Questions men actually ask.

A men's health service with five programs: GLP-1 weight care, testosterone replacement therapy (TRT), sexual health, hair loss, and longevity and energy. The process is the same across all of them — complete an online intake, a medical provider licensed in your state reviews your case, and if treatment is appropriate, medication ships from a licensed pharmacy to your door. To be precise about what we are: Gentlemen's Health Collective is a men's telehealth platform, not a care provider. All medical care is delivered by our medical provider partner, an independent network of US-licensed medical providers, and medication is dispensed by licensed pharmacies. Everything runs online, and the program is 100% self-pay.

None of the three. GHC is a men's telehealth platform, not a care provider — we built the front door, not the exam room. Medical care comes from our medical provider partner, an independent network of US-licensed medical providers. Medication is dispensed by licensed pharmacies. Lab work is performed by licensed laboratories. Every medical decision — whether you qualify, which medication, what dose — is made by a medical provider licensed in your state. Our job is to make getting to that provider fast and to give you straight information along the way.

Start with the intake and say so — you can raise more than one goal in a single assessment. You don't have to self-diagnose before you begin; the intake asks about your health history, symptoms, and goals, and a medical provider determines what's actually appropriate. Several of these areas overlap more than most men realize — excess weight can lower testosterone, low testosterone is one cause of ED, and testosterone therapy affects the hormone behind most hair loss. Which program, or which combination, makes sense for you is a medical decision your provider makes with your full picture in hand, not a menu you order from.

Four steps, with real timelines. One: an online health intake — about five minutes, and completing it costs nothing. Two: a medical provider licensed in your state reviews your case, typically within 48 hours and often sooner. For TRT, lab work comes before any prescription — a diagnosis needs numbers, not a hunch. Three: if treatment is appropriate, your provider prescribes and a licensed pharmacy ships medication directly to your door. Four: ongoing check-ins, unlimited messaging with your care team, and provider-managed adjustments. Plan options and full pricing are shown before payment is ever collected.

No. The intake is free to complete, and on the weight program payment is collected after a medical provider has reviewed your case and approved you — you confirm your plan and enter payment once you're approved, not before. Plan options and exact per-cycle pricing are shown up front, so there's nothing to reverse-engineer from a statement. There are no sign-up fees and no membership fees.

No. The program is 100% self-pay — insurance is never required and never billed, so there are no networks, referrals, or claim denials to manage. The price you see is the price. We don't work with insurance in any way — no claims, no prior authorizations, no paperwork. If you want to pursue coverage for a brand-name medication through your own plan, that's between you and your insurer.

Yes. Your health information is protected under HIPAA, encrypted in transit, and shared only with the people involved in your care — your medical provider and the dispensing pharmacy. We do not sell your health data. Medication arrives in discreet packaging with no product identification on the outside. Most men in these programs have never discussed these topics with anyone; the system is built with that in mind.

A medical provider licensed to practice in your state — part of an independent network of US-licensed medical providers who can prescribe medication, order lab work, and build a treatment plan around your health history. GHC doesn't practice medicine and doesn't influence clinical decisions. Your provider approves, declines, adjusts, and monitors. The same care team stays reachable through messaging after you start.

Both, and the mix is up to your case. The intake is a structured questionnaire because structured data is what a provider needs to review your history properly. After that, virtual visits with your medical provider are part of the program, and you can message your care team any time with questions. If your provider needs more information before making a call, they ask — you're not approved or declined by an algorithm.

For TRT: yes, always — no lab results, no TRT prescription, full stop. Low testosterone is a lab diagnosis, and treating without numbers is guesswork we don't do. For weight care: it's your provider's call. Some men are approved after the intake review; others are asked to complete labs first so the provider can see a fuller picture. When labs are ordered, your provider reviews the results with you and they become the baseline your treatment is measured against.

Ongoing care, not a one-time prescription. Plans include virtual provider consultations, personalized 1:1 coaching on nutrition, training, and habits, unlimited messaging with your care team, a progress-tracking platform, and provider-managed dose adjustments. If something feels off mid-cycle, you message a person and a medical provider decides what changes. Refills continue for as long as your provider determines treatment remains appropriate.

Availability depends on where our medical provider partner's network is licensed, and for TRT there's an extra layer: testosterone is a Schedule III controlled substance, and state rules on prescribing it through telehealth vary. The eligibility check tells you quickly whether care is available where you live — that's the fastest way to a real answer for your state.

No, and we won't pretend otherwise. These programs manage specific treatments — weight care, TRT, sexual health, hair loss, and longevity and energy — with the monitoring each of those requires. They are not a substitute for primary care, annual physicals, or emergency care. Keep your own primary care relationship, and tell your GHC medical provider about any care you receive elsewhere so nothing is managed blind. If you are experiencing a medical emergency, call 911.

Semaglutide is a GLP-1 receptor agonist — it mimics a hormone your body releases after eating. The effect: appetite quiets down, your stomach empties more slowly so you stay full longer, and blood sugar runs steadier. Brand-name semaglutide is sold as Ozempic® (FDA-approved for type 2 diabetes) and Wegovy® (FDA-approved for chronic weight management), both from Novo Nordisk, taken as a once-weekly injection. Compounded semaglutide contains the same active pharmaceutical ingredient but is a separate preparation, and it is not FDA-approved.

Tirzepatide activates two receptors — GLP-1 and GIP — that regulate appetite and blood sugar. Brand-name tirzepatide is sold as Mounjaro® (FDA-approved for type 2 diabetes) and Zepbound® (FDA-approved for chronic weight management), both from Eli Lilly, taken as a once-weekly injection. In published head-to-head trial data on the branded products, tirzepatide produced larger average weight loss than semaglutide — a data point, not a recommendation; which medication fits your case is your provider's call. Compounded tirzepatide is a separate preparation and is not FDA-approved.

Here's the distinction, stated plainly. Brand-name medications (Ozempic®, Wegovy®, Mounjaro®, Zepbound®) are FDA-approved: the exact formulation was reviewed by the FDA and studied in the published clinical trials. Compounded semaglutide and compounded tirzepatide contain the same active pharmaceutical ingredient, but each is a separate preparation made by a state-licensed compounding pharmacy — not FDA-approved, and not the drug that was in the trials. Compounding pharmacies are FDA-regulated, which is a real safeguard but a different one. GHC offers both pathways; a medical provider decides which, if either, is appropriate for you.

