Ulo wants to help men get their edge back with TRT

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Thinning hair, plummeting energy, and a dwindling sex drive. It's not exactly the future most men imagine for themselves, but for many, it becomes their reality.
Society often submits to the idea that aging robs us of physical strength and mental vitality, but what if some of those effects weren't irreversible? Maybe it's not about turning back the clock, but about optimizing health regardless of age. That's what companies like Ulo are trying to make possible with Testosterone Replacement Therapy.
As endocrinologists shine light on age-related testosterone decline, interest in TRT has surged. Clinically known as Andropause and sometimes, on social media as 'Manopause,' the natural decline typically occurs when men reach their late 30s or 40s, causing some to experience symptoms like hair loss, lowered libido, fatigue, and decreased muscle mass.
'Men are tired of feeling off and being told it's just aging or stress. They're realizing it's not normal to feel constantly exhausted, unmotivated, or emotionally flat at 35 or 45,' shared Deep Patel, the co-founder of Ulo, a telehealth startup that recently launched into the TRT space. 'It's like the male version of menopause, except no one acknowledged it until recently.'
Doctors typically recommend that men with these symptoms also take a blood test to determine if their levels are abnormally low. Normal testosterone levels range from 300 to 1,000 nanograms per deciliter. But low testosterone — also known as hypogonadism — is far from rare. Nearly 39% of men aged 45 years and older have low testosterone.
As with many other experts in the space, Patel believes that 'Low T' is even more widespread than society realizes. 'It's not just guys over 50. More and more men in their 20s, 30s, and 40s are dealing with low T. A lot of it comes from stress, lack of sleep, diet, or genetics.'
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Prescribing TRT online is still a relatively uncharted territory, but some companies are trying to change that. Ulo is among the first to build a site that offers a TRT program with a personalized approach to treatment.
'When we built Ulo, our aim was to help men take back control of their health, especially in commonly overlooked areas such as hormones and hair loss. And when you look at those areas, TRT is an obvious solution,' explained Patel, who co-founded the company with Rob English.
Ulo first launched with a focus on everyday men's health concerns, such as hair loss prevention and regrowth. For Patel and English, stepping into the TRT space was part of a natural evolution, especially after they witnessed the powerful impact this kind of treatment had on the people around them.
'I watched friends lose their hair way too young and struggle in silence,' Patel recounted. 'But, I also noticed a deeper issue. A lot of them also felt drained, mentally foggy, and unmotivated. Turns out, in addition to hair concerns, a lot of them were facing low testosterone.'
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Even after optimizing for sleep, diet, and physical activity, their low testosterone was still impacting their everyday lives. But once they got treated, everything shifted.
After Patel began looking into TRT, he came across another alarming statistic. A 2023 study in the Journal of Clinical Endocrinology revealed that testosterone levels in American men have dropped about 1% per year since the 1980s. That's when he realized we were in the midst of what he calls 'a silent epidemic.'
Emerging research has shown that TRT could be one of the most effective, clinically backed treatments for men with low testosterone levels. Another survey, published in 2019, found that 52% of men claimed testosterone improved their energy, 42% saw improvements in libido, and 29% reported muscle growth.
The benefits of TRT are clear, but many people don't know how to get a testosterone prescription or where to go for safe, high-quality treatment. With Ulo, Patel and his team wanted to make TRT more accessible than ever before.
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At Ulo, it costs as low as $159 a month to get started with a prescription — and you could have a customized testosterone treatment within a week, without spending any time in a clinic.
The process is simple. First, men take a blood test and schedule a consultation with one of Ulo's Doctors. The physician will then examine lab results, symptoms, and medical history before determining if they should receive a prescription. From there, they'll create a customized treatment plan.
According to Patel, injections are the most common and effective type of treatment, but Ulo still offers other forms for anyone with strong preferences, including gels and creams. Once everything is cleared, the treatment is shipped directly to their front door.
Patel says that most men start noticing changes after a few weeks have passed. 'Heightened energy, mental clarity, better sleep, and an increase in libido are usually the first things you'll notice. After two to three months have passed, you'll start to notice changes in body composition.'
He noted that men have also noticed they can build muscle more easily; similarly, many find they are now able to get rid of fat that seemed immovable. In tandem with these changes, participants often experience an increase in confidence.
'The most common side effects include acne, water retention, or elevated red blood cell counts,
which can thicken your blood. Some men experience testicular shrinkage or reduced fertility,' he explained, also noting cardiovascular risks for certain populations.
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Currently, TRT is only FDA-approved for specific conditions, like hypogonadism or diminished functional activity of the gonads. Earlier this year, the FDA also issued class-wide labeling changes for testosterone products, including warnings on increased blood pressure as a potential side effect.
Patel explained that the biggest mistake people make is doing TRT without medical guidance or buying unregulated medication online. His advice is to work with a legitimate provider who looks at bloodwork and adjusts the protocol based on how your body specifically responds.
'At Ulo, we take the time to assess whether TRT is the right choice for you,' he said. 'We don't rush people into treatment. We're not a marketing brand in the guise of a clinic. We're a bona fide telehealth platform built from the ground up to give men the long-term support they require.'
