Frequently Asked Questions

Is telehealth testosterone therapy legal and safe?

Yes. Telehealth TRT is fully legal when prescribed by a licensed physician after proper evaluation. We follow all state and federal regulations.

How do I know if I have low testosterone?

Common symptoms include:

Persistent fatigue and low energy

Decreased libido and sexual function

Loss of muscle mass despite working out

Increased body fat, especially around the midsection

Mood changes: depression, irritability, lack of motivation

Brain fog and poor concentration

Reduced confidence

The only way to definitively diagnose low testosterone is through blood testing. If you're experiencing multiple symptoms, a consultation and lab work can determine if hormone optimization is appropriate.

Do you only treat patients in Texas?

Currently, we primarily serve patients in Texas. We're expanding our telehealth services to additional states. Contact us to confirm we can serve your location.

Is my information private and confidential?

Absolutely. We're fully HIPAA-compliant. Your medical information is protected with the highest security standards. Consultations are conducted via secure, encrypted telehealth platforms. Medications are shipped in discreet packaging.

Can I use my insurance?

Laboratory testing is often covered by insurance when medically indicated. We provide all necessary documentation for insurance submission.

Treatment (consultations and medications) is typically self-pay, as most insurance companies consider hormone optimization "elective." However, our transparent pricing is often more affordable than insurance copays and deductibles, and you avoid all the insurance bureaucracy.

HSA and FSA cards are accepted.

Treatment Questions

How long until I see results from TRT?

Timeline varies by individual, but typical progression is:

Week 1-2: Improved mood, motivation, and sleep

Week 3-4: Noticeable energy increase, better libido, enhanced mental clarity

Week 6-8: Physical changes begin—increased muscle, decreased fat, strength gains

Month 3-6: Full optimization with significant body composition changes

Most men notice meaningful improvements within the first month.

Is TRT safe?

When prescribed and monitored by a qualified physician, TRT is very safe for most men. We conduct comprehensive screening to ensure you're a good candidate and monitor you regularly to prevent and manage potential side effects.

TRT has been used for decades with extensive safety data. Risks are minimal with proper medical supervision.

What are the side effects of TRT?

Most men tolerate TRT very well. Potential side effects include:

Acne (usually managed with dose adjustment)

Fluid retention (typically temporary)

Elevated red blood cells (monitored via regular labs)

Testicular shrinkage (prevented with HCG if desired)

Hair loss (genetic predisposition, can be treated)

We monitor for these and adjust treatment accordingly. Most side effects are easily managed.

Will TRT make me infertile?

TRT can reduce sperm production and fertility while you're on treatment. However:

The effect is reversible for most men when you stop TRT

You can preserve fertility by adding HCG to your protocol

If you're actively trying to conceive, we recommend HCG therapy instead of or alongside TRT

We discuss fertility goals during consultation and create protocols that align with your family planning.

Do I have to inject testosterone?

No. We offer multiple delivery options:

Injections (most common and cost-effective)—small needles, easy self-administration

Creams/gels (topical application, no needles)

Pellets (implanted every 3-6 months, minimal maintenance)

Your physician helps you choose the method that fits your preferences and lifestyle.

How often do I need follow-up appointments?

After starting treatment:

Week 2-4: Brief check-in

Month 2-3: Follow-up labs and consultation for dose optimization

Ongoing: Quarterly labs and consultations (every 3-6 months)

Between visits, you have messaging access to our team for any questions.

Can I stop TRT if I want to?

Yes. You're never locked into treatment. If you decide TRT isn't right for you, we can safely discontinue it. Your body will resume natural testosterone production over several months.

However, most men feel so much better on optimized hormones that they choose to continue long-term.

What if TRT doesn't work for me?

TRT is highly effective when properly dosed and monitored. If you're not seeing expected results, we:

Re-evaluate your labs to ensure optimal dosing

Check for other factors affecting your symptoms (thyroid, vitamin D, sleep, etc.)

Adjust protocols or add complementary therapies

We're committed to finding what works for you.

