About This Directory
TRT Find is a free, community-driven directory of testosterone replacement therapy clinics across the United States. Our data is sourced from the National Provider Identifier (NPI) Registry maintained by the Centers for Medicare & Medicaid Services.
We built this tool because finding a qualified TRT provider shouldn't require sifting through sponsored listings or navigating opaque healthcare networks.
What is TRT?
The basics of testosterone replacement therapy and who it's for.
Testosterone replacement therapy restores testosterone levels in men whose bodies don't produce enough. Common delivery methods include injections (intramuscular or subcutaneous), topical gels, transdermal patches, implantable pellets, and nasal gels.
The goal is not to achieve supraphysiological levels, but to restore testosterone to the normal reference range (typically 300–1000 ng/dL), alleviating symptoms while minimizing risks.
Clinical Note: Diagnosis typically involves two morning blood tests confirming low testosterone levels, combined with an evaluation of symptoms. A qualified provider can help determine if TRT is right for you.
The Science of Decline
Why testosterone decreases with age and what drives it.
The Massachusetts Male Aging Study (MMAS), one of the largest longitudinal studies on male hormones, found that total testosterone decreases by approximately 1.6% per year after age 40, while bioavailable testosterone decreases by 2–3% annually.
Contributing Factors
Primary hypogonadism
Age-related Leydig cell dysfunction reduces testicular testosterone production
Secondary hypogonadism
Decreased hypothalamic-pituitary signaling (reduced GnRH and LH pulse amplitude)
Increased SHBG
Sex hormone-binding globulin rises with age, reducing free testosterone
Lifestyle factors
Obesity, metabolic syndrome, chronic stress, poor sleep accelerate decline
The European Male Aging Study (EMAS) established that symptomatic hypogonadism requires both biochemical confirmation (total testosterone below 317 ng/dL) and specific symptoms—particularly reduced morning erections, decreased libido, and erectile dysfunction.
Why It Matters After 40
Testosterone's role in metabolic health, bone density, cardiovascular function, and cognition.
Metabolic Health
The Testosterone Trials (TTrials) demonstrated that testosterone treatment in men 65+ improved insulin sensitivity and reduced fat mass. Low testosterone is independently associated with type 2 diabetes and increased visceral adiposity.
Bone Density
The TTrials Bone Trial showed one year of testosterone treatment significantly increased bone mineral density in the spine and hip—particularly in the trabecular bone most vulnerable to fracture. Low testosterone is associated with increased fracture risk in older men.
Cardiovascular Health
The TRAVERSE trial (2023), the largest cardiovascular safety trial of testosterone, followed 5,246 men and found that TRT did not increase the risk of major adverse cardiovascular events compared to placebo.
Cognitive Function
The TTrials Cognitive Function Trial found modest improvements in verbal memory. Multiple studies show associations between low testosterone and depressive symptoms, with TRT improving mood in hypogonadal men.
The 80s Stigma
How Olympic doping scandals created lasting misconceptions about testosterone therapy.
The public perception of testosterone was permanently altered by high-profile doping scandals in the 1980s. Ben Johnson's disqualification at the 1988 Seoul Olympics became a defining cultural moment—testosterone became synonymous with cheating, unfair advantage, and "roid rage."
This conflation of supraphysiological steroid abuse with legitimate hormone replacement created a stigma that persists today. Many physicians trained in this era remain hesitant to prescribe TRT, even when clinically indicated. Patients often feel shame about discussing symptoms.
The reality is straightforward: restoring a 50-year-old man's testosterone to normal levels has nothing in common with an athlete using 10x physiological doses to gain competitive advantage. The pharmacology, the risks, and the intent are entirely different.
Context: The FDA approved testosterone for hypogonadism in 1953—decades before the doping scandals. TRT's medical legitimacy predates its association with athletic abuse.
Emerging Research
What the latest science suggests—beyond the standard guidelines.
