It’s important to understand that most treatments we offer—including hormone therapy—are considered elective and are typically not covered by insurance.

Many insurance providers classify hormone therapy as preventive or longevity-based care and therefore deem it “not medically necessary.” In some cases, a primary care provider may prescribe testosterone if multiple morning lab tests confirm significantly low levels. However, this approach is often limited to bringing levels into a broad “normal” range, rather than addressing symptoms or optimizing overall health—which is the foundation of our model. Additionally, once levels fall within the standard reference range, insurance coverage is often discontinued, even if symptoms persist.

If you encounter clinics that advertise accepting insurance for hormone therapy or IV treatments, it’s worth asking for a detailed cost breakdown. In many cases, this can be a marketing tactic, and total out-of-pocket expenses may ultimately be higher than at transparent, cash-based practices.

For added convenience, we do accept Health Savings Accounts (HSA) and benefit cards.

Please bring a your photo ID, a current list of medications, and a summary of your health history. We accept all major credit cards and cash. Insurance is not accepted for treatment.

We go beyond basic labs by analyzing 70+ biomarkers, including hormones, cardiometabolic health, thyroid function, inflammation, and key nutrients—far more comprehensive than a typical primary care panel.

For convenience, we offer on-site blood draws, or we can send your lab order to a location of your choice.

Do not eat or drink anything other than water for 6 hours prior to your lab draw.

Pelvic floor physical therapy (PFPT) may help you with a wide range of medical issues. PFPT has been shown to be effective in men with chronic pelvic pain, chronic prostatitis, overactive bladder syndrome and many other issues.

Testosterone Replacement Therapy (TRT) is designed to restore optimal testosterone levels using bioidentical hormones—helping men perform, feel, and function at their best.

When levels are optimized, the benefits can be significant:

• Increased Energy & Drive – Feel more motivated, focused, and energized throughout the day

• Improved Sleep Quality – Deeper, more restorative sleep for better recovery

• Enhanced Muscle Mass & Performance – Build strength, improve endurance, and recover faster

• Optimized Body Composition – Support fat loss while maintaining lean muscle

• Revitalized Sexual Health – Increased libido, performance, and overall confidence

Testosterone therapy is not one-size-fits-all. Every man responds differently based on his baseline health, genetics, lifestyle, and the specific symptoms being addressed. While results take time, most men experience progress in phases:

First 12–16 Weeks

Many men notice an early “honeymoon phase” with improvements in energy, mood, and libido. This stage can plateau, which may lead some to think they need a higher dose—but in reality, even a 10–20% improvement at this point is a strong sign the body is beginning to adapt.

Around 6 Months

More meaningful changes typically develop here, including improvements in body composition, sexual health, and overall well-being. The body often prioritizes internal balance first, so progress may be slower if underlying factors like metabolism, sleep, or lifestyle need optimization.

1–2 Years

This is where the full benefits of TRT become more apparent. With consistency, proper medical guidance, and healthy habits, improvements in physical health, mindset, and overall quality of life continue to build.

Beyond 2 Years

Progress continues, but long-term success depends on discipline and lifestyle. TRT works best when combined with proper nutrition, training, sleep, and ongoing medical oversight.

It’s important to understand that not all benefits happen at the same pace. Some changes—like energy and libido—can improve within weeks, while others, such as body composition, erectile function, bone density, and cardiovascular health, develop gradually over months to years.

Every journey is unique. Comparing your progress to others can be misleading. TRT is not a quick fix—it’s a tool. The best results come from a personalized approach, guided by an experienced provider, and supported by consistent lifestyle habits.

When approached correctly, TRT can be a powerful long-term strategy for improving performance, health, and overall quality of life.

Testosterone Replacement Therapy (TRT) should be approached as a long-term commitment. While it is possible to discontinue therapy, most men who begin TRT choose to stay on it due to the benefits they experience.

