Male Excel vs 1st Optimal: Which Online TRT Program Fits You — and What Each Really Costs

By TRT Provider Guide Editorial Team · Published September 25, 2026 · Last verified: September 2026 (sources checked September 25, 2026)

Educational research based on public documents. Not clinically reviewed. Not medical advice.

Male Excel vs 1st Optimal: Male Excel is easier to price before enrollment: its published starting injection cost is $120 a month plus a required $99 membership. 1st Optimal costs $169 a month for Men’s Hormone Care and adds broader coaching and lab review, but its testosterone price is not public and its live terms still state a 120-day minimum.

That's the short answer. The longer one hides a number neither company shows you: if 1st Optimal's membership really includes the lab testing its FAQ says it does, its testosterone would need to average under about $58 a month for its published first-year subtotal to stay below Male Excel's starting injection model. We show the assumptions below.

One more thing before the details. If low testosterone hasn't been confirmed with repeat morning blood tests, or you want children soon, start with your doctor or a urologist — not either of these programs.

Best for / not for you if

The numbers that matter

Disclosure: We earn a commission if you choose Male Excel. We earn nothing if you choose 1st Optimal. That's exactly why every number on this page is sourced, dated, and shown with its math — so you can check us. Read our affiliate disclosure.

➜ Explore Male Excel's program and current prices → Treatment requires a clinician's evaluation and is never guaranteed. Male Excel doesn't treat men in 11 states — the list is below.

➜ Not sure TRT is even your next step? Use TRT Provider Guide's Find My TRT Path tool →

TRT Provider Guide is the independent decision resource for testosterone replacement therapy — helping U.S. adults understand how low testosterone is evaluated, compare online and local care models and providers, and choose the next step that fits their health needs, fertility plans, budget, state, and care preferences, with every material claim verified and dated.

This comparison covers U.S. adult men evaluating testosterone deficiency. Quick name check: 1st Optimal (1stoptimal.com, Clarkston, Michigan) is not "Optimal Health TRT" or "Optimal Man." Male Excel (maleexcel.com, Charlotte, North Carolina) is not the ExcelMale forum — Male Excel's own footer says the two aren't connected.

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Male Excel vs 1st Optimal: what's the real difference?

Male Excel is a testosterone-focused online program that publishes its medication prices, charges a required $99 monthly membership, and states no minimum term. 1st Optimal is a broader functional-medicine membership at $169 a month with coaching and large lab panels, but it doesn't publish testosterone prices, and its Terms of Service set a 120-day minimum. The biggest practical difference is how much you can know before you pay.

Here's everything side by side. Each row shows what we found on the company's own pages on September 25, 2026.

How to read the labels: Verified = we read it on the company's own live page. Company says = stated by the company, not independently tested. Pages disagree = the company's own pages give different answers. Not published = we looked and couldn't find it.

The clearest thing 1st Optimal adds

Male Excel does not publish a monthly functional-health coaching program like 1st Optimal. Its specific starting finger-prick test page lists five markers, while its current homepage separately advertises a 54-biomarker at-home draw as part of the broader Excel Advantage ⁴⁸. Because those pages do not clearly show which testing package applies at each stage, the clean difference here is coaching: 1st Optimal explicitly bundles monthly functional-health coaching into the $169 plan ¹².

Male Excel's published model comes with different practical advantages. It publishes its medication prices. It states no minimum term. And it backs the membership with a conditional 90-day membership-fee guarantee.

For a man whose biggest fear is a surprise bill or getting stuck, that may be the better fit.

➜ If a clear price and no lock-in matter more to you than bundled monthly coaching, see what Male Excel publishes before you pay →

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The right TRT provider is not the same for every person — it depends on whether low testosterone has been properly evaluated, your symptoms and health history, your fertility plans, your state, your insurance or cash-pay preference, your treatment-format preference, your budget, and whether online or in-person care is the better starting point. Some situations belong with primary care, urology, endocrinology, reproductive urology, or urgent or emergency care when the symptoms warrant it. Because a general answer cannot resolve those for you, use TRT Provider Guide's Find My TRT Path tool to map your situation to the right care route and the questions to ask before you pay.

The tool is educational. It doesn't diagnose low testosterone, decide your eligibility, or guarantee a prescription.

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What did we actually verify?

We read both companies' public pricing, policy, lab, pharmacy, and safety pages on September 25, 2026, and rebuilt each cost from their own published numbers. We did not sign up, get a prescription, or test customer service at either company. This is a documented comparison, not a hands-on review.

