Do You Need a Prescription for Testosterone?

Key Takeaways:

• In the U.S., testosterone is a controlled substance, so you’ll need a prescription to acquire it. While you take it, your provider will order blood tests and monitor you closely to ensure treatment is safe and medically necessary.

• Professional guidance is essential during a course of testosterone therapy. Only a healthcare provider can evaluate your symptoms, check your hormone levels, and recommend the right form of hormone therapy — whether that’s injections, gels, or alternatives.

• When prescribed and monitored appropriately, testosterone therapy may support healthy energy levels, sex drive, and well-being in men with confirmed low levels.

• Self-medicating without medical advice increases the risk of serious side effects and long-term health problems.

Testosterone replacement therapy (TRT) products are controlled substances and require a prescription. To get a prescription, a licensed healthcare provider first needs to assess you and determine that you would benefit from the treatment. 

However, getting a prescription doesn’t have to be a pain. Telehealth platforms like Hims connect customers to healthcare providers, making testosterone support less complicated. Through the platform, at-home testosterone testing, online medical consultations, and prescription delivery are available, saving you the hassle of finding a provider to meet your needs.

Ahead, find out why you need a prescription for testosterone, how to get a prescription from your provider, and why you should think twice about any opportunity you have to buy testosterone without a prescription.

Yes, you need a prescription to purchase testosterone. This applies to all forms — including gels, creams, pellets, injections, and oral testosterone.

According to the Food and Drug Administration (FDA), testosterone products are FDA-approved only for men with low testosterone levels linked to a medical condition. Examples include testicular failure, certain genetic disorders, chemotherapy-related damage, or issues with the hypothalamus or pituitary gland in the brain.

For other cases of low testosterone, a healthcare provider may prescribe testosterone off-label, as FDA labeling does not include age-related low T as an indication. A provider may still prescribe a form of testosterone for age-related symptoms of low T. Even in this case, you’ll need to meet certain criteria, such as the presence of symptoms and two separate early-morning total testosterone results (typically <300 nanograms per deciliter (ng/dL)).

Because testosterone is a controlled substance that’s only available with a prescription, your first step is to consult a medical provider. You can do this in person or through telehealth platforms.

Here’s how the process may look:

• Consult a medical provider. This could entail booking an appointment with your general practitioner, finding a local endocrinologist (hormone specialist), or using a telehealth platform like Hims to connect you with a provider.

• Review symptoms of low testosterone. Your provider will likely ask about your health history and current symptoms. Common symptoms of low testosterone include low libido, erectile dysfunction, decreased muscle mass, mood changes, and more. But symptoms alone aren’t enough.

• Get tested. Your provider will ask you to get your testosterone levels tested. Testosterone deficiency is typically considered a total testosterone level below 300 ng/dL on two separate mornings.

• Rule out other health conditions. Some medical conditions can cause symptoms of low T. These conditions include thyroid disease, depression, anemia, vitamin deficiencies, and sleep apnea.

• Discuss treatment options. Each type of testosterone therapy offers its own benefits and risks. Your healthcare provider can help you determine which formulation is right for you, whether that’s among subcutaneous injections, gels, patches, pills, or implantable testosterone pellets.

Once you’ve been prescribed testosterone, ongoing monitoring is key. This can include follow-up testosterone blood tests, prostate exams, red blood cell counts, and dose adjustments.

It’s ultimately up to you and your provider to determine if TRT is the right choice for you.

Some signs that you may be a good candidate for TRT include having a total testosterone level below 300 ng/dL and the presence of several symptoms linked to low testosterone.

Potential symptoms of low testosterone include:

• Low sex drive

• Erectile dysfunction

• Low energy levels

• Brain fog

• Decreased muscle mass

• Muscle weakness

• Increased body fat

• Less body hair

• Fertility problems

• Depression

• Enlarged breasts (gynecomastia)

TRT is contraindicated or not recommended in those with heart failure, prostate or breast cancer, very high hematocrit (above 54 percent), untreated severe sleep apnea, or serious heart disease.. That means for people with these conditions, testosterone therapy may not be safe. Ultimately, the decision to start TRT is personal and should be made together with a qualified healthcare provider, who can help each individual weigh the potential benefits and risks.

You may also not be a good candidate for TRT if you’re planning on having kids, as research links testosterone to lowered sperm count and infertility in men.

