> ## Documentation Index
> Fetch the complete documentation index at: https://docs.hi-doctor.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# Testosterone replacement therapy

> Hi-Doctor does not prescribe testosterone therapy directly — why, and which EMA-authorised sexual health options a doctor considers instead.

Testosterone replacement therapy belongs to sexual health, but Hi-Doctor does not prescribe it directly because the alternatives we offer carry robust clinical evidence and EMA authorisation without the monitoring burden of TRT. Here is why, and what a doctor considers instead.

<Note>
  Although testosterone therapy is associated with sexual health, it is not the first-line treatment we prescribe on Hi-Doctor. The alternatives we do offer carry robust clinical evidence and EMA authorisation.
</Note>

## Can I get it?

A licensed doctor reviews your case and chooses between EU-authorised options. If none is safe or appropriate for you, they say so at no extra cost.

## What Hi-Doctor offers instead

A licensed doctor decides case by case. We never prescribe without evaluation.

<CardGroup cols={2}>
  <Card title="Sildenafil (Viagra)" href="/library/medicines/sildenafil" icon="heart-pulse">
    Phosphodiesterase-5 inhibitor. The doctor assesses it after ruling out cardiovascular contraindications.
  </Card>

  <Card title="Tadalafil 10/20mg" href="/library/medicines/tadalafil" icon="heart-pulse">
    Long-acting PDE5 inhibitor. Available in low doses for daily use or higher doses on demand.
  </Card>

  <Card title="Vardenafil 5/10/20mg" href="/library/medicines/vardenafil" icon="circle-info">
    Alternative within the same class, sometimes better tolerated depending on the patient's profile.
  </Card>

  <Card title="Avanafil 50/100/200mg" href="/library/medicines/avanafil" icon="circle-info">
    Faster-acting PDE5 inhibitor. An option for selected patients based on medical judgement.
  </Card>
</CardGroup>

Alprostadil (marketed as Vitaros), a topical option for patients who don't respond to PDE5 inhibitors or have contraindications to them, is also assessed by the doctor for suitability.

## Common questions

<AccordionGroup>
  <Accordion title="Does Hi-Doctor prescribe testosterone therapy?">
    No. Hi-Doctor does not prescribe testosterone replacement therapy directly. The doctors review your case and choose between EU-authorised alternatives such as PDE5 inhibitors or alprostadil, which carry robust clinical evidence and EMA authorisation.
  </Accordion>

  <Accordion title="What does Hi-Doctor offer instead of TRT?">
    A licensed doctor considers sildenafil, tadalafil, vardenafil, avanafil or alprostadil depending on your history and the nature of your concern. If none is safe for you, the doctor tells you at no extra cost and the consultation fee is refunded.
  </Accordion>

  <Accordion title="Why doesn't Hi-Doctor prescribe TRT?">
    Testosterone therapy requires regular blood monitoring, is not the first-line treatment for erectile dysfunction in all cases, and the alternatives we do offer are backed by robust clinical evidence and EMA authorisation for sexual health.
  </Accordion>

  <Accordion title="Is TRT the same as testosterone replacement therapy?">
    Yes — testosterone replacement therapy (TRT) is another name for testosterone therapy. It is not prescribed directly through Hi-Doctor, but the doctor can review your case and propose an equivalent sexual health treatment with EU authorisation.
  </Accordion>

  <Accordion title="What if none of the alternatives work for me?">
    If the doctor decides that your case needs investigation by a specialist — for example, an endocrinologist or a urologist — they will tell you. The online review is a first assessment, not a substitute for in-person care where it is needed.
  </Accordion>
</AccordionGroup>

## How Hi-Doctor handles it

<Steps>
  <Step title="Start your online visit">
    Answer a questionnaire about your health and goal. No in-person appointment, no travel.
  </Step>

  <Step title="A doctor reviews your case">
    A licensed doctor reviews your answers personally. If they need clarifications, they message you in the private chat on your account.
  </Step>

  <Step title="Review and payment">
    If the doctor does not approve treatment, your consultation fee is refunded in full within 48 hours.
  </Step>

  <Step title="Ongoing support">
    Private chat with your doctor for questions, a check-in, and renewal before your prescription expires.
  </Step>
</Steps>

See [how the consultation works](/essentials/how-it-works), [how we handle safety and eligibility](/essentials/safety), and [pricing](/essentials/pricing). For the underlying concern, see [erectile dysfunction](/library/conditions/erectile-dysfunction) and [low libido](/library/conditions/low-libido).

## Start a consultation

<Card title="Sexual health consultation" icon="stethoscope" href="https://hi-doctor.ai/consultation/sexual-health/1">
  Answer the sexual health questionnaire and a registered doctor reviews it.
  They decide whether treatment is appropriate, which one, and at what dose —
  and declining is a normal outcome. See [what it costs](/essentials/pricing)
  and [how the review works](/essentials/how-it-works).
</Card>

<Warning>
  This page is reference information, not medical advice and not a prescription. Whether a medicine is appropriate for you is decided by a registered doctor after reviewing your consultation.
</Warning>