Dr. Diana Rangave
Dr. Diana RangaveCurious about TRT in Canada?
Do you want to know exactly what testosterone replacement therapy is, and the steps you need to take to start this treatment option while living in Canada?
Well, you’ve landed in the right place.
In this ultimate guide, we’ll cover everything you need to know about testosterone replacement therapy (TRT) in Canada.
All your questions will be answered, such as:
- Will Medicare cover TRT?
- What kind of specialist can prescribe TRT?
- Can I organize TRT online?
We’ll also discuss what testosterone actually is, side effects from TRT, how much treatment costs, plus any legal issues to be mindful of.
Whether you’re new to TRT, or have been receiving treatment for a while, we promise this guide will teach you something new.
So, let’s get started by taking a look at what testosterone actually is…
Disclaimer: The contents of Testosterone.org are for informational and educational purposes. We do not provide legal advice. Likewise, we do not provide medical advice, diagnosis, or treatment. Please consult your physician prior to consuming any over-the-counter supplements, like a natural testosterone booster, and/or getting a prescription for a pharmaceutical medication. Your access to Testosterone.org is subject to our full disclaimer and terms of use.
What is Testosterone?
If you are a man, and you want to live a healthy life, then you MUST have healthy testosterone levels!
Women also need a certain amount of testosterone for optimal health, but men produce 10-20 times more testosterone on average, so it is especially important for them [1, 2, 3].
Testosterone is often known as the male sex hormone, as it leads to the development of male characteristics in teenage boys. Testosterone isn’t just important for adolescents, though – it benefits the following areas for men of all ages [4]:
- Physical health
- Mental health
- Sexual health
Estrogen is referred to as the female sex hormone. Just as women require some testosterone for good health, men also require certain levels of estrogen for optimum wellbeing [5].
Ideal hormonal health in a man is determined by adequate testosterone levels, with a favorable ratio of estrogen to testosterone [6].
Interest in TRT has increased substantially in recent decades, as researchers have identified a concerning increase in the prevalence of low testosterone (also known as hypogonadism).
It is a well-established fact that hypogonadism is common in older men, but it is now being identified at an alarming rate in middle-age men [7, 8].
Researchers are now even finding teenagers with low testosterone levels [9].
Low testosterone can have several concerning effects on the health and wellbeing of men of any age, such as [1, 10, 11, 12]
- Fatigue, difficulty concentrating, and low mood
- Low sex drive and erectile dysfunction
- Obesity and reduced muscle mass
- Higher risk of serious medical problems, like type 2 diabetes and heart disease
Thankfully, good treatments are now available for men with low testosterone.
What is TRT (Testosterone Replacement Therapy)?
Also known as Hormone Replacement Therapy (or HRT), TRT has been used in medical settings for decades. It is a safe, well-tolerated, and effective treatment for low testosterone levels [13].
The first step in TRT is a hormone test and assessment of symptoms.
If a doctor feels treatment is warranted, TRT can be prescribed in several forms. Injections, HRT patches, and gels are common ways of addressing low testosterone levels [14].
Because of the use of testosterone in sports and bodybuilding, some people (and doctors) worry that TRT is the same as using anabolic steroids. While testosterone is technically a steroid, when used for TRT, it is very different from taking anabolic steroids.
The goal of athletes who use anabolic steroids is to achieve supraphysiological (far higher than normal) levels of testosterone. This provides several advantages for sports, such as improved recovery, increased muscle mass, and gains in strength [15].
It is noteworthy that athletes often use a variety of other substances in addition to testosterone to increase their levels.
In contrast to the above, TRT is only used to bring the testosterone levels of men suffering from hypogonadism into a normal range.
This doesn’t result in any of the benefits, or risks associated with anabolic steroid use.
The reason testosterone is generally the only substance used for TRT, is that it is the safest way of increasing testosterone levels, with the least side effects.
That being said, there are still some concerns to discuss.