No — and any brand that implies otherwise is misleading you. Compounded preparations are not FDA-approved; they're produced by state-licensed compounding pharmacies operating under USP standards, and those pharmacies are FDA-regulated. That's the honest version of the answer: regulated facility, unapproved preparation. The published safety and efficacy data comes from trials of the FDA-approved branded products, which is exactly why provider screening and ongoing monitoring matter more with a compounded option, not less.

Yes. Brand-name options including Ozempic® and Zepbound® are available when a medical provider determines one is appropriate, alongside the compounded options. Brand-name medications cost substantially more — that's the market, and we'd rather show you the real numbers than hide the gap. Branded prescriptions through GHC are self-pay like everything else — we don't bill or coordinate with insurance. Which pathway makes sense is a decision you make with your provider, with the prices in front of you.

Yes. GHC's weight program includes oral compounded options for both semaglutide and tirzepatide in addition to the once-weekly injections. Worth knowing before you choose on preference alone: the large published weight-loss trials were run on the branded injectable products, so the injection is the better-studied route. If needles are the obstacle, say so in your intake — your medical provider will lay out what's realistic and prescribe what fits your case. Oral compounded preparations, like all compounded medications, are not FDA-approved.

The published numbers: in the STEP-1 trial of FDA-approved semaglutide (Wegovy®), participants averaged about 15% body-weight loss over 68 weeks. In SURMOUNT-1, FDA-approved tirzepatide (Zepbound®) averaged up to about 21% at the highest dose over 72 weeks. Both trials paired medication with diet and activity changes. Read those numbers correctly: they're averages from trials of the branded products — compounded preparations weren't studied in them — and individual results vary. Some men lose more, some less, and a small share respond minimally. Your provider helps you set a target based on your body, not a trial average.

Some lean mass typically goes with any significant weight loss — that's physiology, not a defect of the medication. The countermeasures are unglamorous and effective: adequate protein, resistance training, and a loss rate your provider considers appropriate. This is exactly what the 1:1 coaching in the program is for — keeping the weight you lose fat, not strength. If maintaining muscle is a priority, put it in your intake so your plan is built around it from day one.

The common ones are gastrointestinal: nausea, vomiting, diarrhea, constipation, and stomach discomfort — most noticeable when starting or raising a dose, and typically easing as your body adjusts. That's why dosing starts low and steps up gradually. The serious-but-uncommon list deserves equal billing: pancreatitis, gallbladder problems, and a boxed warning for thyroid C-cell tumors seen in rodent studies. Severe, persistent abdominal pain means seek medical care now, not a message later. Your provider screens your history against all of this before anything is prescribed and stays reachable after.

Based on the screening criteria used in this program, GLP-1 medications may not be appropriate if you: are trying to conceive; have end-stage kidney disease or are on dialysis; have end-stage liver disease; have an active or prior eating disorder; have current suicidal ideation or a prior suicide attempt (if you're struggling now, call or text 988 — the Suicide & Crisis Lifeline — before you do anything else); have active cancer or are in cancer treatment; have a current or past episode of pancreatitis; have had an organ transplant; have severe gastrointestinal conditions such as gastroparesis or inflammatory bowel disease; or have a personal or family history of medullary thyroid carcinoma or MEN 2. The list isn't exhaustive — a medical provider makes the final call on your full history.

Appetite changes usually show up within the first two weeks. Meaningful weight change takes longer — dosing deliberately starts low and escalates over several months to keep side effects manageable, and in the published trials of the branded products, weight loss accumulated steadily over roughly a year. If the scale hasn't moved after the early months at a therapeutic dose, that's a provider conversation: adjust, switch, or reassess. Individual results vary.

No, but here's the honest data: appetite typically returns when the medication stops, and in a published follow-up to the branded-product trials, participants regained roughly two-thirds of lost weight within a year of stopping. Providers treat weight as a long-term condition — managed like blood pressure, not cured in a course. Some men eventually taper off with provider guidance and hold their results on habits; others do better with ongoing maintenance. If getting off medication eventually is your goal, say so — your provider can plan for it deliberately.

Yes, for men who qualify: a BMI of 22 or above, a previous diagnosis of obesity (BMI 30+) or overweight (BMI 27+), and GLP-1 treatment within the past 12 months. Below a BMI of 22, continued medication requires in-person clinical management for safety, and this program will tell you that rather than prescribe anyway. Maintenance is provider-managed like everything else — the eligibility quiz is the fastest way to see where you stand.

Testosterone replacement therapy is a prescription treatment that restores testosterone to a normal physiologic range in men whose bodies aren't producing enough of it — confirmed by lab work, not by how you feel on a bad week. What it isn't: a performance enhancer, a bodybuilding shortcut, or something a provider prescribes to a man whose levels are already normal. Testosterone is a Schedule III controlled substance, prescribed and monitored by a medical provider, with lab work before and during treatment. If your levels are low and your symptoms match, TRT is a legitimate medical treatment. If they aren't, it isn't — and this program will tell you so.

The recognized symptom cluster: low sex drive, erectile dysfunction, fewer morning erections, persistent fatigue, loss of muscle mass and strength, increased body fat, low mood or irritability, trouble concentrating, and disrupted sleep. Two things to know before you self-diagnose. First, every symptom on that list has other possible causes — poor sleep, excess weight, thyroid issues, medication side effects, depression — which is exactly why diagnosis starts with lab work. Second, if low mood is the symptom that brought you here, take it seriously on its own terms; the 988 Suicide & Crisis Lifeline is there to call or text if things are heavy, and a medical provider can help you sort out what's hormonal and what isn't.

Two broad categories. Primary hypogonadism: the testes themselves aren't producing enough — from genetics, injury, infection, or certain treatments. Secondary hypogonadism: the signaling from the brain (LH and FSH from the pituitary) is reduced — commonly driven by excess body fat, obstructive sleep apnea, opioid use, certain medications, or chronic illness. The distinction matters because it changes the treatment conversation: lab work can locate where the problem is, and when the cause is something addressable — weight, sleep apnea — treating that cause is part of the honest plan, not a footnote to it.

