oMeds
All comparisons
Comparison · hormone optimization

TRT vs BHRT vs Peptide — Clinical Decision Support

Hormone replacement (TRT/BHRT) and peptide pathways are not mutually exclusive — candidacy depends on biomarkers, fertility goals, age, and symptom profile. This decision-support comparison maps the routing logic used in provider review.

Reviewed by Dr. Laura PurdyMay 29, 2026
Attribute
TRT or BHRT (hormone replacement)
Peptide pathway (axis stimulation)
Confirmed deficiency
Replacement is first-line
Axis stimulation insufficient alone
Fertility preservation desired
Adjunct (hCG/enclomiphene) required
Generally non-suppressive
Borderline biomarkers
Trial of axis support may precede
Often appropriate first step
Recovery / healing primary
Secondary
Primary indication
Combined therapy
Common when biomarker- and goal-aligned
Common
Choose TRT or BHRT (hormone replacement)

Hormone replacement is decisive when biomarkers confirm deficiency and the patient is a candidate after full review.

Explore pathway
Choose Peptide pathway (axis stimulation)

Peptide pathway is decisive when axis support, recovery, or non-suppressive optimization is the goal — or as the first step when biomarkers are borderline.

Educational. Final pathway selection is provider-reviewed via synchronous video consultation against your biomarkers, history, and goals.

Frequently asked

Does the assessment route me?

Yes — the adaptive assessment maps your biomarkers, symptoms, and goals to candidate pathways under provider review.

Can I move between pathways?

Yes — pathway selection is reviewed at each recalibration cadence.

Next step

Take the optimization assessment.

The adaptive assessment maps your symptoms, history, and goals to candidate pathways — and routes you into provider review.

Begin assessment