Testosterone Replacement Therapy | Side Effects and Safety Concerns
No matter how safe a medication is, there are always side effects and safety concerns.
Some potential (but uncommon) side effects of TRT include [16]:
- Acne (either new or worsening)
- Can stress the liver, causing raised enzymes
- Enlarged prostate
- Skin irritation where cream/patch is applied
- Swollen/enlarged breast tissue (gynecomastia)
- Fluid retention
There is a bit of a mixed picture with safety concerns about TRT.
In early studies, some serious concerns were raised (detailed in the list below). However, subsequent research found that most of these problems have no direct link to TRT [17].
The main safety concerns noted with TRT are [16]:
- Increased risk of heart problems and stroke (side effect of low testosterone as well)
- Might make existing prostate cancer worse
- Male infertility
- Worsening of obstructive sleep apnea
The doctor prescribing TRT will discuss any concerns that might apply to you.
Keep in mind, when properly administered, most people do not experience any problems with TRT [13].
Any decision about TRT should involve weighing the large list of likely benefits of TRT, with any potential risks [16].
TRT in Canada | Legalities, Regulations, and More
It’s time to get into some technical legal information now. Don’t skip this part…
The legalities around testosterone in Canada are actually reasonably straightforward. We’ll cover everything you need to know in a simple, easy to understand way.
Testosterone still has a bad reputation amongst some people (and doctors) in Canada.
This is mainly due to the illegal use of anabolic steroids in sports.
Unfortunately, because of this reputation, some men don’t ever even think of discussing TRT with their doctor. Many think testosterone is illegal in Canada. In reality, this is completely untrue.
Testosterone replacement therapy in Canada is completely legal, provided it is appropriately prescribed by a doctor.
To make sure we cover everything you need to know, let’s dive into the legislation that covers the use of testosterone in Canada.
How Is Testosterone Scheduled in Canada?
All drugs (and medications) in Canada are organized into certain classifications under either the Controlled Drugs and Substances Act 1996, or the National Drug Schedules [18, 19].
The National Drug Schedules are maintained by Health Canada. They dictate whether medications are prescription only, require some controls for sale, or no regulation at all.
Because testosterone is already specified in the Controlled Drugs and Substances Act, it actually isn’t listed in the National Drug Schedules at all.
The Controlled Drugs and Substances Act (The Act) classifies testosterone as a ‘Schedule IV’ substance.
Please note there are 5 categories of controlled substances in Canada:
- Schedule I
- Schedule II
- Schedule III
- Schedule IV
- Schedule V
Schedule I substances are the most tightly controlled (with the highest punishments for illegal possession), through to Schedule V, which has the least controls. At schedule IV, testosterone sits on the lower end of the scale.
Interpreting The Act can be a little tricky, in that what The Act does not prohibit is as important as what it does.
There are actually no regulations (or punishments) around possession or use of Schedule IV substances, like testosterone. This means that it is effectively legal to possess and use testosterone, whether you have a prescription or not.
However, it is illegal for anyone to supply, obtain, or import testosterone without a valid prescription.
The Act provides an exemption for authorized pharmacies to supply schedule IV substances (like testosterone) to individuals with a valid prescription. Registered medical practitioners can also administer testosterone where appropriate.
If all that was a bit complicated, read on for the simple version…
Is Testosterone Illegal in Canada?
The answer to this is a clear cut – NO! Testosterone is not illegal in Canada.
Even though it is technically a controlled substance, there are no laws against personal possession or use of testosterone in Canada.
This Government funded information page by HealthLinkBC clearly states that you can obtain testosterone with a prescription in Canada [20].
Please remember, it is illegal to supply and import testosterone without a prescription! Penalties for this do apply under the Controlled Drugs and Substances Act.
So, if testosterone is legal and available by prescription, men in Canada are in luck, right?
Getting TRT should be as simple as seeing a doctor, having an assessment, then starting treatment.
