What disqualifies someone from TRT?
Active prostate or breast cancer, untreated severe sleep apnea, uncontrolled erythrocytosis (hematocrit ≥54%), active and unmanaged thromboembolic disease, and selected cardiovascular contexts. Active fertility goals route to Enclomiphene.
Full answer
Absolute contraindications to TRT include active prostate cancer, active male breast cancer, untreated severe obstructive sleep apnea, uncontrolled erythrocytosis (hematocrit ≥54%), active uncontrolled heart failure, and selected recent cardiovascular events. Relative contraindications and decision points include BPH with severe lower urinary tract symptoms, elevated baseline hematocrit, untreated polycythemia vera, and elevated baseline PSA requiring urologic clearance. Men with active fertility goals are reviewed for Enclomiphene rather than exogenous testosterone. Every candidacy decision is synchronous-video reviewed.
Educational. Not a substitute for individualized provider review.
- Testosterone Optimization pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03