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question from a user

Do you foresee patients currently dependent on TRT to sort of be “screwed” at any point due to increased regulations that make it so they can no longer legally get testosterone? Also, what about enclomiphene?

AlphaMD's Answer

I don’t have a crystal ball, but I don’t see that being a problem. Treatment is becoming more prevalent because we are better at recognizing the symptoms, more open about talking about it, and recent studies have proven it safe. There are millions of men who need this therapy. With the increased prevalence of transgender care, testosterone will never be regulated away.

Enclomiphene is still being used off label as an alternative to TRT. There was just a ruling that said the FDA cannot regulate the off label use of medications. That discretion is left up to the medical provider and the patient.

The hot take short answer is that no, we do not. There are a lot of moving parts in telemedicine right now, as there always is when laws fluctuate in medicine, but it's important to remember that the ones which might impact TRT are doing so as a side effect of targeting other heavier controlled medications like narcotics which are the real goal.

Even with the "worst" outcome for TRT telemedicine from how things are discussed now, that generally just means that someone would need for a provider to see them once a year. As written, this can be a PCP or an urgent care exam unrelated to the telemedicine business.

TRT is an incredibly safe field of medicine and it has grown to the point that there would be a lot of pushback if we had to change things at this point. There is a longer answer out there, but we feel confident enough to continue to expand in TRT rather than shrink, which should say something.

Other medications like that would likely be similarly affect or unaffected.

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