Unfortunately, it’s rarely that simple in Canada…
Many men struggle to find a doctor who will take their concerns seriously and give them the treatment they need.
Thankfully, with the right information, any barriers to obtaining TRT can be easily navigated.
We’ll explain how in the next section. After that, we’ll even give you the details of the best TRT doctors in Canada.
How to Get Testosterone Replacement Therapy in Canada
So, if TRT is effective, legal, and safe, why is it difficult to get a prescription in Canada?
It’s actually due to a combination of factors, including:
- Lack of understanding amongst doctors about guidelines for prescribing TRT through Medicare and provincial health plans
- The negative perception of testosterone in the community
- Limited education of doctors about the negative impact of low testosterone, and the benefits of TRT
While there’s not much we can do about the negative community perception of testosterone, we can give some pointers on dealing with the other two problems.
Let’s start by looking at TRT and Medicare.
TRT and Medicare
The public health system in Canada does a great job of providing treatment for many medical conditions. Unfortunately, low testosterone isn’t one of them.
The cost of an assessment by a primary care physician will be covered by Medicare, but whether TRT is provided is entirely up to the personal opinion of that doctor.
If you have a doctor who understands the benefits of TRT, then you might be in luck. On the other hand, if you see a doctor who is prejudiced against TRT, then there’s not much chance of getting treatment.
Like many countries with large public health systems, government guidelines in Canada are often overly focused on cutting healthcare costs, rather than providing the best services and choices for patients.
Primary care physicians looking for information on low testosterone are limited to guides like this, which immediately highlight their goal of restricting access to the following practices [21]:
- Wellness
- Anti-aging
Public health recommended cut-offs for diagnosing low testosterone in Canada are ridiculously low, at 8nmol/L in younger men, and 6nmol/L for older men (over 50).
For reference, guidelines in Britain – another country with a robust public health system – recommend starting TRT for anyone with levels below 8nmol/L, plus considering a trial in men with symptoms of low testosterone whose levels are below 12nmol/L [22].
Furthermore, the British guidelines recommend aiming for testosterone levels of 15 – 30nmol/L in men receiving TRT.
This is almost double the 6 – 8nmol/L cut-off recommended to doctors in Canada!
For the men in Canada who do manage to get a TRT prescription, there are further hurdles in obtaining medication through provincial health plans…
TRT and Provincial Health Plans
Another factor complicating HRT in Canada, is limitations regarding the testosterone formulations that are approved by provincial health plans.
When a man is prescribed TRT there are several options. Patches, gel, injections, and creams all have their pros and cons, most of which are based on individual factors.
Astoundingly, many provincial health plans only cover one testosterone formulation [23]!
This means that many men may not be able to access the form TRT that would benefit them the most.
In particular, coverage of HRT patches in Canada has been limited, after the Government noticed the increasing use of this formulation in 2010.
Fortunately, men having trouble getting TRT in Canada have another option – private scripts.
Understanding Private Scripts
Despite having a robust public health system, many people living in Canada choose private medical care. For some, this is via private insurance, while others opt to pay full out of pocket costs.
Being a relatively low-cost treatment, TRT is well suited to private arrangements.
It is completely legal for a doctor to provide a private script for TRT. The term “private script” simply describes a treatment arrangement that is provided outside of Medicare.
This allows the patient and doctor to sidestep the barriers around providing TRT through the public system, and just focus on the treatment itself.
The most important thing with a private script is to choose a doctor who is experienced with TRT.
How To Talk To a Doctor About TRT
Fortunately, Canada does actually have some doctors that are understanding about TRT. They realize that following Government guidelines won’t result in the best outcomes for their patients, and are willing to give men with low testosterone a fair go.
If you think you might have low testosterone, finding a doctor with an interest in and understanding of this issue is essential.
It is MUCH easier to work with a doctor who approaches the problem from a compassionate and supportive perspective, than to change the mind of someone who is prejudiced against TRT.