Three, as of now, all prescribed only when a medical provider determines treatment is appropriate. One: testosterone cypionate injection — a compounded formulation that can include anastrozole where prescribed. Two: enclomiphene, an orally disintegrating tablet — a compounded medication that works differently from testosterone itself (details below). Three: gonadorelin, an orally disintegrating tablet used as an add-on for some men on testosterone. Brand-name options are available when medically appropriate. Compounded preparations are not FDA-approved; they're dispensed by state-licensed compounding pharmacies. Which option fits your labs, goals, and fertility plans is your provider's decision, made with you.

It depends on which product, so here's the map. FDA-approved testosterone products exist — testosterone cypionate injection is available in FDA-approved forms, and that approval belongs to those specific products. Compounded formulations, including combination preparations that add anastrozole, are not FDA-approved — they're made by state-licensed compounding pharmacies. Enclomiphene is not FDA-approved in any form; it's available only as a compounded medication. When you review options with your medical provider, ask which category your prescription falls in — you're entitled to that answer, and here it's stated on the label and the paperwork, not buried.

Because some testosterone converts to estradiol — an estrogen — through a process called aromatization, and in some men on TRT that conversion runs high enough to cause side effects like water retention or breast tissue tenderness. Anastrozole is an aromatase inhibitor: it slows that conversion. It isn't automatically necessary — estradiol has real jobs in men, including bone health, and driving it too low causes its own problems — so whether your prescription includes it, and at what amount, is a lab-guided decision your medical provider makes and monitors. The combined preparation is compounded and not FDA-approved.

Numbers plus symptoms — you need both. The standard approach, consistent with clinical practice guidelines: a morning blood draw measuring total testosterone, repeated on a separate day to confirm, interpreted alongside your symptoms and history by a medical provider. One low reading isn't a diagnosis, and a normal reading with vague symptoms isn't a prescription. This program doesn't prescribe testosterone from a questionnaire; lab work comes first, every time.

Because testosterone moves. It's highest in the morning and declines through the day; it dips when you're ill, short on sleep, or under acute stress; and day-to-day variation alone can swing a borderline number across the diagnostic line. A single afternoon reading can make a normal man look low or a low man look normal. Repeating a morning measurement on a separate day is how guidelines separate a real deficiency from a bad Tuesday. It costs a little more time up front and prevents the more expensive mistake: treating a number that was never really low.

The core: total testosterone, drawn in the morning. Depending on your case, your medical provider may also look at free testosterone (the unbound fraction available to your tissues), LH and FSH (pituitary signals that locate whether the issue is production or signaling), estradiol, and baseline safety markers — typically hematocrit, and PSA where appropriate for prostate monitoring. The exact panel is your provider's call. The point of measuring more than one number: it tells you not just whether testosterone is low, but why — and the why changes the treatment.

Lab work is ordered by your medical provider and completed before any TRT prescription — an in-person blood draw at a licensed laboratory, with results reviewed by your provider and by you. Morning draws are the standard for testosterone, and your provider will tell you exactly what's ordered and why. Ongoing monitoring labs during treatment follow the same pattern. Details on lab locations and timing are laid out during intake for your state.

Then TRT isn't the answer, and you'll hear that directly — a normal testosterone level means testosterone isn't the thing to fix. That's not a wasted test; it's the guesswork eliminated. Your symptoms are still real, and the usual suspects behind low-T-like symptoms with normal labs — sleep debt, sleep apnea, excess weight, thyroid issues, medication effects, stress, low mood — are each worth running down, some of them within GHC's weight program, most of them with your own primary care provider. What this program won't do is prescribe a controlled substance to a man whose numbers don't support it.

Published clinical data on testosterone therapy shows a staggered timeline, not an overnight switch: changes in sex drive and energy often appear within about 3 to 6 weeks; mood effects tend to follow a similar early window; changes in body composition — more lean mass, less fat — build over 3 to 6 months and can continue toward the one-year mark. Individual responses vary, and dose adjustments along the way are normal. If nothing at all has shifted by the point your provider expects it to, that's a data point too — levels get rechecked and the plan gets revisited.

Different mechanisms, honestly different trade-offs. Testosterone cypionate is replacement: it supplies testosterone directly, which reliably raises your level — and also signals your brain to slow its own production, which suppresses sperm production while you're on it. Enclomiphene works upstream: it prompts the pituitary to release more LH and FSH, pushing your own testes to produce more testosterone — which generally preserves fertility signaling, though it depends on your body being able to respond to that push. Enclomiphene is not FDA-approved and is available only as a compounded medication. Which mechanism fits your labs, your fertility plans, and your goals is your medical provider's call.

On a schedule, not on vibes. The typical pattern, consistent with clinical practice guidelines: baseline labs before starting, a recheck in the first months of treatment (commonly around the three-month mark) to confirm your level landed in range and to check hematocrit, another after any dose change, and then periodic monitoring — your provider sets the cadence, often every 6 to 12 months once stable. PSA monitoring is included where appropriate. Monitoring isn't an upsell here; it's the condition of treating with a hormone at all, and refills are tied to it.

Yes — but plan the exit with your provider instead of just not refilling. While you're on testosterone, your body's own production stands down; stop abruptly and there's a gap before your natural output recovers, during which low-T symptoms can return or worsen. A medical provider can manage that transition deliberately — tapering, timing, sometimes medications that help restart your own production — and recheck labs along the way. Also worth saying plainly: nothing about this program is designed to trap you on treatment. Cancel any time and future cycles stop billing; just loop your provider in on the medical side of stopping.

Not automatically, but be realistic about what it is: treatment for the time your body under-produces, not a cure that fixes production and walks away. Many men whose deficiency has a fixed cause stay on TRT long-term, with monitoring, the way other chronic conditions are managed. Others — especially where weight, sleep apnea, or medications were driving the number down — address the underlying cause and reassess with their provider whether treatment is still needed. Your labs, your cause, your call to make together with your medical provider, revisited over time rather than decided forever on day one.

