Disclosure
This article contains affiliate links. If you sign up with Male Excel or Taurus Meds through a link on this page we may earn a commission, at no extra cost to you. We do not accept payment for favourable coverage. Read our full affiliate disclosure. This page is informational only and is not medical advice — testosterone therapy is a prescription treatment with long-term consequences, and the decision belongs to you and a licensed clinician who has seen your bloodwork.
The short version
Obesity suppresses testosterone through a well-understood mechanism, and losing weight often raises it back. Data presented at ENDO 2025 found that among 110 men with obesity treated with GLP-1 medications, the share with testosterone in the normal range rose from 53% to 77% over 18 months — driven by the weight loss itself.
So the order matters. Get properly tested, treat the obesity, retest, and only then decide about testosterone replacement. Starting TRT first suppresses your own production and makes the question unanswerable.
Why Obesity and Low Testosterone Travel Together
This is not a coincidence or a marketing claim; it is a mechanism. Adipose tissue is rich in the aromatase enzyme, which converts testosterone into oestradiol. More fat mass means more conversion, and the resulting hormonal signalling suppresses the pituitary output that instructs the testes to produce testosterone. The loop reinforces itself: lower testosterone favours fat gain, and fat gain lowers testosterone further.
Clinically this is called functional hypogonadism — testosterone deficiency caused by an underlying condition rather than by a primary failure of the testes or pituitary. The distinction is the whole point of this article, because functional hypogonadism is frequently reversible when the underlying condition is treated. Primary hypogonadism is not.
It is also badly under-recognised. Men present with fatigue, low libido, poor concentration and loss of morning erections, and the internet has a well-funded answer waiting for them. The answer is sometimes correct. It is often premature.
What GLP-1 Weight Loss Does to Testosterone
Research presented at ENDO 2025, the Endocrine Society's annual meeting, tracked 110 men with obesity — many of whom also had type 2 diabetes — during treatment with semaglutide, dulaglutide or tirzepatide. Over 18 months, the proportion whose testosterone sat in the normal range rose from 53% to 77%, alongside roughly 10% weight reduction. The relationship was dose-dependent in the way you would expect: the men who lost more weight saw the larger improvement.
The researchers attributed the improvement to the weight loss rather than to any direct hormonal effect of the medications, which is consistent with the aromatase mechanism above.
How much weight to put on that
This was a conference presentation of an observational study in 110 men, without a control group, in a population skewed towards type 2 diabetes. It is a genuine and encouraging signal, and it is consistent with decades of evidence linking adiposity to testosterone. It is not a randomised trial, and it does not establish that any individual's testosterone will normalise.
What it does justify is sequencing: if you are about to start losing a substantial amount of weight, that is a reason to retest before committing to lifelong therapy — not a reason to assume the problem will fix itself.
The Order to Do This In
- Get diagnosed properly. The Endocrine Society guideline calls for diagnosis only in men with both symptoms and unequivocally low levels, confirmed by total testosterone measured on two separate mornings while fasting. Testosterone follows a daily rhythm; an afternoon sample or a single reading is not a diagnosis. Be wary of any service willing to start you on one convenient test.
- Treat the obesity first, if that is the driver. Functional hypogonadism responds to weight loss. If you are starting a GLP-1 anyway, you are already running the intervention most likely to help.
- Retest after meaningful weight loss. Give it months, not weeks, and retest under the same conditions as the first time.
- Then decide about TRT, knowing what it commits you to. If levels remain low and symptoms persist after weight loss, that is a much stronger basis for therapy than a single low reading taken at your heaviest.
What TRT Actually Commits You To
Testosterone replacement is an effective treatment for genuine hypogonadism. It is also not a supplement, and the consequences of starting are frequently glossed over in the advertising.
- Fertility. Exogenous testosterone suppresses the pituitary hormones that drive sperm production. Pooled data indicate sperm concentration falls by roughly 85–95% within three to six months. If children are a possibility, raise this before you start, not after.
- It tends to be long-term. Because replacement suppresses your own production, stopping means a period with neither your natural output nor the replacement. Going in, assume this is a long commitment rather than a trial.
- Blood monitoring is not optional. Testosterone raises red cell production. TRAVERSE titrated dosing to keep haematocrit at or below 54%, and any legitimate provider will monitor it.
- Cardiovascular safety looks reassuring when properly indicated. The TRAVERSE trial, randomised and placebo-controlled, found no significant increase in major adverse cardiovascular events in hypogonadal men with cardiovascular risk. That applies to men who meet diagnostic criteria — it is not an argument for treating men who do not.
- There is a fertility-sparing alternative. Clomiphene raises testosterone by stimulating your own production rather than replacing it, and generally preserves sperm production. It is worth asking about specifically.