Our full method is How We Review TRT Providers. We don't give clinics scores out of ten. We show what each one publishes and what it costs. Our editorial standards explain how we separate facts, company claims, customer reports, and our own conclusions.

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How much does Male Excel cost vs 1st Optimal in the first year?

Male Excel's published starting injection model works out to about $2,727 in the first year before shipping: a $99 start order, $99 monthly membership, and injections from $120 a month. 1st Optimal's $169 Men's Hormone Care membership totals $2,028 a year before medication. Its FAQ says lab testing is included, while its shop separately sells men's panels, so the public pages do not support adding a required lab fee to every member's bill.

Two headline numbers. $99 and $169. It looks like an easy comparison.

It isn't. Neither number is the complete bill.

Male Excel's real monthly price

Male Excel's pricing page says TRT options start as low as $95 a month, but that lowest figure is for Triclozene, an oral non-testosterone option discussed below. Here's the published stack for testosterone itself ¹²:

• $99 once for the online consultation and at-home hormone test.
• $99 every month for the Medical Membership. Male Excel's price cards say plainly that the medication price "does not include Medical Membership, which is required for treatment."
• Medication on top: injections from $120/month or cream from $132/month, sold as 60-day supplies and billed every other month.
• Shipping and handling extra. The amount isn't listed.

So the published starting monthly equivalent for injections is $219, not $99 and not $120. Because medication is sold in 60-day supplies while membership bills monthly, the amount leaving your account can vary by billing month.

And the price moves with your dose. Male Excel says so on its own pricing page. That makes the starting price a floor for this model, not a quote for every patient.

1st Optimal's real monthly price

1st Optimal's Men's Hormone Care plan is $169 a month. The plan card lists "Testosterone Replacement or Boosting Options," follow-up blood work and review, monthly coaching, and nutrition, supplement, and lifestyle support ¹². Its FAQ says membership includes medical consultations, lab testing, shipping and handling, medical supplies, follow-up consultations, special member treatment pricing, and ongoing support ¹⁴.

What's missing is the testosterone price. 1st Optimal says members receive reduced pricing on treatments, but its public plan and FAQ pages do not publish what testosterone itself will cost ¹²¹⁴.

The lab language needs care too. 1st Optimal's shop separately sells men's testing products ¹⁹²⁰:

Those shop prices do not prove that a Men's Hormone Care member must buy one of these panels on top of the $169 membership. The FAQ says lab testing is included, while the shop offers standalone testing. The public pages we checked do not clearly explain which tests are included in membership, which are optional, or when an extra lab charge applies. Get that in writing before you pay.

Your first 90 days, 120 days, and year — side by side

Male Excel (injections, published starting price)

*The 90-day figure models charges, not medication consumed within exactly 90 days. A second 60-day supply would extend beyond day 90.

With cream instead, the published first-year subtotal is $2,871 before shipping ¹².

1st Optimal (Men's Hormone Care) — before medication

These are our calculations from each company's published prices on September 25, 2026. They're budget models, not quotes. Unknown costs are shown as unknown — never as $0.

The number neither company shows you

Here's the useful break-even question: if the $169 membership really includes the lab testing you need, how cheap would 1st Optimal's testosterone have to be for its published first-year subtotal to stay below Male Excel's starting injection model?

Male Excel's modeled first-year injection subtotal is $2,727 before shipping. 1st Optimal's 12-month membership subtotal is $2,028 before medication.

$2,727 − $2,028 = $699 a year, or about $58.25 a month.

So under that specific assumption, 1st Optimal's testosterone would need to average less than about $58 a month for the published first-year subtotal to remain below Male Excel's $2,727 starting injection model. Male Excel shipping is still unknown, so this is not a verified savings claim.

If 1st Optimal separately charges you for a lab product, subtract that charge from the $699 medication budget:

That table is a sensitivity model, not a claim that any shop panel is mandatory. The core unknown remains the same: 1st Optimal does not publish the testosterone price. Ask for your medication price and whether any lab charge sits outside the $169 membership before you pay a deposit.

Can you use HSA or FSA money?

Both providers say HSA/FSA funds can be used for eligible services ¹¹⁴. Check with your plan administrator on what counts as a qualified expense. HSA/FSA use is not the same as insurance coverage.