Patel believes that when administered correctly, TRT can have a profound impact on men's physical, mental, and emotional health. Ulo's mission is simple: To make the process safe, efficient, and transparent from day one through every single dose.
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Q&A with Deep Patel at Ulo
The New York Post spoke with Deep Patel to clear up some frequently asked questions regarding Testosterone Replacement Therapy offered at Ulo.
What does Ulo's TRT program include?
At Ulo, we offer a full-service program that includes comprehensive blood work, one-on-one consultations with licensed physicians, prescriptions, custom treatment plans, and regular follow-ups. The process is crafted to be efficient and transparent from start to finish. Best of all, you won't have to spend time in labs and clinics.
Who oversees the treatment?
A licensed, U.S.-based physician oversees every treatment plan at Ulo. Our doctors are specialists in hormone optimization and men's health. They're not just checking a box. Before making decisions, they examine your lab results, symptoms, and medical history. When you join Ulo, you can rest assured that you're getting genuine individualized medical supervision as opposed to a one-size-fits-all program.
How do you personalize dosage or adjust the protocol over time?
We rely on data and feedback from the men. Your physician will examine your blood work and any changes in symptoms, and will ask how you're feeling in general. If something seems off or if you're not progressing as expected, the team at Ulo will make adjustments to dosage, frequency, or support meds. Everything can be fine-tuned. The goal is to ensure you feel your best.
How is TRT administered?
Injections are the most common and reliable method, typically once or twice a week. Some guys use creams or gels, but those can be inconsistent in how they absorb, and there's a risk of transferring to partners or kids. Injections might sound intense, but once you're used to them, it takes less than a minute. Most men do it themselves at home with tiny insulin needles.
Will TRT affect fertility?
Yeah, it can, especially if you're not using anything to counteract it. TRT significantly suppresses natural testosterone production, which can also reduce sperm production. But if fertility matters to you, there are medications like HCG or enclomiphene that can be taken alongside TRT to preserve it. In a 2021 study, over 90% of men maintained normal sperm counts when using these fertility-preserving medications with TRT. Just make sure your provider knows that's a priority from the beginning.
How often is blood work required, and is it included in the program cost?
Blood work is included in the program cost. The first lab takes place before your initial consultation with the doctor. A second lab is done 30 days after treatment begins to help prepare for your 45-day follow-up. After that, labs are required every quarter and are paired with a live consultation to make sure your treatment stays safe, effective, and personalized.
How is the cost for the TRT plan broken up?
We ensure pricing is simple, offering a flat monthly rate that includes physician oversight, medication, lab testing, and access to your care team. No surprise bills or upsells. Our program is significantly more affordable than most in-person clinics. And we never compromise on the quality of care.
Is TRT covered by insurance through Ulo?
Most insurance plans won't cover TRT unless your levels are extraordinarily clinically deficient. Currently, Ulo operates outside of insurance. That gives us the flexibility to treat based on how someone feels. At Ulo, you're never just a box to tick or a chart to fill in. Our approach is proactive, not reactive.
This article was written by Miska Salemann, New York Post Commerce Writer/Reporter. As a health-forward member of Gen Z, Miska seeks out experts to weigh in on the benefits, safety and designs of both trending and tried-and-true fitness equipment, workout clothing, dietary supplements and more. Taking matters into her own hands, Miska intrepidly tests wellness products, ranging from Bryan Johnson's Blueprint Longevity Mix to home gym elliptical machines to Jennifer Aniston's favorite workout platform – often with her adorable one-year old daughter by her side. Before joining The Post, Miska covered lifestyle and consumer topics for the U.S. Sun and The Cannon Beach Gazette.
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Here to help us make sense of the testosterone boom is Stephanie Pappas, a freelance reporter based in Colorado. Stephanie recently covered the growing popularity—and availability—of TRT for Scientific American. Thanks so much for coming on to chat. Stephanie Pappas: Thank you. Feltman: So you recently wrote about testosterone replacement therapy for Scientific American. For folks who are not on the right part of the Internet to have heard all about this—or maybe staying off the wrong parts [laughs] of the Internet, depending on your perspective—what's going on with TRT right now? Pappas: Well, testosterone replacement therapy has become extremely popular. It has been something that's been in the background for many, many years. Synthetic testosterone was first invented in 1935, but for a long, long time people thought that testosterone replacement, if it was used for any kind of symptoms men might be having, that it could cause prostate cancer. 