Once you have picked a doctor, explain the symptoms that you feel are related to low testosterone. This document has a great list of official descriptions if you need some pointers [24].
You will likely need a blood test, although symptoms are an important part of the diagnosis.
Don’t be surprised if your doctor goes through the potential for abuse of testosterone and risks of TRT. Even with private scripts, doctors are legally required to provide responsible medical care.
An interesting development in Canada in recent years, has been the availability of online and telehealth TRT doctors. Let’s take a look now at our top two recommendations…
Online TRT Doctors in Canada | #1 Option?
For online TRT in Canada, it doesn’t get better than the On Men TRT clinic.
There are other online TRT doctors in Canada, but none can match the ease of use, affordability, and professionalism of On Men.
Through their secure online platform, On Men will arrange a blood test to check testosterone levels, consultation with a doctor experienced in TRT, plus delivery of any medication that is prescribed.
There is a small fee for the blood test, then you only pay for the doctor’s consultation if a prescription is approved.
To help with the cost of TRT, On Men will even directly bill insurance if your plan provides coverage.
What makes On Men different, is that they aren’t just TRT doctors – they are a fully functioning Men’s wellness service.
As well as TRT, On Men can treat other Men’s issues, including:
- Erectile dysfunction
- Sexual difficulties
- Hair loss
- STD’s
The team at On Men understands that these issues can be awkward to discuss, which is why all treatment is handled confidentially and efficiently through their online system.
With On Men, there are no wait times for treatment. No uncomfortable conversations. No standing in line at a pharmacy to pick up meds.
Aside from the blood tests, all treatment with On Men can be done from the comfort of your own home.
To get started, just head over to their website, pick a product, and create a profile. All they need is some basic information, then the assessment can start right away.
Online TRT Doctors in Canada | #2 Option?
Coming in as a close second for online TRT doctors in Canada, is Marek Health.
Marek Health has been operating in the US for a while now. After establishing a reputation and loyal following in the states, they are now expanding into Canada.
As soon as you land on their website, you will notice something a bit different about Marek.
They don’t just offer TRT – they provide total hormonal and overall health optimization.
Described as a premiere coaching and concierge medicine service, Marek Health offers a full suite of medical and wellness services, to help anyone achieve their peak level of physical wellness.
For all patients, Marek’s goals are to maximize the following areas of men’s overall health:
- Physical performance
- Health and longevity
- Overall sense of well-being
In recognition of the fact that, Marek Health has built its entire service on a telehealth streaming system, knowing that government regulations have made TRT and performance-based medical care is difficult to obtain in traditional settings.
When you choose Marek Health, you will be matched with a Patient Care Coordinator with specific expertise in your areas of concern.
They will conduct a full assessment, arrange any tests that might be required, then arrange an appointment with a Physician from their network of specialized providers.
For those people who are serious about optimizing hormonal balance, achieving peak mental and physical performance, and maximizing overall wellbeing, Marek Health is the clear choice for an online provider.
TRT Cost in Canada | What You Must Know
Unfortunately, we can’t detail the costs of every TRT provider in Canada.
HRT cost in Canada will vary depending on the doctor you choose, whether medication is covered by insurance, and what form of TRT you end up using (i.e. injections, gel, patches).
What we can tell you, is that if you are serious about getting the most out of TRT, you will need to be prepared for the fact that Medicare probably won’t cover all of the costs.
Some men don’t have any problems arranging TRT through their primary care physician, but most get the best results using a specialized provider who offers private billing.
That being said, TRT is surprisingly affordable through private providers in Canada, especially online.
Take On Men for example, who we detailed above. Their costs are just $50 for the initial blood test, $150 for an initial assessment, then $200 quarterly for follow-ups. They can even bill insurance directly if your plan provides coverage.
TRT in Toronto, Canada
The top choice of TRT clinic in Toronto is clear – Sovereign Male is head and shoulders above the competition.
