BHRT and Testosterone Therapy for Men in Leawood

Medically reviewed by Mark Strehlow, MD, Medical Director — September 2026

Testosterone therapy treats testosterone deficiency, also called male hypogonadism. The diagnosis needs two things: symptoms that fit, and low testosterone on at least two blood tests taken early in the morning on different days. For men who have it, treatment can improve sex drive and erectile function, among other things, and it has risks that need regular monitoring. At Rock Creek Wellness in Leawood, KS, we don’t prescribe testosterone for symptoms alone. If your results don’t support it, we’ll tell you, and we’ll look for what else is going on.

Is there a male menopause? Andropause vs. menopause

“Andropause” and “male menopause” are popular names for the fall in testosterone that comes with age. It isn’t much like menopause.

  • Menopause happens to every woman. Periods stop for good, and the ovaries’ production of estrogen and progesterone falls greatly over several years, usually starting between 45 and 55.
  • In men, testosterone falls slowly, by about 1% a year from the late 30s. The testes keep making sperm, though more slowly, and there’s no sudden change.
  • Most men don’t develop a problem. In a European study of 3,369 men aged 40 to 79, about 2% met a strict definition of late-onset hypogonadism: three sexual symptoms (fewer morning erections, low desire and erectile dysfunction) together with low testosterone.

Doctors call the condition late-onset hypogonadism, or testosterone deficiency. It’s more common in men who have type 2 diabetes, overweight or sleep apnea, and some medicines, including opioids, can lower testosterone. Our article on what affects testosterone in men covers the everyday factors.

Symptoms of low testosterone

Sexual symptoms are the most specific:

  • lower sex drive
  • weaker erections, or fewer morning erections

Other symptoms and signs include:

  • low energy, fatigue and less endurance
  • loss of muscle, more body fat, and less body or beard hair
  • low mood, irritability, poor concentration or memory, and low motivation
  • enlarged breast tissue, or a low sperm count

None of these is unique to low testosterone, and most have other possible causes. That’s why the diagnosis depends on blood tests as well as symptoms.

How low testosterone is diagnosed

  • Two morning tests. Total testosterone is measured early in the morning, when levels are highest, on two separate days. Being ill can lower it for a while.
  • A clear threshold. The American Urological Association (AUA) uses a total testosterone below 300 ng/dL, together with symptoms or signs. Free testosterone is added when the total is borderline, or when a condition changes the protein that carries testosterone in the blood.
  • Finding the cause. Tests such as LH help show whether the pituitary gland, which controls the testes, is the source of the problem.
  • Safety checks first. Before treatment, guidelines call for a hematocrit (a measure of red blood cells) and, for men over 40, a PSA test for prostate cancer.

The Endocrine Society advises against screening all men for low testosterone. It also advises against routinely treating every man over 65 whose level is low; for older men, the decision is made case by case.

What testosterone therapy can and can’t do

For men with confirmed testosterone deficiency, the AUA says treatment may improve:

  • sex drive and erectile function
  • anemia
  • bone density and lean muscle mass
  • depressive symptoms

The evidence is inconclusive for energy, fatigue, memory and thinking, blood sugar, cholesterol and overall quality of life. Individual results vary. If your symptoms haven’t improved 3 to 6 months after your testosterone reaches the normal range, the AUA advises talking about stopping.

FDA-approved testosterone products are approved for men whose low testosterone is caused by a medical condition. Their labels state that safety and effectiveness in “age-related hypogonadism” haven’t been established.

Risks of testosterone therapy

  • Fertility. Testosterone from outside the body signals the testes to make less of their own, which lowers sperm production and can stop it. The AUA says it shouldn’t be prescribed to men who are trying to conceive. If you might want children, tell us before you start: other medicines can be considered, and we can refer you to a urologist.
  • Red blood cells. Testosterone raises your hematocrit. It’s checked before and during treatment, and a level of 54% or higher calls for a change.
  • Blood pressure. In 2025 the FDA required every testosterone product to carry a warning that it can raise blood pressure, which can increase cardiovascular risk over time. Blood pressure should be checked periodically, and testosterone isn’t recommended if yours is uncontrolled.
  • Heart. The TRAVERSE trial followed 5,246 men aged 45 to 80 with low testosterone who had heart disease or a high risk of it. Over about three years, men using testosterone gel had no more heart attacks, strokes or cardiovascular deaths than men using a placebo gel. They did have more atrial fibrillation, acute kidney injury and blood clots in the lungs. The gel was dosed to keep testosterone within the normal range. After the trial, the FDA removed heart-risk language from the boxed warning on testosterone products.
  • Prostate. There’s no evidence linking testosterone therapy to the development of prostate cancer. It isn’t started in men with a prostate lump, or a raised PSA, until a urologist has evaluated it, and prostate cancer risk is reviewed during the first year of treatment. Testosterone can also worsen urinary symptoms from an enlarged prostate.
  • Other effects include acne, breast enlargement, fluid retention (mainly in men with heart, kidney or liver disease), a rise in PSA, and new or worse sleep apnea.
  • Pellet insertion can cause bruising, bleeding, infection, or a pellet working its way out through the skin.