Population-Wide Testosterone Decline
Cross-generational studies show that men today have significantly lower testosterone than their fathers did at the same age. A 2007 study in the Journal of Clinical Endocrinology & Metabolism found a population-level decline of about 1% per year—independent of aging. Environmental factors, including endocrine-disrupting chemicals (plastics, pesticides), obesity rates, and lifestyle changes are suspected contributors.
The 300 ng/dL Threshold Debate
The commonly cited "low testosterone" cutoff of 300 ng/dL is based on population statistics, not optimal health. Many clinicians now recognize that symptoms can occur at levels considered "normal" and that optimal ranges may be 500–800 ng/dL for most men. The goal of treatment is symptom resolution, not just reaching a statistical threshold.
Free Testosterone Matters
Total testosterone only tells part of the story. As men age, SHBG increases, binding more testosterone and reducing the bioavailable fraction. A man with "normal" total testosterone can have low free testosterone and experience classic symptoms. Comprehensive assessment should include free testosterone, calculated from total T and SHBG.
Protocol Optimization
Research and clinical experience increasingly favor more frequent, smaller injections (e.g., twice weekly or every other day) over traditional once-every-two-week protocols. This minimizes hormonal fluctuations, reduces estrogen spikes, and often produces better symptom control with fewer side effects.
Sleep and Testosterone
The majority of daily testosterone release occurs during deep sleep. Studies show that restricting sleep to 5 hours per night for one week reduces testosterone by 10–15%. For men with borderline levels, optimizing sleep may be the first intervention—before considering TRT.
Common Myths
Separating evidence-based medicine from misconceptions.
"TRT causes prostate cancer"
Multiple meta-analyses found no increased risk. The saturation model (Morgentaler) suggests prostate tissue is maximally stimulated at low testosterone levels. Standard screening is recommended, not heightened concern.
"TRT is the same as steroid abuse"
TRT restores testosterone to normal physiological levels under medical supervision. Steroid abuse involves 5–20x normal doses without oversight. The risk profiles are fundamentally different.
"TRT permanently shuts down natural production"
TRT does suppress the HPG axis, but recovery is possible—especially with shorter treatment durations. Studies show most men recover endogenous production within 3–12 months of cessation, though older men and long-term users may take longer. Protocols using hCG or SERMs can help preserve testicular function during treatment.
"If you feel fine, your testosterone is fine"
False. Testosterone decline is gradual, and the body adapts. Many men normalize reduced energy and libido as "just getting older." Blood work is essential for accurate assessment.
Getting Started
A structured approach to evaluating whether TRT is right for you.
- 1
Get comprehensive blood work
Total testosterone, free testosterone, SHBG, LH, FSH, estradiol, CBC, metabolic panel. Blood drawn before 10 AM when testosterone peaks.
- 2
Confirm with two separate readings
The Endocrine Society recommends confirming low testosterone on two different days.
- 3
Evaluate symptoms honestly
Use validated questionnaires like ADAM or AMS. Document fatigue, libido, mood, and physical changes.
- 4
Find a qualified provider
Urologists, endocrinologists, or specialized men's health providers. Use our directory to find providers in your area.
- 5
Monitor regularly
TRT requires ongoing blood work to optimize levels and monitor hematocrit, PSA, and other markers.
References
Bhasin S, et al. J Clin Endocrinol Metab. 2018;103(5):1715-1744.
Snyder PJ, et al. N Engl J Med. 2016;374(7):611-624. [TTrials]
Lincoff AM, et al. N Engl J Med. 2023;389(2):107-117. [TRAVERSE]
Wu FC, et al. N Engl J Med. 2010;363(2):123-135. [EMAS]
Feldman HA, et al. J Clin Endocrinol Metab. 2002;87(2):589-598. [MMAS]
Morgentaler A, Traish AM. Eur Urol. 2009;55(2):310-320.
Travison TG, et al. J Clin Endocrinol Metab. 2007;92(1):196-202. [Population decline]
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Browse our directory of TRT providers across the United States.