Yes — this is the one to read before you start, not after. Testosterone therapy suppresses the pituitary signals (LH and FSH) that drive sperm production, and on TRT, sperm counts fall — often dramatically, sometimes to zero. Recovery after stopping is common but slow — typically months, sometimes longer — and it isn't certain for every man. So the rule is simple: if having children is in your plans, near-term or someday, say so in your intake. Options exist for exactly this situation — enclomiphene instead of testosterone, gonadorelin alongside it, or banking sperm first — and your medical provider will build around your answer. TRT is not a form of birth control, either; suppressed doesn't mean zero.

Enclomiphene is a selective estrogen receptor modulator taken as a tablet. Instead of replacing testosterone from outside, it blocks the estrogen feedback signal at the brain, which raises LH and FSH — the hormones that tell your testes to produce both testosterone and sperm. That's the fertility logic: your own production goes up rather than being shut down. The honest caveats: it requires a body that can respond to the signal (it targets secondary, not primary, hypogonadism), published long-term data is thinner than for testosterone itself, and it is not FDA-approved — it's available only as a compounded medication from state-licensed compounding pharmacies. Whether it fits your case is your medical provider's determination.

Gonadorelin is a synthetic version of GnRH — the hormone at the very top of the chain that prompts the pituitary to release LH and FSH. For some men on testosterone therapy, a provider adds it to keep those signals from going fully quiet, with the goal of maintaining testicular function and size during treatment. It's an add-on when appropriate, not a default, and it's a compounded medication, not FDA-approved. If preserving testicular function or future fertility matters to you, it's a specific thing to raise with your medical provider by name.

The most common lab finding on TRT: testosterone stimulates red blood cell production, and in some men hematocrit — the fraction of your blood that's red cells — climbs too high, a condition called erythrocytosis. Blood that's too thick raises clot risk, which is why hematocrit is checked at baseline and rechecked on schedule rather than assumed. If it rises, the fixes are practical and provider-managed: dose adjustment, a change in formulation or frequency, or in some cases donating blood. This is the textbook example of why TRT without monitoring isn't a shortcut — it's just untracked risk.

Here's the current evidence, straight. The largest cardiovascular safety trial to date — TRAVERSE, published in the New England Journal of Medicine in 2023, roughly 5,200 men with hypogonadism and elevated cardiac risk — found testosterone therapy did not increase major adverse cardiac events (heart attack, stroke, cardiovascular death) versus placebo. The same trial saw higher rates of atrial fibrillation, pulmonary embolism, and acute kidney injury in the testosterone group — real signals that belong in the conversation, not the fine print. Net read: for appropriately screened and monitored men, the old headline fear isn't supported by the best data, and the newer signals are exactly why screening and monitoring aren't optional. Your medical provider weighs your specific cardiac history before prescribing.

The best current evidence doesn't show that testosterone therapy causes prostate cancer — the older assumption that more testosterone straightforwardly feeds prostate cancer hasn't held up in modern trial data, including dedicated prostate-safety analyses. That's not the same as "no prostate considerations": active prostate cancer is a contraindication to TRT, PSA is checked where appropriate at baseline and during treatment, and an unexplained PSA rise gets investigated rather than ignored. Evidence-honest summary: monitored TRT and prostate vigilance travel together — you get both here or neither.

Screening rules some men out, and the list is worth knowing up front: men with active prostate cancer or male breast cancer; men actively trying to conceive now (TRT suppresses sperm production — raise this in your intake and the conversation changes to fertility-preserving options); men with untreated severe obstructive sleep apnea; men with severely elevated hematocrit; men with uncontrolled heart failure or a recent heart attack or stroke; and men whose lab work doesn't actually show a deficiency. This list isn't exhaustive, and edge cases exist in both directions — the final call belongs to a medical provider with your full history and your labs in front of them.

The common ones: acne or oilier skin, injection-site soreness, some fluid retention, testicular shrinkage (the suppression effect described above), and changes in mood or sleep as levels adjust. The monitored ones: rising hematocrit, shifts in estradiol that can cause water retention or breast tenderness, and worsening of existing sleep apnea. The structural one: suppressed sperm production while on treatment. None of this is listed to scare you off a legitimate treatment — it's listed because you should hear it from the program before you hear it from your body. Most of it is manageable with dose and formulation adjustments, which is what the monitoring schedule is for.

GHC's sexual health program offers prescription treatments for erectile dysfunction, reviewed by a medical provider licensed in your state. The options are rapid-dissolve oral treatments — orally disintegrating tablets built on the molecules sildenafil, tadalafil, and apomorphine, offered as single-molecule tablets and as compounded combination tablets. What's actually appropriate for you, at what strength, or whether medication is appropriate at all, is decided by a medical provider from your health history — not self-selected from a menu. The compounded combination tablets and ODT formats are not FDA-approved. Everything is prescription-only, provider-gated, and 100% self-pay.

Both are prescription molecules that work on the blood-flow side of an erection — they don't create arousal, they support the vascular response once arousal is there. The practical difference between them is time. Sildenafil is shorter-acting and taken as needed. Tadalafil stays active longer — up to about a day and a half — which is why it can also be prescribed as a low daily dose. Sildenafil is the active ingredient in Viagra® and tadalafil is the active ingredient in Cialis®; what's offered through GHC is not those brand-name products — it's compounded ODTs, a different regulatory category described further below. Which molecule fits your case is your medical provider's decision.

Learn: Sildenafil vs. Tadalafil — The Honest Differences →

Apomorphine works upstream from the blood-flow molecules — on dopamine signaling in the brain rather than on blood flow. Two honest facts stated plainly: no FDA-approved ED medication contains apomorphine, and its published evidence for ED is thinner than sildenafil's or tadalafil's. It exists in the GHC formulary only inside compounded combination tablets, and whether that trade-off makes sense for you is your medical provider's call, not a checkout option.

For some men one molecule is exactly right, and the single-molecule ODTs exist for that reason. Combination options pair a blood-flow molecule (sildenafil or tadalafil) with a second mechanism to give a provider more to work with when a single molecule alone isn't the best fit. More molecules isn't automatically better — it's more pharmacology, which is precisely why a medical provider decides rather than you picking from a shelf. Combination ODTs are compounded preparations and are not FDA-approved.