Who shouldn’t start testosterone. Guidelines advise against it for men planning to father a child soon, and for men with breast or prostate cancer, a high hematocrit, untreated severe sleep apnea, severe urinary symptoms, uncontrolled heart failure, a heart attack or stroke in the last 6 months, or a blood-clotting disorder.

BHRT for men: bioidentical, FDA-approved and compounded testosterone

“Bioidentical” means a hormone with the same chemical structure as your own. For men, that hormone is testosterone. It comes as gels, injections, patches, pellets, a nasal gel and pills, and FDA-approved versions exist, including a testosterone pellet.

The testosterone pellets we use are made by a compounding pharmacy. Compounded products aren’t FDA-approved, and the AUA advises prescribing commercially manufactured testosterone rather than compounded testosterone when possible. Ask us which product you’d receive, and why.

How testosterone therapy works at Rock Creek Wellness

  1. Free consultation. Tell us what’s going on, and we’ll tell you honestly whether testing makes sense.
  2. Evaluation and testing. Your provider reviews your symptoms, health history, medicines, sleep and goals. Comprehensive blood testing includes total and free testosterone, LH, estradiol, SHBG, a complete blood count and PSA. Every new patient also has a DEXA scan, which measures bone density and body composition.
  3. Cause first. If something treatable may be lowering your testosterone, such as weight, sleep apnea or a medicine, we address it first or alongside treatment. The AUA advises counseling every man with low testosterone about lifestyle changes.
  4. A decision together. If the diagnosis is confirmed and treatment suits you, your provider goes through the benefits, risks and alternatives with you, including FDA-approved options. We prescribe testosterone in every common form, including injections, gels, creams and pellets, and the choice depends on your needs and preferences. Pellets are placed under the skin of the upper buttock through a small incision, under local anesthetic, in a visit of about 10 to 15 minutes, and they’re usually replaced every 4 to 6 months. Read more about pellet hormone therapy.
  5. Monitoring. Guidelines advise dosing to reach the middle of the normal range, then checking testosterone, hematocrit and prostate markers after you start and regularly after that. The labels also call for periodic blood pressure checks. Your follow-up labs and visits cover these.

New patients see Dr. Mark McPhee, Dr. Angela Barnett or Hannah Osborn, APRN. Most of our long-term patients choose Premier Care, our most comprehensive program. It starts with a four-hour consultation and testing visit, including a DEXA scan and cardiovascular screening, and continues with ongoing care for a monthly fee.

We’re a cash-pay clinic. Premier Care prices are listed on its page; for anything else, we’ll give you the price at your consultation. We see men from across the Kansas City area at our Leawood clinic.

If erection problems are your main concern, we also prescribe ED medicines and offer shockwave therapy for ED; start with our sexual wellness care. For the wider picture, read about the benefits of a healthy sex life for men.

Book a free consultation, or call (913) 727-7700. Looking for hormone care for women? See BHRT and menopause hormone therapy for women.

Common questions

Can I get testosterone therapy if my level is normal?
No. We prescribe testosterone for diagnosed testosterone deficiency, which needs symptoms and low levels on repeat testing.

Can andropause be reversed?
Sometimes low testosterone improves when its cause is treated. Keeping a healthy weight, eating well, staying active, sleeping about seven hours a night, treating sleep apnea and avoiding heavy use of alcohol and other addictive substances may help keep testosterone in the normal range. In men who are overweight, losing weight and being more active can raise testosterone or ease symptoms.

What’s the difference between TRT and BHRT?
For men, they usually mean the same thing: replacing testosterone. “Bioidentical” describes the hormone, not how well it works.

Sources

  • Mulhall JP, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol 2018 (validity confirmed 2024). auanet.org
  • Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2018. PubMed
  • U.S. Food and Drug Administration. FDA issues class-wide labeling changes for testosterone products. 2025. fda.gov
  • Lincoff AM, et al. Cardiovascular Safety of Testosterone-Replacement Therapy (TRAVERSE). N Engl J Med 2023. PubMed
  • Wu FC, et al. Identification of late-onset hypogonadism in middle-aged and elderly men (EMAS). N Engl J Med 2010. PubMed
  • Cleveland Clinic. Low Testosterone (Male Hypogonadism). clevelandclinic.org
  • MedlinePlus. Aging changes in the male reproductive system. medlineplus.gov
  • National Institute on Aging. What Is Menopause? nia.nih.gov
  • AndroGel 1.62% (testosterone gel) prescribing information. DailyMed 2025. dailymed.nlm.nih.gov
  • Testopel (testosterone pellets) prescribing information. DailyMed 2025. dailymed.nlm.nih.gov