When you start TRT, your body naturally reduces its own testosterone production. The pituitary gland decreases its signaling in response to higher hormone levels, which can lead to reduced sperm production and testicular function. As a result, ongoing therapy is typically required to maintain optimal levels.

If TRT is discontinued, testosterone levels may return to baseline—but in some cases, they can remain lower than pre-treatment levels due to the body’s adaptation over time. This risk is even greater in individuals with a history of anabolic steroid use, where natural production may be significantly impaired or permanently suppressed.

For this reason, TRT should not be viewed as a short-term trial. Coming off therapy can be unpredictable and often results in the return of symptoms such as low energy, decreased libido, and reduced overall performance.

Before starting TRT, it’s essential to take a comprehensive, informed approach. This includes detailed lab work, a thorough medical evaluation, and a clear understanding of the long-term commitment involved. When done correctly and under expert guidance, TRT can be a powerful tool—but it requires intention, consistency, and a commitment to your overall health.

While experienced providers have a general understanding of the testosterone levels that tend to improve symptoms, there is no universal “ideal” number that works for every man.

Response to therapy is highly individual. The goal is not to chase a specific lab value, but to effectively relieve symptoms while minimizing side effects. What works well for one person may be ineffective—or even problematic—for another.

In many cases, symptom relief occurs when testosterone levels are in the upper end of the reference range, or sometimes slightly above it. It’s also important to recognize that current “normal” ranges are based on modern population averages, which have declined over time—meaning “normal” does not always equal optimal.

At the same time, not all symptoms are driven by testosterone alone. Many signs of low testosterone overlap with other health conditions, and underlying factors like sleep, stress, metabolic health, and lifestyle often play a significant role.

There is also a ceiling effect with TRT. Once optimal levels are reached, the “feel-good” benefits tend to plateau. Increasing the dose beyond this point does not lead to additional improvements and can increase the risk of unwanted side effects.

Not all men with erectile dysfunction (ED) have low testosterone—and not all men with low testosterone experience ED.

ED is defined as difficulty achieving or maintaining an erection and can result from a wide range of factors, including cardiovascular disease, diabetes, nerve damage, psychological stress or anxiety, certain medications (such as SSRIs, blood pressure medications, and DHT blockers), and lifestyle factors like smoking, alcohol use, or inactivity. Hormonal imbalances, including low testosterone, can also play a role—but they are just one piece of the picture.

Low testosterone is associated with a broader set of symptoms beyond ED, including reduced libido, low energy, decreased strength and endurance, poor sleep, weight gain, depressed mood, brain fog, joint discomfort, slower recovery, and an overall decline in well-being. You don’t need to experience every symptom to be a candidate for treatment.

While there can be overlap, ED and low testosterone are not the same condition and often occur independently. The decision to pursue testosterone therapy should be based on a comprehensive, individualized evaluation with your provider—taking into account your health history, symptoms, and personal goals.

Optimizing testosterone levels is about more than sexual health. Low testosterone has been linked to metabolic dysfunction and other long-term health risks, meaning that even in the absence of ED, addressing low levels can play an important role in overall health, performance, and quality of life.

This is one of the biggest myths about testosterone therapy—and a common reason men avoid treatment unnecessarily.

The belief started in the 1940s from a very small study, but newer research has shown the opposite: low testosterone is actually linked to a higher risk of prostate cancer, not high testosterone.

More recent studies have debunked the idea that testosterone causes prostate cancer, but the misconception still exists.

For men who already have prostate cancer, lowering testosterone can help shrink tumors. However, research shows there is a “threshold” where prostate tissue stops responding to additional testosterone—meaning higher levels don’t continue to fuel cancer growth.

In simple terms: raising testosterone to normal levels does not appear to increase prostate cancer risk.

Men with a history of treated prostate cancer can often safely use TRT with proper monitoring, like regular PSA checks.

This is a common myth surrounding testosterone therapy. There is no strong evidence showing that testosterone causes aggression.

In fact, the most comprehensive research to date—a meta-analysis of 14 experimental studies—found that testosterone replacement therapy (TRT) does not significantly increase aggression overall.

