a stroke
• a heart attack
• blood clots
• liver disease

It also isn’t for anyone who is pregnant.^[9] Possible side effects include spotting or bleeding, breast soreness, bloating and headaches.^[9] Bleeding after you’ve gone 12 months without a period should be checked by a healthcare professional.^[7]

Follow-up matters. For testosterone, guidelines call for regular monitoring of levels and side effects during treatment.^[2][3] For menopausal hormone therapy, ACOG recommends talking each year about whether to continue.^[9] Your history and your family history matter, so for anything medical, talk with a licensed clinician.

Peptide therapy and hormone therapy

Some people also ask about peptide therapy. For some people, a licensed clinician may discuss adding peptide therapy to hormone therapy. If your levels are in range, a licensed clinician may look for other causes, and for some people, peptide therapy on its own may be worth discussing. Evidence varies by peptide, and human research is often limited. Either way, it’s a decision you make with a licensed clinician.

Start with labs

Labs give you and a licensed clinician something real to work from. Our lab panels range from focused to comprehensive and can include hormone and thyroid markers. Lab results don’t diagnose anything on their own. Go over your results with a licensed clinician.

Why I keep this page plain

I’m not a clinician, so I won’t tell you whether hormone therapy is right for you. A lot of hormone marketing skips the risks and the “it depends.” I’d rather you see both sides, understand the basics, and bring better questions to a licensed clinician.

Where to start

01 Ask questions. Request a private call with the founder to learn how it works. It’s a conversation, not medical care.

02 Start with labs. In most cases, labs come first.

03 Medical questions go to a clinician. For anything medical, talk with a licensed clinician.

Frequently asked questions

Can I get hormone therapy online?

Licensed telehealth clinicians can prescribe hormone therapy where federal and state rules allow. Testosterone is a controlled substance, so extra federal and state prescribing rules apply, and federal telehealth rules for controlled substances are temporary and may change. In most cases, labs come first.

What are the symptoms of low testosterone?

Symptoms people often link to low testosterone include a lower sex drive, erection problems, reduced energy, low mood or irritability, and loss of muscle mass. They overlap with many other causes, so guidelines call for symptoms plus consistently low levels, confirmed by repeat early-morning tests, before a diagnosis.

What’s the difference between perimenopause and menopause?

Perimenopause is the transition before menopause, when estrogen rises and falls and periods often become irregular. Menopause is when periods stop for good, and you’ve reached it once you’ve gone 12 months in a row without a period.

Can hormone therapy help with perimenopause symptoms?

According to ACOG, hormone therapy is a medical treatment that can help relieve the symptoms of menopause and perimenopause. It also has risks that depend on the type, dose, how long it’s used, your age and timing, and your health history. Whether it makes sense for you is a conversation to have with a licensed clinician.

Is hormone therapy safe?

Hormone therapy has real risks wherever it’s prescribed. For men, testosterone can raise red blood cell counts, lower fertility and affect the prostate. For women, risks can include blood clots and stroke and, with some types and longer use, a higher risk of breast cancer. Regular monitoring matters, so talk with a licensed clinician about the risks that apply to you.

Can peptide therapy be used with hormone therapy?

For some people, a licensed clinician may discuss adding peptide therapy to hormone therapy. If your levels are in range, a licensed clinician may look for other causes, and for some people, peptide therapy on its own may be worth discussing. Evidence varies by peptide, and human research is often limited. Either way, it’s a decision you make with a licensed clinician.

Next steps

Available nationwide. Some visit requirements vary by state.

Have questions first? Request a private call with me, Charles, the founder. I’m not a clinician, and the call isn’t a medical appointment. You can also look at our lab panels or see all services.

Sources

1. Endocrine Society. Hypogonadism in Men (patient resource). https://www.endocrine.org/patient-engagement/endocrine-library/hypogonadism
2. Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. https://www.endocrine.org/clinical-practice-guidelines/testosterone-therapy
3. American Urological Association. Evaluation and Management of Testosterone Deficiency (2018; reviewed and validity confirmed 2024). https://www.auanet.org/guidelines-and-quality/guidelines/testosterone-deficiency-guideline
4. MedlinePlus (U.S. National Library of Medicine). Hypogonadism. https://medlineplus.gov/ency/article/001195.htm
5. Lincoff AM, et al. Cardiovascular Safety of Testosterone-Replacement Therapy (TRAVERSE). N Engl J Med. 2023;389:107-117. https://pubmed.ncbi.nlm.nih.gov/37326322/
6. National Institute on Aging (NIH). What Is Menopause? https://www.nia.nih.gov/health/menopause/what-menopause
7. Mayo Clinic. Perimenopause: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
8. American College of Obstetricians and Gynecologists (ACOG). The Menopause Years. https://www.acog.org/womens-health/faqs/the-menopause-years
9. ACOG. Hormone Therapy for Menopause. https://www.acog.org/womens-health/faqs/hormone-therapy-for-menopause
10. The 2022 Hormone Therapy Position Statement of The North American Menopause Society (now The Menopause Society). Menopause. 2022;29(7):767-794. https://pubmed.ncbi.nlm.nih.gov/35797481/
11. MedlinePlus. Hormone Therapy for Menopause. https://medlineplus.gov/hormonetherapyformenopause.html