Hormonal Protocol • ICD-10 E29.1
Male Hypogonadism & Androgen Deficiency
Biochemically confirmed low morning serum total and free testosterone accompanied by somatic, sexual, hematologic, and neurocognitive symptoms.
Medically Reviewed by Dr. Julian Sterling, MD, FACS (NPI #1376841536)
Male Hypogonadism & Androgen Deficiency Optimal Biomarker & Diagnostic Fact Matrix
| Metric | Verified Benchmark | Source |
|---|---|---|
| ICD-10-CM Diagnostic Classification | E29.1 | WHO / CMS ICD-10-CM Clinical Modification |
| Biomarker: Free Testosterone (Equilibrium Dialysis) | 120 – 220 pg/mL | DotMD Preventive Optimal Target Range |
| Biomarker: LH & FSH | 2.5 – 7.5 mIU/mL | DotMD Preventive Optimal Target Range |
| Biomarker: Estradiol (Ultrasensitive LC/MS) | 20 – 38 pg/mL | DotMD Preventive Optimal Target Range |
| Biomarker: Hematocrit | 42% – 49% | DotMD Preventive Optimal Target Range |
Pathophysiology & Clinical Presentation
Primary Leydig cell attrition or secondary hypothalamic-pituitary GnRH/LH pulsatility suppression — frequently exacerbated by visceral aromatase activity and elevated SHBG — diminishes androgen receptor transcriptional signaling.
Hallmark Clinical Signs & Biomarker Triggers
- Morning total testosterone < 300 ng/dL on two separate draws
- Diminished libido, loss of nocturnal erections, and blunted drive
- Refractory visceral fat gain and loss of appendicular muscle
- Depressed mood and reduced bone mineral density
Evidence-Based Medications & Cash Arbitrage for Male Hypogonadism & Androgen Deficiency
| Medication | Mechanism Class | Worth-It Score | Retail Avg | Lowest Cash |
|---|---|---|---|---|
| Testosterone Cypionate (17-Beta-Cyclopentylpropionate) Depo-Testosterone | Esterified Parenteral Androgen Receptor Agonist | 94.20% (48) | $98.00 | $42.00/mo |
| Chorionic Gonadotropin (hCG / Pregnyl) Pregnyl, Novarel, Ovidrel | Luteinizing Hormone / Choriogonadotropin Receptor (LHCGR) Agonist | 91.00% (26) | $278.00 | $128.00/mo |
| Enclomiphene Citrate (Pure Trans-Isomer SERM) Androxal (Investigational / 503A Compounded) | Hypothalamic Estrogen Receptor Antagonist / Gonadotropin Secretagogue | 89.80% (39) | $165.00 | $95.00/mo |
| Cabergoline Dostinex | Long-Acting Lactotroph Dopamine D2-Receptor Agonist | 89.70% (15) | $176.00 | $18.60/mo |
| Raloxifene Hydrochloride Evista | Benzothiophene Bone-Agonist / Breast-Antagonist SERM | 85.60% (18) | $112.00 | $9.80/mo |
| Prasterone (Micronized Dehydroepiandrosterone) Intrarosa | Adrenal Zona Reticularis Intracrine Steroid Precursor | 83.00% (14) | $248.00 | $38.00/mo |
| Anastrozole Arimidex | Non-Steroidal Reversible Type II Aromatase (CYP19A1) Inhibitor | 78.40% (21) | $58.00 | $6.10/mo |
| Clomiphene Citrate (Racemic Enclomiphene / Zuclomiphene) Clomid, Serophene | Mixed Selective Estrogen Receptor Modulator (SERM) | 74.20% (27) | $124.00 | $34.50/mo |
INSTANT PRESCRIPTION & CASH ROUTING
DotMD Club Members get $29 flat-rate script renewals →
Verified Online Prescribers & Wholesale Pharmacies for Male Hypogonadism & Androgen Deficiency
Hone Health Hormone & At-Home Biomarker Lab (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~3 days
$
65.00
Consult / Starting Tier