The idea of “roid rage” comes from the stigma associated with anabolic steroid abuse, where doses are far beyond what is used in a medical setting. Even in studies evaluating men using higher doses of bioidentical testosterone, there were no meaningful increases in aggression or anger.

Unfortunately, this misconception distracts from the real benefits many men experience with testosterone therapy. In men with low testosterone, research consistently shows improvements in mood, reduced depressive symptoms, decreased fatigue, and an overall better quality of life.

It’s important to recognize that individual responses can vary. Factors like dosing and frequency of administration can influence how someone feels. In some cases, men who already have traits such as high dominance or low impulse control may notice increased irritability. This doesn’t mean testosterone creates aggression—it may simply amplify traits that were already present.

In other words, testosterone doesn’t change who you are—it helps optimize how you feel.

Overall, most men report improved mood, greater emotional stability, clearer decision-making, and a renewed sense of energy and drive for life.

In 2015, the FDA placed a black box warning on testosterone therapy due to concerns about blood clots, stroke, and heart attack risk. However, this decision was based on two retrospective studies with notable methodological limitations.

Since then, higher-quality research has told a different story. A meta-analysis published in the New England Journal of Medicine found no evidence linking testosterone therapy to thromboembolic events. In addition, multiple randomized controlled trials (RCTs) and large meta-analyses have shown no increased risk of cardiovascular disease in men receiving testosterone therapy. Based on this growing body of evidence, the FDA has since removed the warning.

In fact, testosterone therapy may offer cardiovascular benefits—especially in men with metabolic dysfunction. By reducing visceral fat, improving insulin sensitivity, and increasing lean muscle mass, testosterone can help lower overall cardiovascular risk.

Low testosterone, on the other hand, is strongly associated with higher rates of coronary artery disease, obesity, and increased mortality. Several RCTs in men with pre-existing heart disease have also demonstrated no increased risk of disease progression or death with testosterone therapy.

Many of the cardioprotective effects of testosterone are linked to its conversion into estradiol. When estradiol is suppressed during therapy, cardiovascular risk can rise back to levels seen in untreated testosterone deficiency.

TRT Add-Ons & Support Options

Some treatments and supplements may be used alongside TRT based on your goals:

hCG
Helps preserve fertility and testicular size by mimicking LH. Only needed if fertility is a priority. Best introduced separately from TRT due to potential side effects.

Clomid (Clomiphene)
Stimulates natural testosterone production. Can be used instead of TRT or after stopping—but should not be combined with TRT. May cause mood or vision side effects.

Aromatase Inhibitors (AIs)
Not recommended during TRT. Estrogen is essential for overall health, and blocking it can increase risks like heart disease, bone loss, and joint pain. Most “estrogen side effects” are actually due to poor dosing—not estrogen itself.

Supportive Supplements

• DHEA & Pregnenolone: Support mood, cognition, and hormone balance
• Creatine: Muscle, recovery, brain, and bone support (5g daily)
• Nitric Oxide: Improves blood flow for sexual and heart health
• Vitamin D3: Essential for immune, metabolic, and bone health
• Low-dose Tadalafil: Supports blood flow, performance, and cardiovascular health
• Thyroid Support: Thyroid issues are common and can impact TRT results

Bottom Line
TRT is not one-size-fits-all. Your plan should be personalized to your goals, symptoms, and health history—working with an experienced provider is key to getting the best results.

The best testosterone delivery method is the one you can stay consistent with long-term.

Common options include intramuscular (IM) injections (2-3x weekly), subcutaneous (SQ) injections (several times per week to daily), and trans-scrotal testosterone cream (once or ideally twice daily). Some men eventually experience “injection fatigue” and choose to switch to cream.

Testosterone cream is not inferior to injections. When used properly, it provides steady levels and may reduce side effects like acne, water retention, and elevated hematocrit. It can also support higher free testosterone and DHT levels, which are more closely linked to symptom improvement than total testosterone alone.