An orally disintegrating tablet dissolves in your mouth — no water, no pill bottle to manage. Every option in the GHC sexual health program is an ODT. Worth being precise about what that means: the dissolving format is a convenience, not a potency claim. It doesn't make a molecule stronger or faster in any way the program claims; it's simply a different, more discreet way to take it.

These are generally taken around the moment they're meant for rather than on a rigid daily schedule — with one exception: tadalafil's longer duration means it can be prescribed as a low daily dose in some cases. Your medical provider gives you the specific instructions for whatever you're prescribed, including any limit on how often to take it. Follow those instructions rather than improvising — dosing and frequency are part of what keeps these safe, and they're set for your case, not generic.

Tell your provider — don't just double up on your own. The first prescription is a starting point, and if it disappoints, your medical provider can adjust the molecule, the strength, or the approach based on what happened. Which option and strength is a provider decision from the start, and it stays a provider decision when something needs to change. Never stack these with another ED medication, including herbal or gas-station products, to compensate — regulators have repeatedly found those to contain undisclosed prescription-strength ingredients at unknown doses.

Generally no for ED. The intake asks real health-history questions instead — every medication you take, blood-pressure medicines and nitrates especially, and what's changed. If something in your answers needs a closer look, your medical provider handles it, including a video visit when your case requires one. Because these medications aren't controlled substances, the path is typically faster than testosterone therapy, and the assessment confirms your state in about a minute.

The hard stop is nitrates. If you take nitrates in any form — nitroglycerin, isosorbide, tablets, patches, or sprays — sildenafil and tadalafil are off the table, because the combination can drop your blood pressure to dangerous levels. It's the first thing your medical provider screens for, and it is not negotiable. Beyond that, sex is exertion: if your cardiovascular picture can't safely carry exertion — a recent cardiac event, unstable chest pain, uncontrolled blood pressure — the answer may be no until that's addressed. Some prostate-relaxing medications and some blood-pressure medications also interact. List everything in the intake; the final call belongs to your medical provider.

Nitrates, yes — that combination is dangerous and is screened out first, without exception. Other heart and blood-pressure medications aren't an automatic no, but they require provider judgment because some of them stack with these medications' own blood-pressure effects. That's exactly why the intake asks you to list every medication you take. Your medical provider makes the dosing decision with the full picture in front of them.

The everyday list: headache, flushing, congestion, and upset stomach. Sildenafil can cause temporary visual changes; tadalafil can cause back or muscle aches. The combination options that include apomorphine add their own possibilities — nausea, dizziness, drowsiness, yawning, and drops in blood pressure. Most effects pass, and your medical provider tells you which ones shouldn't be waited out. One emergency line worth knowing before you start: an erection lasting more than four hours is a medical emergency that can cause permanent damage — emergency room, not wait-and-see — as is chest pain during sex or any sudden change in vision or hearing.

Yes, and it's worth taking seriously. An erection is a vascular event, and the arteries involved are small — so trouble here can show up years before it shows up anywhere else in your body. That's why the intake asks real health-history questions instead of just handing over a pill: treating ED without looking at the health behind it is treating the dashboard light instead of the engine. Even if this program isn't the right fit for you, don't ignore the signal — get a medical provider to look at the health behind it. And if what's weighing on you is more than physical, the 988 Suicide and Crisis Lifeline is there to call or text, any hour.

Yes. The assessment happens privately online — no waiting room, no pharmacy-counter conversation — and if you're prescribed, medication ships from a state-licensed compounding pharmacy in discreet packaging with nothing on the outside identifying the contents. Your health information is protected under HIPAA and shared only with the people involved in your care.

It's async-first. A medical provider licensed in your state reviews your case asynchronously, typically within 24 to 48 hours — not an algorithm, and not a sales page. If your case calls for a live conversation, you get a prescheduled video visit with a medical provider; if it doesn't, you skip it. Async-first is the default, not a shortcut past medicine — the provider still makes every call.

Learn: How Online ED Treatment Actually Works →

Medication is supplied as pouches of ODT packets, dispensed by a state-licensed compounding pharmacy, and billed per the plan you confirm at the end of intake — the per-pouch prices are shown before you pay anything. A refill review with your medical provider every 12 weeks keeps the prescription honest. Prices are self-pay, with no surprise price hikes: if pricing ever changes, you hear it from us in advance, before it touches a billing cycle. Cancel any time and future pouches stop billing; past payments are not refundable.

No. Sildenafil and tadalafil are real molecules that also exist in FDA-approved brand-name products, but the compounded ODTs offered through GHC are not FDA-approved — they're a different regulatory category. Each one is prepared to your medical provider's prescription by a state-licensed compounding pharmacy operating under USP <795> standards. They contain the same molecules in the case of sildenafil and tadalafil, but they are not the same drug products and were not the products studied in the brand-name clinical trials. Apomorphine goes a step further: it isn't an ingredient in any FDA-approved ED medication at all. What the compounded route offers is combinations and a dissolving-tablet format that don't exist as brand-name products; what it doesn't offer is FDA approval or a claim to be the same thing.

Often, yes — but it's a medical decision, not a bundle. Low testosterone is itself one of the possible causes of ED, so if you're on or considering TRT, that's worth raising in your intake because it may change the conversation. Excess weight and the cardiovascular strain that travels with it are among the other causes. Tell your provider every medication and treatment you're on, here and elsewhere, so nothing is managed blind. Whether treatments run together is your medical provider's call, made from your full picture.

Most male hair loss runs on one mechanism: a hormone called DHT, made from testosterone, gradually shrinks genetically sensitive follicles until the hair they produce gets finer, shorter, and finally stops coming back. It isn't your shampoo, your hat, or your character — it's biochemistry plus inheritance, running on its own schedule. That's actually useful, because a mechanism gives medicine something to act on: the prescription options either lower DHT at the follicle or push follicles to grow more actively.

A formulary of prescription options — topicals applied to the scalp, once-daily oral tablets, combinations that use two mechanisms at once, and supportive adjuncts — plus honest labeling of which category each falls in. Every option ships as a 4-week supply and bills every 28 days. What your medical provider actually prescribes — one of these, a different one than you expected, or none — comes from your history and your pattern of loss, not from which option you liked. Some formulations are FDA-approved generics; several are compounded and not FDA-approved; and a few FDA-approved medications are prescribed off-label for hair. All three categories are labeled plainly.

