At-Home Hormone Replacement Therapy (HRT)

At HOOT HRT, we believe men shouldn’t have to choose between their health and their schedule. Our Self-Inject TRT program brings custom-dosed testosterone therapy to your doorstep—paired with medical oversight through secure telehealth.

How it works

1. Telehealth consult and baseline labs
   Meet with your HOOT HRT provider by video. We order a morning hormone panel through a partner lab near you.

2. Confirm the diagnosis
   If your initial results suggest Low T, we repeat morning labs and complete a deeper review of your medical history, medications, and goals.

3. Personalize your plan
   Once Low T is confirmed and therapy is appropriate, we finalize your dosing strategy during a telehealth visit with Dr. John Cash or PA Joe Hamm.

4. Delivery to your door
   Your quarterly supply of testosterone cypionate and supplies ships discreetly to you—prepped for simple self-administration.

5. Ongoing monitoring
   We follow up regularly via telehealth and schedule labs at approximately 6 weeks, 6 months, and 12 months to keep dosing safe and effective.

Why choose HOOT HRT for TRT

• No weekly clinic visits—true schedule flexibility
• Custom-dosed therapy—exact prescription
• Expert supervision—telehealth check-ins plus regular labs
• Transparent, cash-based pricing—no insurance required. Unbelievable value. For services rendered. Even compared to other clinics that accept insurance. 
• Discreet shipping—fast, reliable delivery to your home

Ready when you are. Book your telehealth consult to see if Self-Inject TRT is right for you.

Symptoms of Low Testosterone in Men

Low testosterone can creep up gradually—many men chalk it up to stress or “just getting older.” If these changes are limiting your energy, focus, or drive, it’s worth a closer look.

Physical symptoms
• Fatigue or low stamina
• Loss of muscle or strength
• Increased abdominal fat
• Slower metabolism
• Lower bone density (in some cases)

Sexual symptoms
• Reduced libido
• Fewer morning or spontaneous erections
• Erectile difficulties
• Lower semen volume

Emotional and cognitive symptoms
• Irritability or low mood
• Brain fog or trouble concentrating
• Poor sleep quality
• Low motivation or diminished sense of well-being

Why testing matters
Many of these symptoms overlap with other conditions. That’s why HOOT HRT starts with data: morning labs, a detailed history, and a clear plan.

The HOOT HRT approach
• Telehealth consult with Dr. John Cash or PA Joe Hamm
• Comprehensive hormone panel
• Custom-dosed TRT when clinically appropriate
• Regular follow-ups and lab monitoring
• Dose adjustments to support long-term safety and results

When to test
If you’re noticing several symptoms—especially fatigue, low libido, or mood changes—schedule a hormone evaluation. Early detection can improve quality of life and long-term health.

Health Risks Linked to Low Testosterone

Untreated hormone deficiency—particularly Low T—can be associated with broader health concerns. A proper evaluation helps you address root causes and reduce risk.

Obesity and metabolic health
• Low T and abdominal fat often reinforce each other
• Excess fat raises inflammation and insulin resistance
• Higher risks: type 2 diabetes, metabolic syndrome, and cardiovascular disease

Type 2 diabetes
Testosterone supports glucose metabolism and insulin sensitivity. Low levels can contribute to insulin resistance and metabolic disorders, especially in midlife.

Cardiovascular factors
Low T may be associated with adverse lipid patterns and arterial stiffness. Addressing overall risk includes lifestyle, labs, and evidence-based therapy when appropriate.

Cognition and mood
Some studies associate Low T with a higher risk for mild cognitive impairment and mood changes. Evaluating and treating underlying deficiencies may support clarity and well-being.

Prostate considerations
Testosterone does not cause prostate cancer, but pre-existing cancer can be influenced by hormone changes. That’s why HOOT HRT screens with PSA and monitors over time.

When to get tested
Energy decline, low libido, brain fog, mood changes, or increased central fat are good reasons to evaluate testosterone and overall metabolic health.