Male Excel, Reviewed
Male Excel is a telehealth clinic focused on men's hormone therapy — testosterone, thyroid and erectile dysfunction — delivered entirely online with at-home lab testing and home delivery. If, after the sequencing above, therapy is the right answer for you, it is one of the more substantial operators in this category. Here is what it publishes and what it does not.
What it costs
| Item | Published price | Notes |
|---|---|---|
| Membership | $99/month | Unlimited provider access, 60-day assessments, comprehensive bloodwork every six months, initial at-home hormone test kit, ongoing management. |
| Medication | Not published | Billed separately “based on your personalized protocol, with member pricing”. No figure is given, so the all-in monthly total cannot be calculated in advance. |
| Formats offered | — | Testosterone cypionate injection, testosterone Lipoderm cream, oral clomiphene (Triclozene), plus sildenafil and tadalafil for ED. |
| Guarantee | 90 days, membership only | Follow the plan for 90 days and, if symptoms do not improve, three months of membership fees are refunded. Medication costs are not covered by it. |
| Not available in | 9 states | Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Mississippi, New Hampshire, Rhode Island, as listed in August 2026. |
The main criticism
You cannot work out what Male Excel will cost you. The $99 membership is published clearly; the medication — the part you are actually there for — is not, and is described only as billed separately at member pricing. A membership fee plus an unquoted drug cost is not a price, and it means you cannot compare Male Excel against anything until you have already invested time in an assessment.
Ask for the full monthly figure for your specific protocol, in writing, before you provide payment details. Note too that the 90-day guarantee refunds membership fees only — roughly $297 — not what you spent on medication.
Credentials, and what is genuinely good here
Male Excel names its medical leadership publicly — Peter Fotinos, MD as Chief Medical Officer and Lorna A. Brudie, DO as Medical Director — and states that its providers are trained in-house rather than drawn from a rotating contracted network. That is meaningfully better disclosure than most telehealth hormone clinics, which name nobody, and it is the strongest point in its favour.
The clinical model also looks appropriate rather than transactional: comprehensive bloodwork rather than a single convenient reading, six-monthly retesting, structured 60-day reviews and unlimited provider contact. For a therapy that requires ongoing haematocrit monitoring, that matters. Offering clomiphene alongside replacement is a further point in its favour, because it means the fertility-preserving option is actually on the menu.
Against that: the medications are compounded and Male Excel does not name the compounding pharmacy, and the marketing leans on language — restoring vitality, treating root causes — that outruns what the evidence supports. Compounded preparations are not FDA-approved products.
The Verdict
A more serious clinical model than most online hormone clinics — real bloodwork, named medical leadership, proper retesting, and a fertility-sparing option on the menu. It loses significant ground for publishing a membership fee while leaving the medication cost blank, and for a 90-day guarantee that quietly covers only the smaller half of your bill.
Opens Male Excel · Ask for your all-in monthly cost before paying
Taurus Meds, Compared
Taurus Meds is the other online TRT service we are asked about, and setting it beside Male Excel is instructive because each is strong exactly where the other is weak.
Taurus publishes what it costs, which Male Excel does not. Intake is $49 and includes a blood work panel through LabCorp or Quest partner locations plus a clinician consultation, with provider review inside 12 to 24 hours. If treatment is appropriate, TRT runs from $149/month on a six-month commitment or $199/month billed monthly, covering injectable testosterone or enclomiphene shipped to you. It also offers ED treatment from “$12.99/dose or less” and a peptide range.
| Taurus Meds | Male Excel | |
|---|---|---|
| Cost | $49 intake including labs, then $149/mo on six months or $199/mo monthly. Published in full. | $99/mo membership plus medication at an unpublished price. You cannot calculate a total. |
| Labs | Included in the $49 intake, via LabCorp or Quest. | $65 per biomarker test, with six-monthly retesting. |
| Clinical disclosure | “Licensed clinicians”, none named. States it is not itself a laboratory or medical provider. | Names its Chief Medical Officer and Medical Director publicly. |
| Guarantee | None published. | 90 days — but refunds membership fees only, not medication. |
| Fertility-sparing option | Yes — enclomiphene offered alongside injectable testosterone. | Yes — clomiphene, branded Triclozene. |
The reservation about Taurus
Its public reviews are polarised, and the negative ones are about the worst category there is for a mail-order pharmacy: several describe paying and not receiving medication, in terms as blunt as “they take your money and don't send your meds”. Others report fast delivery and satisfaction. We cannot adjudicate individual accounts, but non-delivery complaints are worth weighing differently from complaints about, say, response times.
Taurus Medical, Inc. also lists its address as a PMB — a private mailbox — in Wilmington, Delaware, and states plainly that the platform is not itself a laboratory or a medical provider. Neither is improper, and the second is an honest disclosure. But combined with no named clinicians and no published refund policy, it means there is less to verify here than the published pricing might suggest.