Finasteride is an oral medication that lowers DHT — the hormone driving most male hair loss. The finasteride 1mg tablet is a generic of the brand-name product that has been FDA-approved for male pattern hair loss since 1997; the generic carries that same brand-name approval. Finasteride also appears in some compounded topical formulations, which are not FDA-approved as those formulations. Whether finasteride fits your case, and in which form, is your medical provider's decision — and the sexual side-effect question that comes up with it is answered plainly further down.

Minoxidil pushes follicles toward a more active growth phase. Topical minoxidil (the 5% foam) is the generic of a brand-name FDA-approved over-the-counter medication, applied to the scalp. Oral minoxidil (low-dose 2.5mg tablets) is the generic of a medication first approved by the FDA decades ago for blood pressure; its low-dose use for hair is off-label — an approved medication prescribed outside its original approval, which is legal, common, and a judgment your provider makes. Same molecule, two deliveries; which one, if either, fits you is a provider call. Oral minoxidil can uncommonly cause unwanted hair growth beyond the scalp, ankle swelling, or a racing heartbeat — report those promptly.

Learn: Oral vs. Topical Minoxidil for Men →

Dutasteride is an oral DHT-blocker — it blocks DHT more broadly than finasteride and stays in your system considerably longer after you stop. It's the generic of a brand-name product FDA-approved for enlarged prostate; using it for hair loss is off-label, stated plainly. It also appears in some compounded topical combinations, which are not FDA-approved as those formulations. It carries a similar class of sexual side effects to finasteride, so whether it's appropriate is a provider decision made with those trade-offs on the table.

They're supporting players, not the main event. Tretinoin appears in some compounded topical formulations to help the active ingredients penetrate the scalp; a low-dose anti-inflammatory version exists for easily irritated scalps. Ketoconazole 2% shampoo is the generic of a brand-name product FDA-approved for certain scalp conditions; its role in a hair-loss plan is supportive and off-label. Neither is a stand-alone hair-loss cure — they're adjuncts a provider may include to make a core treatment work better or sit easier on your scalp. Compounded formulations are not FDA-approved.

Here's the honest version: biotin is a dietary supplement, not a drug, and unless you're genuinely deficient, the evidence that biotin regrows hair is thin. It's offered as support, and the program won't pretend otherwise. Supplement statements haven't been evaluated by the FDA, and biotin isn't intended to diagnose, treat, cure, or prevent any disease. If a provider includes it, it's as a small piece of support alongside the medications that do the real work.

Here are the numbers instead of the whisper. In the original clinical trials of brand-name finasteride 1mg, sexual side effects — lower sex drive, erection difficulty, changes in ejaculation — were reported by roughly 4 in 100 men, versus about 2 in 100 men on placebo. So the difference attributable to the medication was roughly two additional men in 100. Most cases resolved, either with continued treatment or after stopping. A smaller number of men report symptoms that persisted after stopping; how often that happens and why is still genuinely debated in the medical literature — but you deserve to know those reports exist before the first tablet, not after. These figures are from trials of the brand-name original; individual results vary, and compounded preparations weren't part of those trials.

Learn: Finasteride Side Effects — The Honest Guide →

Yes, and it belongs on the table. Depression and, rarely, suicidal thoughts have been reported in men taking finasteride and dutasteride. If your mood shifts on treatment, tell your medical provider promptly. And if you're struggling right now, call or text 988 — the Suicide and Crisis Lifeline — any hour, before anything else.

That's the shed, and it's common — especially on minoxidil. In the early weeks, many men shed more hair before they see improvement, as follicles reset their growth cycle. It looks like the treatment is failing. It usually isn't. We tell you now so week three doesn't blindside you; it's a phase most men pass through, not a verdict.

Three to six months for the earliest visible change, and a year for the fair verdict. The first weeks are working underneath where the mirror can't see it, often with that early shed. Loss typically slows over months two and three. Months three to six is the earliest window where visible change shows up for men who respond — and not everyone responds; a real fraction of men see stabilization but little regrowth, and some see neither. By a year, you and your provider know what treatment does for your follicles. Anyone promising faster is selling the montage, not the medicine. Take a photo in consistent light at a regular interval — memory is a terrible instrument.

Then your provider levels with you rather than charging you to keep guessing. Your 12-week refill review is where a medical provider reads your progress and side effects and decides to continue, adjust, or stop the plan based on what's actually happening — not on hope. Some men are told up front that their pattern won't respond enough to be worth it, or that a long-bare area is past the point medication can help. That answer costs you nothing and comes from a provider, not a sales page.

Yes — photos of your hairline and crown do more diagnostic work than any quiz answer, so you'll add them during the assessment. Front hairline and crown, in good, consistent lighting. They're also where the every-12-week refill reviews pay off: they give your provider a real record over time to read your progress against, instead of relying on memory.

Probably not, and the program won't charge you to find out slowly. Treatment defends what's still active and can recover ground lost recently; a follicle that's been bare for years is usually beyond reach. There's no cure for this kind of hair loss. The provider review is where you get that answer honestly, before you spend a dollar.

Results last while treatment continues. Stop, and the underlying process resumes within months — that's not a subscription trick, it's how the biology works. It's a maintenance decision, and it's yours to make with your provider and the full picture in front of you.

Every option is a 4-week supply, billed every 28 days — which means 13 billing cycles across a 364-day year, not 12, and we'd rather print that arithmetic than let you find it on a statement. Prices run from $29 to $89 per 28-day supply depending on the option. Provider review, refill reviews every 12 weeks, messaging, and shipping from a state-licensed pharmacy are included — nothing sold separately, no sign-up or membership fee. You pay nothing until a medical provider approves treatment and you confirm your plan. No surprise price hikes; cancel any time and future cycles stop billing.

Often yes, but it's worth a specific conversation. Testosterone therapy can affect DHT levels, and finasteride and dutasteride lower PSA readings by about half — something any provider monitoring your prostate on TRT needs to know. So if you're on or considering TRT, put your hair-loss interest in the same intake and tell your provider everything you're taking. Whether the two run together, and which hair-loss option fits alongside testosterone, is your medical provider's call.

