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Ranked Guide · 2026

Best Men's Hormone Therapy Protocols

Men's hormone optimization spans testosterone replacement (TRT), fertility-preserving alternatives (enclomiphene), supportive co-therapies (HCG, gonadorelin), and estrogen management (anastrozole). The right protocol depends on baseline labs, fertility goals, and tolerance for injections versus oral medication. Every protocol on this list requires comprehensive bloodwork and physician review.

Medically reviewed by Dr. Mohammad Laeeq, MD · May 2026
  1. 1
    Testosterone Cypionate
    $149/mo

    Gold-standard testosterone replacement. The most-effective and most-studied protocol for clinically low T. Subcutaneous or IM weekly injection produces stable serum levels.

    Best for: Men with confirmed hypogonadism (total T <300 ng/dL on two morning labs) and symptoms.
    See full Testosterone Cypionate protocol
  2. 2
    Enclomiphene
    $99/mo

    SERM that stimulates the body's own testosterone production. Preserves fertility and avoids exogenous hormone replacement. Oral dosing — no injections needed.

    Best for: Younger men with secondary hypogonadism who want to preserve fertility and avoid lifelong injections.
    See full Enclomiphene protocol
  3. 3
    HCG
    $199/mo

    Mimics LH, keeping testicles active during TRT. Preserves testicular size, fertility, and intratesticular testosterone production.

    Best for: Men on TRT who want to preserve fertility or testicular function.
    See full HCG protocol
  4. 4
    Gonadorelin
    $179/mo

    GnRH analog that stimulates LH and FSH release at the pituitary level. Alternative to HCG with arguably more physiological signaling.

    Best for: TRT add-on for fertility/testicular preservation; alternative when HCG isn't tolerated.
    See full Gonadorelin protocol

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FAQ

Do I need bloodwork before starting TRT?

Yes — Pepti requires a full hormone panel (total T, free T, estradiol, SHBG, LH, FSH) plus a complete metabolic panel and PSA before any TRT prescription. Re-test at week 6 and quarterly thereafter.

Will TRT make me infertile?

TRT alone typically suppresses spermatogenesis. Adding HCG or gonadorelin preserves fertility in most men. If fertility is a priority, enclomiphene monotherapy avoids the issue entirely.

How long until I feel TRT working?

Energy, mood, and libido changes within 2-4 weeks. Body composition and strength changes appear gradually over 12-24 weeks with consistent dosing and bloodwork monitoring.

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