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No one exactly agrees on what the cutoff is, and probably that's because there's a lot of variability in our hormones—like, anyone who's ever tried any sort of hormone treatment, including birth control or HRT [hormone replacement therapy], can tell you that people respond really differently. So for men who really do have low testosterone, the evidence suggests that you can see some benefits in mood if you have major depression. You may see some improvements in energy. The most well-established result from the studies of TRT is that you'll probably see a little boost in libido if you have low testosterone and you now start taking TRT, and that's because testosterone works in the brain to increase sexual desire. Feltman: Hmm. Pappas: For men who don't have low testosterone, which are many of the men who are now getting treatment, the evidence for benefits is much, much lower. We don't know if you really see much besides additional muscle-building abilities. Feltman: And what are the potential downsides? You mentioned that one of the reasons there's such a boom right now is that research has showed that the connection to prostate cancer is not concerning the way we once thought it was. But what about other issues that can come up when you don't have low testosterone and you start taking a bunch of testosterone? Pappas: Right, so if you are taking a testosterone supplement, your body actually shuts down its own testosterone production. There's this neat little feedback loop that says, 'Oh, if the testosterone's high in the blood, we're going to just kind of ramp it down.' And a side effect of that is, actually, because testosterone is involved in sperm production, your body will also stop producing sperm. So as more younger men turn to TRT, we are seeing that men who are interested in still having children are finding they're losing their fertility. Oftentimes men are told, 'Oh, you'll recover it once you stop.' But that can actually be slow and complicated, so urologists in the field often see men who aren't understanding why they're not, you know, able to get their partner pregnant, and they may have tried for quite some time. Feltman: Right, and, you know, not that this is the reason that's upsetting, but there is also kind of an irony there because a lot of the marketing is sort of stereotypical masculinity, so it's not surprising that people are caught off guard by that potential downside. Pappas: Yes, absolutely. They are really marketing this—if you go, you can see it on billboards or online—these ads are all about muscles, they're about machoism. And oftentimes the reports from some of these freestanding clinics is that men are not being told all the information about all the side-effect possibilities. Feltman: When you say that regaining fertility after these treatments can be complex and slow, could you walk us through what you mean by that? Pappas: Sure, because your own testosterone levels and sperm production drop, you're going to have to, usually, get off the testosterone. That can really lead to a hormone crash; since your body is, really, at that point in quite low testosterone, you may feel irritable, you may feel fatigue. So you're gonna have to go through that—a bit of a roller coaster. Doctors will prescribe some medications that can help even out your levels and help encourage your body to start producing its own sperm again. That can take some time; it can be a little expensive. Urologists can help you, though. But they do say that they are concerned that men have a, often, too rosy picture of what that's gonna look like. It can take up to two years to recover full fertility, there's kind of an unknown as to whether sperm quality will be quite as high as it was beforehand. And as anyone who's trying to have kids knows, two years can be quite a while when you're dealing with fertility problems. Feltman: Yeah, so let's talk some more about those freestanding clinics. You know, in addition to TRT, you know, being more in demand and more in the conversation, it also seems like it's more accessible than ever, so what are some of the sort of concerning characteristics of these clinics that are popping up? Pappas: Well, you don't wanna paint all clinics with the same brush ... Feltman: Sure. Pappas: Because there is a wide variety of care out there. So it can be any provider that can prescribe—because testosterone is a controlled substance—but they may not really be running you through a full workup, as a urologist or an endocrinologist affiliated with a practice or a hospital system might do. The recommendations from professional societies suggest you get two testosterone tests on different days because testosterone levels swing wildly. I could not find anyone who'd reported to me that they'd gotten two tests. I can't say that there aren't clinics that do it. Typically you're gonna get one test. Typically they are motivated to prescribe what they can to you. The problem, often, is that because of this long-term fear around testosterone, is that many primary care doctors are nervous about prescribing it or don't feel that they've been trained. I spoke to one man who, actually, his doctor said, 'Yes, your testosterone is undeniably low, but I don't know what to do about it. Maybe just go to one of these clinics, and they can help you.' His experience in that clinic, unfortunately, was that they kind of gave him a generic prescription, did not really test through his levels, didn't really talk through, you know, alternative treatments or other things he might look at doing. So he felt his loss and he ended up looking on Reddit for advice, which, as we all know [laughs], is a real hit-and-miss proposition ... Feltman: Sure. 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So one doctor I spoke to said, 'The first thing we do is we look for sleep apnea in our patients. If we can cure that, oftentimes we don't need to look at their testosterone levels again.' And don't be in a rush to walk out that first day with a prescription that might be too high for you and might lead to side effects like acne, or another side effect you can see is an overgrowth of red blood cells that can lead you to need to have to donate blood every month to keep that in normal range. Look for something that's not going to cause the side effects that can really affect your life in the long term. Feltman: Sure, well, thank you so much for coming on to talk us through your feature. I really appreciate it. Pappas: Thank you so much. Feltman: That's all for today's episode. You can read Stephanie's full story on TRT in the July/August issue of Scientific American. We'll be back next week with something special: a three-part miniseries on bird flu. From avian influenza's wild origins to its spread across U.S. farms to the labs trying to keep it from becoming the next pandemic, this looming public health threat has a lot of moving parts, but we'll get you all caught up. Science Quickly is produced by me, Rachel Feltman, along with Fonda Mwangi, Kelso Harper, Naeem Amarsy and Jeff DelViscio. This episode was edited by Alex Sugiura. Shayna Posses and Aaron Shattuck fact-check our show. Our theme music was composed by Dominic Smith. Subscribe to Scientific American for more up-to-date and in-depth science news.

New York Post

2 days ago

• New York Post

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