Three compounds, each with a very different story: NAD+, sermorelin, and B12 MIC. The program's whole premise is the honest version — what these are, where the science is solid and where it's thin, and a private review by a medical provider who decides what, if anything, is appropriate for you. All three are compounded and not FDA-approved. Whether any of it fits your situation, and which one, is a provider decision from your health history, not something you self-select from a menu.

NAD+ — nicotinamide adenine dinucleotide — is a coenzyme found in every cell in your body. Its job is chemistry: it's central to how cells convert fuel into usable energy and to several cellular-repair pathways. Through GHC it's offered as a compounded injection or nasal spray. Important to separate two things: that's a description of what the molecule does inside a cell, not a claim about how you'll feel — and the compounded preparations are not FDA-approved.

Here's the honest read. The biochemistry isn't in dispute — NAD+ is essential to cellular metabolism, full stop. What's thin is the human evidence that supplementing it produces the anti-aging or performance results the market implies. Most of the striking findings come from cell and animal studies; well-controlled human trials on hard outcomes are limited and early. Anyone selling NAD+ as a settled fountain of youth is ahead of the data. The honest position: interesting compound, active research, unproven for the big promises — which is exactly why a provider, not a checkout page, decides whether it's worth it for you.

Learn: What Is NAD+ — and What the Evidence Actually Shows →

Both are compounded preparations of the same coenzyme, offered through GHC as an injection or as a nasal spray; they're two delivery formats rather than two different medicines. Which format — or whether NAD+ is appropriate for you at all — is your medical provider's decision from your health history. Neither format is FDA-approved, and neither changes the honest evidence picture: the biochemistry is established, the big human-outcome promises are not.

Sermorelin is a synthetic peptide — a fragment of the natural signal (growth-hormone-releasing hormone) your body uses to tell the pituitary gland to release growth hormone. Instead of supplying a hormone from outside, it nudges your own gland to do its own signaling. One fact stated up front, because most sites bury it: there is no FDA-approved sermorelin product on the market today, for any use. It's available only as a compounded medication, offered through GHC as a compounded injection.

Learn: Sermorelin — What to Know Before You Consider It →

Its mechanism is plausible — it can stimulate the body's own growth-hormone signaling. What the published human evidence does not establish is that this translates into the longevity, body-composition, or vitality outcomes it's marketed for in healthy adults. Its record is thinner and older than the marketing suggests, and there's no FDA-approved sermorelin product to point to. It's a compounded medication, and the decision to use one is a medical one your provider makes with you.

B12 MIC is methylcobalamin — vitamin B12 — usually combined with MIC, three compounds (methionine, inositol, choline) grouped under the label lipotropic, offered as a compounded injection. B12 has a well-established medical use: correcting a diagnosed B12 deficiency. The broader claims stapled to B12 and MIC shots in people who aren't deficient are a different matter, and the program is honest about that distinction.

If you have a genuine B12 deficiency, correcting it is real, established medicine with real effects. If you don't, the popular claims — that B12 or MIC shots raise energy, speed metabolism, or drive fat loss in people with normal levels — are not well supported by the evidence. The program won't tell you otherwise to sell you a subscription. Whether your levels warrant it is exactly the kind of thing a medical provider looks at.

Honestly, that's the open question the whole category oversells. These are real compounds surrounded by largely unproven human-outcome claims, so the program doesn't promise you a feeling on a timeline. What it does promise is structure: if you're prescribed something, a refill review with your medical provider at 3 to 4 weeks confirms how you're actually doing before anything continues, and reviews every 12 weeks after that. A high mechanism reading isn't an outcome — involved in cellular energy is chemistry, not a promise about how you'll feel.

No. The NAD+, sermorelin, and B12 MIC offered through GHC are compounded medications, not FDA-approved. Sermorelin goes a step further: there's no FDA-approved sermorelin product for any use on the market today, so there isn't even a branded original to compare a compounded version against. Compounded means each preparation is made to a medical provider's prescription by a state-licensed compounding pharmacy — a real, regulated pathway, and a different regulatory category from an FDA-approved drug that has completed the agency's full review.

Some histories make one or more of these inappropriate — active cancer, certain hormone-sensitive conditions, significant kidney or liver issues, and others among them. The full list isn't something a web page can complete; your history and your provider decide. These are medical products, not groceries: an injectable or intranasal compound goes into your body and interacts with the rest of your health, which is why the model is provider-gated and why the honest answer is sometimes no. Tell your provider everything you already take, including any over-the-counter longevity or peptide products bought online.

Sometimes. Your medical provider orders labs when your history or a specific compound calls for it, rather than as a blanket upsell. The intake starts with health history and what's changed; if something in your answers needs numbers behind it, that's a provider decision, not an automatic add-on.

New starts don't run on auto-pilot. If you're prescribed something, an early refill review with your medical provider at 3 to 4 weeks confirms how you're doing before anything continues, then reviews every 12 weeks keep the prescription honest. Medication ships from a state-licensed compounding pharmacy. Pricing is per 28-day supply, with multi-week plans billed once per term — a 28-day cycle means 13 cycles across a 364-day year, the real arithmetic stated up front. No surprise price hikes, 100% self-pay, and you can cancel any time; future cycles stop billing and past payments are not refundable.

Both programs exist under one roof, and some men are candidates for both — but whether they run together, in sequence, or one at a time is a medical decision your provider makes during intake, not a bundle you add to a cart. The biology genuinely overlaps: excess body fat increases the conversion of testosterone to estrogen and suppresses production, while low testosterone makes it harder to hold muscle and lose fat. Tell the intake everything — weight history, symptoms, fertility plans, goals — and your medical provider will sequence what's appropriate. One rule doesn't change: each treatment is prescribed only if your labs and history support it on its own merits.

It can — and an honest program tells you so before selling you hormones. Published research consistently shows that meaningful weight loss in men with obesity raises testosterone levels, with larger losses producing larger rebounds; for some men whose low reading was driven primarily by excess weight, that recovery is enough on its own. For others it isn't, and lab work is how you find out which man you are instead of guessing. If your numbers are borderline and your weight is the likely driver, your medical provider may point you at weight care first and recheck — that's the numbers-first order of operations working as intended.