HOOT HRT makes it straightforward
• Comprehensive telehealth evaluation
• Morning labs through partner facilities
• Custom-dosed care with regular monitoring

Causes of Low Testosterone in Men

Testosterone supports energy, mood, focus, strength, metabolism, and sexual health. Levels naturally decline about 1% per year after 30—but clinically low levels often have multiple contributors.

Medical causes
• Testicular injury or surgery
• Chemotherapy or radiation
• Pituitary disorders affecting hormone signaling
• Infections or autoimmune conditions
• Genetic conditions (for example, Klinefelter syndrome)

Lifestyle and health factors
• Excess body fat and insulin resistance
• Chronic stress and elevated cortisol
• Poor sleep or sleep apnea
• Excess alcohol
• Certain medications (opioids, corticosteroids, anabolic steroids)
• Chronic illness (type 2 diabetes, liver or kidney disease)

How HOOT HRT treats Low T
We don’t guess. We test.
• Comprehensive hormone panel and history
• Telehealth visit to review symptoms, labs, and medications
• If Low T is confirmed and appropriate: custom-dosed TRT with regular lab monitoring and dose adjustments

Hormone Replacement Therapy (HRT) for Women

Hormones shape energy, sleep, mood, cognition, metabolism, and sexual health. When estrogen, progesterone, or testosterone decline, life can feel “off.” We help you understand what’s changing—and offer a plan that fits your body and goals.

Common signs of imbalance
• Fatigue or low energy
• Hot flashes or night sweats
• Mood changes or irritability
• Insomnia or fragmented sleep
• Brain fog or trouble concentrating
• Low libido or sexual discomfort
• Weight gain or slowed metabolism

Your first steps with HOOT HRT

1. Telehealth consultation

2. Comprehensive labs (for example: SHBG, estradiol, progesterone, DHEA-S, LH, FSH, prolactin, TSH, Free T3/Free T4, total and free testosterone, CBC, lipid panel, CMP)

3. Follow-up visit to start your personalized plan

Treatment options may include
• Estrogen and progesterone (topical and oral options where appropriate)
• Targeted supplements and lifestyle guidance
• Topical testosterone when clinically appropriate

Ongoing care
We monitor labs, symptoms, and outcomes over time—adjusting your plan as your needs evolve.

Testosterone Therapy for Women

Women need balanced testosterone, too. When levels are low—common in perimenopause, menopause, or after chronic stress—daily life can feel harder than it should.

Why testosterone matters
• Energy and resilience
• Bone and muscle support
• Mood, motivation, and focus
• Sexual desire and satisfaction

Common signs of low testosterone in women
• Persistent fatigue
• Mood changes or irritability
• Lower libido or sexual dissatisfaction
• Muscle weakness or increased fat mass
• Thinning hair or changes in skin
• Brain fog that affects focus and memory

Is therapy right for you?
We begin with a comprehensive hormone evaluation and a telehealth consult. If testosterone therapy is appropriate, we typically use topical formulations for steady, consistent dosing.

Convenient at-home care
• Custom-dosed topical testosterone (for example, Topi-Click applicators)
• Shipped to your door
• Ongoing monitoring and dose adjustments via telehealth

Why HOOT HRT
• Care led by Dr. John Cash and PA Joe Hamm
• Evidence-based protocols and safety monitoring
• Personalized plans that evolve with you

Symptoms of Hormone Imbalance in Women

Hormonal shifts can be subtle—or disruptive. If you feel “not yourself,” it’s time to look under the hood.

What is a hormonal imbalance?
Too much or too little of key hormones—estrogen, progesterone, testosterone, thyroid hormones, or cortisol—can affect everything from temperature control and sleep to mood and metabolism.

Common symptoms

Hot flashes and night sweats
Linked to fluctuating estrogen; often affects sleep and concentration.

Vaginal dryness
Lower estrogen can thin vaginal tissue and reduce natural lubrication.

Low libido
Changes in estrogen, progesterone, and testosterone can lower desire and arousal.