For men concerned about medication transfer—especially with a pregnant or breastfeeding partner—injections are often preferred, as they eliminate that risk.

Foundational health habits—like treating sleep apnea, exercising, and maintaining a balanced diet low in sugars and refined carbs—are essential for hormone optimization. No supplement can correct true hormone deficiency, and some may even be harmful due to poor regulation.

In some cases, medications like clomiphene (Clomid) or enclomiphene are used as alternatives to testosterone therapy. These SERMs work by stimulating the body to produce more testosterone and sperm, rather than replacing testosterone directly.

While often considered a more “natural” option, Clomid doesn’t truly replicate normal hormone balance. Although lab values may improve, this doesn’t always translate to symptom relief. Some men—especially younger men wanting to preserve fertility—may benefit short-term, but it’s not typically a long-term solution.

Testosterone lab ranges are broad, and “normal” doesn’t always mean optimal. Many men fall within range but still experience symptoms like fatigue, low libido, brain fog, and poor recovery.

We don’t treat numbers alone. We look at the full picture—your symptoms, health history, lifestyle, and labs—to determine if treatment is appropriate. That’s why some men labeled “normal” elsewhere may still benefit from therapy.

Potential side effects of TRT can include elevated red blood cell levels, acne or oily skin, decreased sperm production, and fluid retention. These effects vary by individual and are often manageable with proper monitoring and adjustments.

We closely track labs and symptoms throughout treatment to keep therapy safe, effective, and personalized. If you have a history of prostate cancer, heart failure, kidney disease, or fertility concerns, these should be discussed with your provider before starting TRT.

Erections rely on healthy blood flow. Medications like Viagra and Cialis enhance nitric oxide, helping relax blood vessels and improve blood flow to make it easier to achieve and maintain an erection.

They do not create arousal—sexual stimulation is still required for them to work.

There’s no one-size-fits-all option. Viagra and Cialis are both effective—the right choice depends on how quickly you want it to work, how long you want it to last, your lifestyle, and how your body responds. Many men try both to see what works best for them.

GAINSWave is a branded treatment approach for men’s sexual health that uses low-intensity shockwave therapy to support blood flow, performance, and overall penile health. It is not a device, but a protocol typically performed with systems such as Storz or Evive.

There is clinical research behind shockwave therapy, especially for men with vasculogenic erectile dysfunction. Evidence suggests it can improve erectile function in appropriate candidates, though outcomes depend on the device used, treatment protocol, and provider expertise.

The majority of Erectile Dysfunction and Peyronie’s Disease issues are caused by poor blood flow. Acoustic Wave Therapy is high frequency, low intensity acoustical sound waves that remove decades of micro-plaque. By breaking down the plaque, aged blood vessels are repaired, and new vessels and erectile tissue grow. The result of restored blood flow is fuller and spontaneous erections, greater sensitivity, and enhanced orgasms.

How many treatments are required?

We use the InBody scale, an advanced body composition tool that goes beyond weight. It tracks key metrics like body fat, muscle mass, and visceral fat to measure real progress.

This allows us to tailor your plan so you’re losing fat—not muscle. At Apex, the focus isn’t just weight loss—it’s better body composition, improved health, and lasting results.

Hormones play a key role in fat storage, muscle growth, and metabolism. Low testosterone in men is often linked to increased body fat, reduced muscle mass, low energy, and slower recovery—making weight loss more challenging.

Optimizing hormones can support better metabolism, improved body composition, and more consistent energy for training and nutrition. At Apex, hormone optimization isn’t a shortcut—it’s one part of a comprehensive plan to help your body perform and respond better overall.

Myers’ Cocktail is one of the most popular IV therapies for a reason. This well-balanced blend of vitamins and minerals supports energy, immunity, hydration, recovery, and overall wellness—all in one efficient treatment.

Most IV vitamin drips take about 60 minutes. Depending on the size of the bag and the treatment selected. Smaller drips are often closer to 30 minutes, while larger bags may take up to an hour.