Concerned with all aspects of male wellness and appearance, Sovereign Male provides expert-led TRT and a range of other men’s sexual health, cosmetic, and health optimization services.
When you choose Sovereign Male for TRT, you can rest assured that treatment will be provided in a safe, sustainable, and effective way.
The doctors at Sovereign Male understand that optimum results from TRT require more than just a prescription and sending people on their way.
They work to achieve the delicate balance involved in hormone replacement therapy that will help men fully regain their vitality and health.
In addition, Sovereign Male can treat the entire range of other problems that often go along with TRT, like sexual difficulties, poor body composition, and other health issues.
To arrange a no-obligation TRT consultation, jump on the Sovereign Male website and book an appointment.
TRT in Montréal, Canada
Finding a TRT clinic in Montréal actually isn’t that easy. Not many clinics in the area specialize in TRT, which makes choosing a provider difficult.
No need to stress, though. We’ve got you covered!
While it is marketed as a male and female sexual health clinic, Elna Sexual Wellness is a solid choice for men looking for TRT in Montréal.
Everything you need to know about their TRT service is detailed here.
Because Elna Sexual Wellness is led by a team of experienced Urologists and allied health professionals, they can comprehensively treat every aspect of low testosterone, helping men deal with this devastating issue.
Some TRT clinics only offer a limited range of treatment options, but not Elna Sexual Wellness.
Their dedicated staff will work with you to develop an individual plan that can include any of the TRT options currently available on the market, including:
- Skin patch
- Mouth patch
- Gels and creams
- Injections
- Implants
If you are in Montréal and are serious about getting high-quality, effective TRT, reach out to Elna Sexual Wellness and book an appointment at any of their three clinics.
TRT in Vancouver, Canada
Pollock Clinics are a rapid access, private care TRT clinic in Vancouver, that people can access without a referral.
They provide a range of men’s sexual health services, including a comprehensive, world-class Testosterone Deficiency Program.
What is unique about Pollock Clinics, is that they are a no-fuss, easily accessible TRT service, that is staffed by experienced doctors.
Many TRT services that provide hassle free appointments don’t offer much more than a quick assessment and prescription – not Pollock Clinics.
By choosing Pollock Clinics for TRT, you can rest assured that you are being treated by medical experts, with a team of skilled support staff behind them.
Pollock Clinics provide effective, evidence-based treatment for men with low testosterone.
They can also address any other sexual health concerns that might be present, including:
- Erectile dysfunction
- Premature ejaculation
- Sexually transmitted diseases
Pollock Clinics are one of the few practices in Canada offering penile enlargement through PRP (Platelet Rich Plasma) treatment.
The Pollock Clinics website has a HEAP of information about low testosterone.
If you are interested in learning more, head over and have a read.
TRT in Canada | The Ultimate Guide
We’ve covered a lot of information in this guide.
If you have been wondering about TRT in Canada, we’ve detailed everything you need to know.
While it’s not always possible for men with low testosterone to get TRT through Medicare in Canada, there are other options.Men in Canada with low testosterone don’t have to suffer in silence.
They can choose to use one of the many online or clinic-based TRT doctors detailed in this guide.
All of these doctors understand the huge negative impact low testosterone has on men, and are keen to make affordable treatment easily accessible.
If you have been putting off treatment for a while, don’t wait!
Reach out to one of the providers from our guide, and take control of your health and wellbeing.
Here are our recommended online TRT clinics in Canada:
- Online clinic #1 – On Men
- Online clinic #2 – Marek Health
If you would rather visit an in-person clinic, here are our favorites:
- Toronto – Sovereign Male
- Montreal – Elna Sexual Wellness
- Vancouver – Pollock Clinics
However, we understand some men prefer an in-person option, so have provided some good options for TRT clinics as well.
In most cases, commencing TRT fully resolves the problems experienced from low testosterone.
Once you are linked up with a provider, a blood test and checkup a few times a year is generally all that is required for ongoing treatment.