Anxiety or irritability
Hormone shifts can impact neurotransmitters tied to mood regulation.

Sleep problems
Estrogen, progesterone, and cortisol influence sleep onset and quality.

Hair thinning
Can reflect thyroid changes, estrogen fluctuation, or androgens.

Other signs
• Fatigue or low energy
• Weight gain or slowed metabolism
• Breast tenderness
• Acne or oily skin
• Bloating
• Irregular or absent periods
• Headaches or joint pain
• Brain fog

Thyroid matters, too
Hypothyroidism may cause constipation, cold sensitivity, dry skin, puffiness, and low mood. Hyperthyroidism may cause unexplained weight loss, restlessness, sweating, and palpitations. HOOT HRT includes thyroid testing when indicated.

Why timely evaluation helps
Addressing imbalance isn’t just about comfort. It can support bone density, metabolic health, cardiovascular risk factors, and cognitive well-being.

The HOOT HRT process
• Telehealth visit with targeted labs
• Custom plan (HRT and supportive care when appropriate)
• Ongoing monitoring and dose adjustments

Risks of Hormone Deficiency in Women

Your body is designed for balance—yet stress, age, medical conditions, and lifestyle can push hormones off course. Listening to early signals helps you prevent small issues from becoming bigger ones.

Three ways imbalance creates risk

1. Underlying conditions go undetected
   Symptoms like fatigue, irregular cycles, or hair loss can point to thyroid disorders, PCOS, adrenal issues, or other conditions. Proper labs are the fastest way to clarity.

2. Quality-of-life declines
   Untreated imbalance can pile on symptoms—sleep disruption, mood swings, weight gain, joint aches, acne, low libido—making daily life harder.

3. Long-term health can be affected
   Imbalances may contribute to unfavorable cholesterol patterns, decreased bone density, insulin resistance, and poor sleep—all of which influence long-term health.

What to do next
If your body is “whispering” that something’s off, don’t ignore it. HOOT HRT provides targeted labs, clear explanations, and a plan that includes lifestyle changes, supportive supplements, and hormone therapy when appropriate.

Causes of Hormone Imbalance in Women

Persistent imbalance can trigger symptoms like bloating, brain fog, fatigue, hair loss, headaches, palpitations, irregular cycles, irritability, insomnia, mood swings, and vaginal dryness.

Common causes

Diabetes (type 1 or 2)
Glucose dysregulation can alter ovarian function and the timing of menopause.

Endometriosis
An estrogen-dependent condition; excess estrogen often worsens pain and mood symptoms.

Excess body fat
Higher visceral fat can elevate estrogen and lower SHBG, altering the hormone landscape.

Chronic stress
Elevated cortisol interferes with estrogen/progesterone balance and thyroid conversion—fueling heavy, frequent, or missed periods, hair changes, and night sweats.

Thyroid disorders
Too much or too little thyroid hormone affects cycles, weight, energy, hair, skin, and mood.

Menopause and primary ovarian insufficiency
Physiologic decline or early loss of ovarian function reduces estrogen and progesterone.

PCOS
Insulin resistance and androgen excess can cause irregular periods, acne, hair changes, and fertility challenges.

Diet and gut health—what’s the link?
A highly processed diet can disrupt the gut microbiome and intestinal barrier. When this barrier is impaired, inflammatory signals rise, which:
• Worsens insulin resistance and cravings
• Lowers SHBG, increasing free androgens
• Interferes with estrogen metabolism in the gut-liver axis

How to support balance
• Protein-forward, fiber-rich meals; limit ultra-processed foods and added sugar
• Omega-3s and colorful plants for anti-inflammatory support
• Adequate sleep and stress management to normalize cortisol
• Strength training to improve insulin sensitivity
• Targeted supplements when indicated (for example, magnesium, vitamin D)

How HOOT HRT helps
We identify the “why” with focused labs and a full history, then tailor a plan that may include lifestyle changes, supplements, thyroid optimization, and HRT when appropriate—managed entirely by telehealth.