Keep reading to learn more about the side effects and risks of TRT.

When you have low levels of testosterone, your quality of life can take a real hit. You might feel tired all the time, irritable, depressed, or you might notice changes in your body, like more fat and less muscle.

The goal of TRT is to restore your testosterone levels to be within a normal range while reducing symptoms that can affect your quality of life.

Potential benefits of TRT in men with low T include:

• Improved sexual function

• More lean muscle mass

• Higher energy levels

• Better body fat distribution

• Increased strength

• Improved mood and well-being

There are also potential risks and side effects of testosterone therapy:

• Skin irritation from topical and transdermal treatments

• Swelling at the injection site for intramuscular injections

• Increased risk of blood clots (thrombosis)

• Acne

• Hair loss

• Reduced sperm count and infertility

• Increased risk of heart attack

• Mood changes

• Worsened sleep apnea

• Enlarged prostate

In February 2025, the FDA removed the boxed cardiovascular risk warning from testosterone product labels after large clinical trials found no overall increase in major adverse cardiac events. However, the FDA now requires a warning that testosterone therapy may elevate blood pressure, and healthcare providers should monitor patients accordingly.

So, you found testosterone for sale online, and you don’t need a prescription to buy it? If that seems weird to you, you’re right to hesitate. Those products are unregulated and illegal in the U.S.

Testosterone use without a prescription is illegal in most Western countries because the risks outweigh the benefits: Users are more vulnerable to adverse reactions, and unregulated use is often tied to performance enhancement in sports. This is what sets prescribed testosterone apart from anabolic steroid misuse. While both involve synthetic testosterone, prescribed therapy is designed to restore normal testosterone levels, whereas steroid abuse pushes testosterone to supraphysiologic levels to promote extreme strength, muscle growth, and performance.

Furthermore, medications bought from unregulated sources online are notorious for being contaminated or counterfeit. Studies show that such products can cause severe side effects beyond the usual risks of testosterone therapy, such as cardiotoxicity, arrhythmia, stroke, blood clotting problems, liver damage, metabolic complications, and even death.

While TRT is often a first-line treatment for low testosterone, it isn’t the only option. Some men with low T may benefit from alternative treatments, especially if they don’t want to compromise their fertility.

One alternative option to TRT is enclomiphene citrate. Belonging to a class of medications called selective estrogen receptor modulators (SERMs), enclomiphene increases your body’s natural testosterone production without lowering sperm count. However, it is not FDA-approved and may be prescribed only through compounding pharmacies with clinician oversight, and long-term safety data remain limited.

Hims offers access to enclomiphene and a combination treatment containing enclomiphene and tadalafil (the active ingredient in Cialis^®) to improve testosterone and erectile function simultaneously. You’ll do your consultations from the comfort of home. We’ll even send a testosterone testing kit to your address to get the ball rolling.

While you’re waiting for your results, there are other ways you can work on improving your hormonal health, whether you ultimately decide to use TRT, an alternative testosterone treatment, or neither. Following a healthy diet, exercising regularly, and lowering your stress levels are just a few steps in the right direction for increasing your testosterone levels naturally.

To start on testosterone replacement therapy, you need a prescription from a licensed healthcare provider — and for good reason.

A prescription protects users by ensuring that therapy is medically necessary, the dose is safe, and the side effects are minimal.

If you have symptoms of low testosterone, work with a provider who can confirm low levels with blood tests and then guide your treatment across different forms of testosterone.

Do you need a prescription for testosterone gel or injections?

Yes. All forms of testosterone therapy — including gels, patches, testosterone injections, and oral testosterone — require a prescription.

What testosterone level is considered low?

Most providers diagnose low testosterone (hypogonadism) when total testosterone is below 300 ng/dL on two separate early-morning tests, and clinical symptoms are present.

What are the risks of taking testosterone without a prescription?

Unprescribed testosterone use can lead to serious side effects, including cardiac events, blood clotting problems, liver damage, metabolic complications, and even death.

Can testosterone therapy affect fertility?

Yes. TRT can reduce sperm count and cause testicular shrinkage, but alternatives like enclomiphene may boost testosterone while preserving fertility.

What forms of testosterone are available with a prescription?

Options include testosterone injections, gels, creams, patches, oral capsules, and pellets. Each form comes with unique benefits, risks, and dosing schedules.