A genuinely transparent price including real lab work at intake — the thing Male Excel most conspicuously lacks — and a fertility-sparing option on the menu. Held back by unnamed clinicians, no published refund terms, a private-mailbox address and public complaints alleging non-delivery.
TRT and ED · No GLP-1 · Get your bloodwork done properly first
Who should look elsewhere
Anyone who has not had testosterone measured properly on two separate fasting mornings — get that first, from anyone. Anyone about to lose a substantial amount of weight who has not retested afterwards. Anyone who wants children in the near future and has not had a specific conversation about fertility. Anyone in the nine states listed above. And anyone who needs to know the total cost before committing, because you will not find it published.
Frequently Asked Questions
Do GLP-1 medications raise testosterone?
Indirectly, and the evidence so far is encouraging but limited. Research presented at ENDO 2025, the Endocrine Society's annual meeting, followed 110 men with obesity — many also with type 2 diabetes — treated with semaglutide, dulaglutide or tirzepatide. Over 18 months the proportion with testosterone in the normal range rose from 53% to 77%, alongside about 10% weight reduction, and the men who lost more weight saw more improvement. The researchers attributed the effect to the weight loss rather than to any direct hormonal action of the drugs. Treat it as promising rather than settled: this was a conference presentation of an observational study with no control group.
Why does obesity lower testosterone?
Principally because adipose tissue converts testosterone into oestradiol via the aromatase enzyme, and the resulting hormonal signalling suppresses the pituitary output that tells the testes to produce testosterone. The result is often called functional hypogonadism — low testosterone caused by an underlying condition rather than by a primary problem with the testes or pituitary. It is frequently reversible when the underlying condition improves, which is exactly why the sequencing in this article matters.
Should I start TRT while losing weight on a GLP-1?
That is a question for a clinician who has seen your bloodwork, and this article is not medical advice. The general argument for waiting is that if your low testosterone is driven by obesity, substantial weight loss may resolve it without lifelong therapy — and starting exogenous testosterone suppresses your own production, which makes it much harder to find out. The argument for not waiting is that symptoms are real now and weight loss takes many months. Have that conversation explicitly rather than defaulting either way.
Does TRT affect fertility?
Substantially, and this is the single most under-discussed consequence. Exogenous testosterone suppresses the pituitary gonadotropins that drive sperm production; pooled data indicate sperm concentration falls by roughly 85–95% within three to six months of starting. If you want children in the foreseeable future, raise this before you begin. Clomiphene is an alternative that raises testosterone by stimulating your own production rather than replacing it, and it generally preserves fertility — Male Excel offers it, branded as Triclozene.
How much does Male Excel cost?
Male Excel publishes a $99 per month membership that covers unlimited provider access, comprehensive blood testing every six months, an initial at-home hormone test kit and ongoing management. It does not publish medication costs — those are billed separately based on your protocol, at what it calls member pricing. That means you cannot calculate your real monthly total from the website, which is our main criticism of it.
Is Male Excel available in every state?
No. As listed on its site in August 2026, Male Excel does not serve Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Mississippi, New Hampshire or Rhode Island. Availability rules for telehealth hormone therapy change, so confirm your state at sign-up rather than relying on any list, including this one.
How is testosterone deficiency properly diagnosed?
The Endocrine Society clinical practice guideline is specific: diagnose only in men who have both symptoms and signs consistent with deficiency and unequivocally low levels, and confirm by measuring total testosterone on two separate mornings while fasting. A single reading, or one taken in the afternoon, is not sufficient — testosterone follows a daily rhythm and varies considerably. Be cautious of any provider willing to start therapy on one convenient sample.
Is TRT safe for the heart?
The TRAVERSE trial, a large randomised placebo-controlled study, found that testosterone therapy did not significantly increase major adverse cardiovascular events in men with hypogonadism and existing cardiovascular risk. That is meaningful reassurance for appropriately indicated use. It is not a green light for treating men who do not meet diagnostic criteria. TRT also raises red cell production, so haematocrit needs monitoring — TRAVERSE titrated to keep it at or below 54%.
Where to Go Next
- GLP-1 provider reviews — if the weight is the thing to treat first, start here
- GLP-1 eligibility requirements — who qualifies, and what the intake actually assesses
- Mental health support on a GLP-1 — what the regulators concluded about mood, and where therapy fits
Medical Disclaimer
We're not doctors, and this article is for education only — it isn't medical advice. GLP-1 medications are prescription-only and require evaluation by a licensed healthcare provider. Individual results vary widely, and only a clinician who knows your history can determine what is safe and appropriate for you. See our full medical disclaimer.
Keep Comparing
Every provider we've researched, with published pricing, medication type, and what's actually included.
Affiliate Disclosure: This article may contain affiliate links. If you sign up through one, we may earn a commission at no additional cost to you. We do not accept payment for favorable coverage. Read our full affiliate disclosure policy.