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Telehealth TRT: What Has Changed
Testosterone replacement therapy has been available for decades, but telehealth has transformed how men access it. Instead of scheduling multiple in-person appointments with endocrinologists or urologists (often with weeks-long wait times), telehealth TRT platforms offer at-home blood work, video consultations, medication delivery, and ongoing monitoring through a single platform.
The market has grown quickly, and the platforms vary significantly in clinical rigor, cost, testing protocols, and state availability. This guide compares four established telehealth TRT providers to help you evaluate your options.
What Responsible TRT Looks Like
Before comparing platforms, it helps to understand what a quality TRT program should include:
Initial blood work. Comprehensive labs before prescribing are non-negotiable. The panel should include total testosterone, free testosterone, SHBG, estradiol, PSA (prostate-specific antigen), CBC (complete blood count), metabolic panel, lipid panel, and thyroid function. Some providers also test LH and FSH to help determine the cause of low testosterone.
Clinical evaluation. Beyond blood work, a thorough intake should cover symptoms, medical history, medications, family history (especially prostate and cardiovascular disease), and lifestyle factors.
Two confirmed low readings. The Endocrine Society guidelines recommend confirming low testosterone with two separate morning blood draws, as testosterone levels fluctuate throughout the day and can be affected by illness, stress, and sleep.
Ongoing monitoring. After starting TRT, blood work should be repeated at 6 to 12 weeks to check levels, then every 6 to 12 months. Monitoring should include hematocrit (to watch for polycythemia), PSA, estradiol, and testosterone levels.
Treatment of root causes. Low testosterone can result from pituitary disorders, medication side effects, obesity, sleep apnea, or other treatable conditions. A responsible provider investigates causes before defaulting to TRT.
Hone Health
Overview: Hone Health is a men's health telehealth platform focused on hormone optimization. Their TRT program includes at-home blood testing, provider consultations, medication delivery, and ongoing lab monitoring.
Testing protocol: Hone sends an at-home blood test kit that measures total testosterone, free testosterone, SHBG, estradiol, PSA, CBC, metabolic panel, and more. Results are reviewed by a licensed provider before any treatment decisions.
Medications offered: Injectable testosterone cypionate (the most common TRT delivery method), testosterone cream, and in some cases enclomiphene as an alternative to testosterone for men who want to preserve fertility.
Cost: Starting around $149 per month, which includes provider consultations, medication, and ongoing lab monitoring. At-home test kits are included in the program cost.
Follow-up schedule: Blood work is repeated at approximately 8 to 12 weeks after starting treatment, then every 6 months. Provider check-ins are available monthly.
State coverage: Available in 40+ states. Check their site for current availability.
Strengths: Comprehensive testing included in the price. Transparent all-in-one pricing. At-home blood draw convenience. Focus specifically on men's hormones.
Limitations: Primarily focused on testosterone — less suited for complex endocrine cases. The at-home blood test uses finger-prick collection, which some patients find less reliable than venous draws.
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Opt Health
Overview: Opt Health positions itself as a premium men's health optimization platform. Beyond TRT, they offer broader wellness services including peptide therapy, metabolic testing, and longevity-focused protocols. Their provider network includes physicians who specialize in hormone therapy.
Testing protocol: Opt Health uses comprehensive lab panels drawn at local labs (LabCorp or Quest). The initial panel is extensive, covering testosterone, thyroid, metabolic markers, cardiovascular risk factors, and more. This venous blood draw approach is considered more reliable than finger-prick testing.
Medications offered: Injectable testosterone cypionate, testosterone cream, HCG (for fertility preservation), DHEA, and other adjunctive treatments depending on clinical findings.
Cost: Plans range from approximately $149 to $249 per month depending on the tier and medications included. Lab work may be additional or included depending on the plan.
Follow-up schedule: Regular lab monitoring every 3 to 6 months. Provider consultations are available on-demand.
State coverage: Available in 35+ states. Expanding coverage.
Strengths: More comprehensive approach to men's health beyond just testosterone. Lab-based venous blood draws for accuracy. HCG and adjunctive therapy options. Physician-level providers.
Limitations: Higher cost than some competitors. Less transparent pricing — plan details may require consultation. Not available in all states.
PeterMD
Overview: PeterMD is a telehealth platform specializing in men's hormone health. They offer TRT along with other men's health services including ED treatment and hair loss. Their model combines physician consultations with medication delivery.
Testing protocol: PeterMD requires lab work before prescribing. Patients can use existing recent lab results or order labs through the platform. The panel includes total testosterone, free testosterone, estradiol, PSA, CBC, and metabolic markers.