Often yes, and it's a common pairing — but raise it as one conversation, not two separate orders. Testosterone therapy affects DHT, the hormone behind most male hair loss, and the hair-loss medications finasteride and dutasteride lower PSA readings by about half, which any provider monitoring your prostate on TRT needs to know. Put both in the same intake and tell your provider everything you're taking. Which hair-loss option fits alongside testosterone, and whether the two run together, is your medical provider's decision with the full picture in front of them.

They're often related, which is part of why treating both can make sense — but it's a medical decision, not a bundle. Excess weight and the cardiovascular strain that travels with it are among the causes of ED, and low testosterone is another; a provider looks at what's actually driving your case. Both programs are prescription-only and provider-gated on their own merits, and some of the same screening — blood-pressure medications, nitrates, cardiovascular history — matters for the sexual health side. List everything in your intake and your medical provider sequences what's appropriate.

One intake, one care team, one provider view of your health. Because every GHC program runs through the same medical provider partner — an independent network of US-licensed medical providers — the provider reviewing one treatment can see the full picture rather than working blind. That coordination is exactly why the program asks you to list every medication and treatment you're on, here and elsewhere. Whether treatments run together, in sequence, or one at a time is a provider decision made from that whole picture — never a menu you assemble yourself.

The numbers, per 28-day billing cycle. Compounded semaglutide injection: $249 every 28 days on the flexible plan, $219 per 28 days on the 12-week plan (billed $657 every 12 weeks), $199 per 28 days on the 24-week plan (billed $1,194 per term), and $179 per 28 days on the 52-week plan (billed $2,327 per term). Compounded tirzepatide injection: $339 flexible, $309 on 12-week (billed $927), $289 on 24-week (billed $1,734), $269 on 52-week (billed $3,497 per term). Oral compounded options are also available — oral semaglutide from $209 and oral tirzepatide from $269 per 28 days on longer plans. Brand-name medication runs on a different scale — Ozempic® is $1,309 and Zepbound® is $1,409 per 28-day supply through the program. Every plan includes provider care, 1:1 coaching, messaging support, and shipping — no membership or sign-up fees. TRT plans add a $50 initial lab panel, one time; ongoing labs through Quest or Labcorp are included at no cost to you. Exact plan options and billed totals are shown before you pay anything.

The numbers, per 28-day billing cycle. Testosterone cypionate injection: $169 every 28 days on the flexible plan, $149 per 28 days on the 12-week plan (billed $447 every 12 weeks), and $129 per 28 days on the 24-week plan (billed $774 per term). Enclomiphene tablets: $189 every 28 days on the flexible plan, and $169 per 28 days on the 12- and 24-week plans (billed $507 and $1,014 per term). Initial lab work is $50, one time. Gonadorelin, when a provider adds it, is $35 per 28 days. Longer commitments price lower per cycle — the same trade you'd expect anywhere. TRT plans include provider care, monitoring, coaching, messaging support, and shipping. Your exact options and billed totals are shown during intake, after lab work and provider review establish what's actually appropriate to offer you.

Because they're not the same thing — and the difference is both medical and financial. The medical part first: these medications run on a fixed rhythm — weekly injections, daily tablets. A 28-day cycle is exactly four weeks of medication, every single time. Calendar months wobble between 28 and 31 days; bill "monthly" against a weekly regimen and your doses and your shipments slowly drift apart. On a 28-day cycle they can't — every cycle covers the same number of doses and your refill lands on the same rhythm you dose on.

The financial part: a 28-day cycle means 13 billing cycles across a 364-day year — not 12. Brands that advertise a "monthly" price on a 28-day cycle are quietly understating your annual cost by about 8%. We'd rather give you the real arithmetic: multiply your per-cycle price by 13, not 12, and that's your actual year. Per-cycle price and billing cadence are shown before you enter payment. If a charge ever looks wrong, message us — billing questions deserve boring, precise answers.

On the weight program, no — your per-cycle price stays the same across dose levels, so a provider-directed dose increase doesn't show up as a surprise on your statement. And on pricing generally, here's the commitment we'll actually stand behind: no surprise price hikes. If pricing ever needs to change, you'll hear about it from us in advance, before it touches a billing cycle — never discovered on a statement after the fact.

The program is 100% self-pay — no insurance, Medicare, or TRICARE is accepted, required, or billed, which is what keeps the pricing flat and the process fast. GHC doesn't handle insurance paperwork of any kind — if you want to pursue coverage for a brand-name medication through your own plan, that runs directly between you and your insurer. On TRT and insurance generally, a straight word: many insurers cover testosterone only with documented deficiency under their own criteria and their own re-testing rules — the self-pay route here trades that process for flat pricing you can see up front.

Medication ships from a licensed pharmacy directly to your door, with expedited shipping included in your plan price. Packaging is discreet — nothing on the outside identifies the contents. Injectable GLP-1 medication should go into the refrigerator when it arrives, per the label or the pharmacy's instructions. Shipments are timed to your billing cycle so you aren't counting doses at the end of a cycle. If a package arrives late, damaged, or warm, don't use it on a guess — contact your care team or the pharmacy first.

Weight-program refills continue automatically for as long as your medical provider determines treatment remains appropriate, with a quick check-in around refill time so dose changes are caught before the next shipment. TRT runs tighter, by design and by law: testosterone is a Schedule III controlled substance, so refills stay tied to active provider oversight and your monitoring schedule — current labs, periodic reviews, no indefinite auto-pilot. If that sounds like more structure than some clinics advertise, it is. It's also what responsible hormone treatment looks like.

Cancel any time — future billing cycles stop, with no cancellation fee and no long-term contract. Past payments are not refundable, so if you intend to cancel, do it before your next billing cycle rather than after. Plan changes are handled by messaging your care team; medication and dose changes go through your medical provider as part of normal care. One medical note worth repeating: if you're on TRT, tell your provider you're stopping rather than just letting the plan lapse — stopping testosterone abruptly has real physiology attached, and a planned exit beats an accidental one.