Process Questions

How quickly can I start treatment?

From initial consultation to starting treatment typically takes 2-3 weeks:

Day 1-7: Book and complete consultation

Day 8-10: Complete lab work

Day 11-13: Results reviewed, treatment plan created

Day 14: Results consultation and prescription sent

Day 16-18: Medication arrives, begin treatment

Do I need to have lab work done before my first appointment?

No. We'll order appropriate labs during your initial consultation. However, if you have recent hormone labs (within past 3 months), we can often use those to expedite your treatment.

Where do I get my lab work done?

We order labs at facilities convenient to you—typically Quest Diagnostics or LabCorp locations near your home or work. Most locations accept walk-ins.

Do you ship medications to all states?

We ship to states where Dr. Sani is licensed to practice and prescribe. Contact us to confirm your state is covered.

What if I have questions after starting treatment?

You have direct messaging access to our provider team. Most questions are answered within a few hours during business hours. For urgent medical concerns, we provide phone support.

Cost Questions

How much does treatment cost?

Initial Setup:

Consultation: $149

Labs: $150-$300 (often insurance-covered)

Monthly Treatment:

TRT: $150-$250/month

TRT + HCG: $250-$400/month

Peptide therapies: $100-$500/month depending on protocol

Ongoing Monitoring:

Quarterly labs and follow-ups: $175-$250

See our Pricing page for complete details.

Are there any hidden fees?

No. We're completely transparent about all costs upfront. The prices we quote include medication, supplies, and provider support. No surprise charges.

Do you offer payment plans?

We're committed to making treatment accessible. Contact us to discuss payment options if cost is a concern.

Is TRT covered by FSA or HSA?

Yes. Medical consultations, lab testing, and prescribed medications are typically HSA/FSA eligible expenses.

Safety & Medical Questions

Who should NOT use TRT?

TRT may not be appropriate if you have:

Active prostate cancer

Severe untreated sleep apnea

Uncontrolled heart failure

Elevated red blood cell count (polycythemia)

Desire to conceive in near future (without HCG)

We evaluate your medical history during consultation to ensure TRT is safe for you.

How do you monitor for prostate cancer?

We check PSA (prostate-specific antigen) levels before starting TRT and monitor regularly during treatment. Current evidence shows TRT doesn't cause prostate cancer, but we monitor out of caution.

Men over 50 (or 40 with family history) should have regular prostate screening regardless of TRT.

Will TRT cause heart problems?

Current research shows properly monitored TRT is cardiovascular-safe for most men and may even have protective effects. We screen for cardiovascular risk factors and monitor heart health markers regularly.

Men with existing severe heart conditions need individual evaluation.

Can I take TRT if I have high blood pressure or diabetes?

Often yes—and TRT may actually improve both conditions. Low testosterone contributes to metabolic dysfunction. Optimization often improves blood sugar control and cardiovascular health.

We evaluate your specific situation during consultation.

What if I'm on other medications?

Most medications are compatible with TRT. We review your current medications during consultation to ensure safety. Some medications may need dose adjustments.

Peptide Questions

Are peptides safe?

Yes, when prescribed and monitored appropriately. Peptides have been used in medicine for years with good safety profiles. Side effects are typically minimal.

Are peptides FDA-approved?

Most peptides we use are prescribed off-label. They're legal to prescribe but not FDA-approved for all the applications we use them for. This is common in medicine—many effective treatments are used off-label.

Do I need to be on TRT to use peptides?

No. Peptides can be used independently or combined with hormone therapy. We create protocols based on your individual goals.

Can peptides help me lose weight?

Yes. GLP-1 peptides (semaglutide, tirzepatide) are highly effective for weight loss, producing 15-20%+ body weight reduction on average. Growth hormone peptides also support fat loss while building muscle.

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Vanguard Men's Health

Vanguard Men’s Health specializes in personalized, physician-led hormone optimization and men’s wellness care. We combine medical expertise, advanced diagnostics, and a patient-first approach to help men restore energy, confidence, and long-term health—without insurance hassles or rushed appointments.