Medications offered: Injectable testosterone cypionate, topical testosterone, and in some cases anastrozole (an estrogen blocker) as adjunctive therapy when estradiol levels are elevated.
Cost: Typically $150 to $250 per month including medication and consultations. Lab work costs vary depending on whether drawn through the platform or existing labs.
Follow-up schedule: Follow-up blood work at 8 to 12 weeks, then every 6 months. Regular provider check-ins included.
State coverage: Available in 30+ states.
Strengths: Straightforward men's health focus. Accepts existing lab work, reducing redundant testing. Reasonable pricing for a physician-led platform.
Limitations: Smaller platform with less name recognition. State coverage is more limited than larger competitors. Less comprehensive initial testing than Opt Health.
Defy Medical
Overview: Defy Medical is one of the longest-running telemedicine hormone therapy practices. Founded over a decade ago, they specialize in hormone replacement for both men and women, with particular expertise in complex cases. Their providers include physicians with extensive experience in hormone therapy.
Testing protocol: Defy Medical uses comprehensive lab panels drawn at local labs. Their initial panel is one of the most thorough available, often including total and free testosterone, SHBG, estradiol, PSA, CBC with differential, comprehensive metabolic panel, lipid panel, thyroid panel, DHEA-S, IGF-1, and vitamin D.
Medications offered: Injectable testosterone cypionate, testosterone cream, HCG, DHEA, anastrozole, and other adjunctive treatments. Defy is known for individualized protocols tailored to lab results rather than one-size-fits-all dosing.
Cost: Defy uses a pay-per-visit model rather than a monthly subscription. Initial consultation is approximately $200 to $250. Follow-up visits are $100 to $150. Medication costs are separate and vary. Total monthly cost depends on visit frequency and medications but typically ranges from $150 to $300.
Follow-up schedule: Follow-up labs at 8 to 10 weeks, then every 6 to 12 months. Consultation frequency depends on the patient's stability and needs.
State coverage: Available in most US states via telemedicine.
Strengths: Longest track record among telehealth TRT providers. Most comprehensive lab work. Individualized dosing protocols. Expertise with complex hormone cases. Broadest state coverage.
Limitations: Pay-per-visit model makes costs less predictable than subscription platforms. The platform is less polished than newer competitors. No included at-home testing — requires local lab visits.
Side-by-Side Comparison
| Feature | Hone Health | Opt Health | PeterMD | Defy Medical |
|---|---|---|---|---|
| Monthly Cost | ~$149+ | ~$149-$249 | ~$150-$250 | ~$150-$300 |
| Lab Testing | At-home kit | Local lab (venous) | Either | Local lab (venous) |
| Initial Panel | Comprehensive | Extensive | Standard | Most extensive |
| HCG Available | Limited | Yes | No | Yes |
| Adjunctive Meds | Limited | Yes | Anastrozole | Full range |
| State Coverage | 40+ | 35+ | 30+ | Most states |
| Pricing Model | Subscription | Subscription | Subscription | Pay-per-visit |
| Experience Level | Established | Established | Mid-tier | Longest running |
How to Choose
If convenience and simplicity are your priority: Hone Health's all-in-one model with at-home testing and transparent pricing is the most streamlined option.
If comprehensive health optimization interests you: Opt Health's broader approach covering hormones, metabolic health, and longevity markers goes beyond basic TRT.
If you have complex hormone needs: Defy Medical's experience, individualized protocols, and extensive testing make them the strongest choice for patients with complicated presentations or who have not done well with standard protocols.
If budget is the primary concern: Compare total costs carefully. Hone Health's $149 all-inclusive price is the simplest to evaluate. Defy Medical's pay-per-visit model can be more economical for stable patients who need fewer visits.
Red Flags in Telehealth TRT
No blood work required. Any provider prescribing testosterone without comprehensive lab work is not practicing responsibly.
Prescribing after a single low reading. Guidelines recommend two confirmed low readings before starting TRT.
No follow-up monitoring. Ongoing lab work is essential to monitor hematocrit, PSA, estradiol, and testosterone levels.
One-size-fits-all dosing. Testosterone dosing should be individualized based on lab results, symptoms, and response. Providers who start everyone on the same dose are not personalizing care.
No discussion of fertility. Exogenous testosterone suppresses sperm production. Providers should discuss this with all patients of reproductive age and offer alternatives (like enclomiphene or HCG) when fertility preservation is desired.
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