➜ Want to check the starting numbers yourself? Compare them against Male Excel's current pricing →

For a wider look at visits, labs, medication, and insurance costs, see our TRT cost guide.

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Can you cancel Male Excel or 1st Optimal — and get money back?

Male Excel's price cards say "No Contract, Cancel Anytime," but its Terms say sales are final, except for a conditional 90-day guarantee that refunds membership fees. 1st Optimal's Terms of Service set a 120-day minimum, while its FAQ and men's page say there's no long-term contract. Being able to cancel and being able to get money back are two different things.

This section can save you real money whichever one you pick.

Cancelable is not the same as refundable

What Male Excel's 90-day guarantee actually covers

Male Excel advertises: follow your provider's plan for 90 days, and if your symptoms don't improve, your membership fees come back ⁴. The terms add the fine print ⁶:

• It's for new members who stay on the program for 90 continuous days.
• You must follow the protocol, attend scheduled appointments, and show adherence if asked.
• You must request it within 30 days after the 90 days end.
• It refunds membership fees only — three months, or $297. Not medication. Not the $99 start order.

So if you quit at day 90 on injections, you'd have paid about $876 before shipping. If you qualify, you'd get up to $297 back, for a net of about $579. It's a real, partial safety net. Know its edges.

One more Male Excel rule worth knowing: its telehealth consent form says you must dispute an incorrect charge in writing within 15 days of the charge ⁷. Check your statements.

1st Optimal's three different answers about commitment

This is the most important thing on this page if you're leaning toward 1st Optimal. Three of its own pages answer "Am I locked in?" differently:

One possible explanation is timing: the Terms show a June 2025 update while the FAQ and men's page were updated in 2026. But the live Terms still state a 120-day minimum. At $169 a month, four monthly charges total $676 in membership alone. Get the term that will govern your enrollment in writing before paying.

The billing date has the same problem. The Terms say you're billed "on the same day as your initial sign." The FAQ and men's page say drafts run on the 1st or the 16th of the month ¹³¹⁴¹⁵. And the FAQ says medication is charged about 3 weeks before a refill, while the men's page says 6–7 weeks ¹³¹⁴.

None of this means 1st Optimal is acting in bad faith. It means you should get one answer, in writing, before you pay: "Am I committing to 120 days, and on what dates will I be charged?"

➜ If "no minimum term" is the deciding factor for you, review Male Excel's program and terms →

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What testosterone do you actually get — and who makes it?

Male Excel describes its testosterone as compounded in the U.S. and names WellDyne and AnazaoHealth as pharmacy partners. 1st Optimal names Belmar Pharmacy, a 503A compounding pharmacy, but its public pages do not establish the FDA-approval or compounded status of every testosterone product it may dispense. Compounded drugs are not FDA-approved. Male Excel lists injections and cream; 1st Optimal lists injections, gels, or pellets.

FDA-approved vs compounded, in plain words

An FDA-approved drug is a specific product the FDA reviewed for safety, effectiveness, and quality. FDA-approved testosterone products exist.

A compounded drug is mixed by a pharmacy for a patient's prescription. It can fill a real need, but it doesn't go through FDA approval review ²⁶. A 503A pharmacy compounds for individual prescriptions. A 503B outsourcing facility registers with the FDA — but registration is about the facility, not approval of each drug ²⁶.

The word "bioidentical" is not an FDA-approval status. 1st Optimal markets its hormones as "100% bioidentical" ¹³, while Male Excel calls its testosterone "bioidentical testosterone compounded in the United States" ⁴. Those marketing descriptions do not establish that a product is FDA-approved, safer, or more effective than an approved product.

Who fills the prescription

• Male Excel names two pharmacy partners: WellDyne in Lakeland, Florida, and AnazaoHealth in Tampa, Florida ³¹⁰. AnazaoHealth describes itself as a compounding pharmacy with a 503A pharmacy in Tampa and a 503B outsourcing facility in Las Vegas ¹¹. Male Excel's Terms say it will not send your prescription to a different pharmacy ⁵. If you want to use your own local pharmacy, that's a real restriction.
• 1st Optimal names Belmar Pharmacy – Colorado, a 503A pharmacy, at the bottom of its Terms of Service ¹⁵. Its FAQ says treatments are "made-to-order" and that partner pharmacies "typically ship within 14 business days" ¹⁴.

We didn't verify which pharmacy fills any one person's order. Ask.

Daily small doses vs weekly shots

Male Excel's approach is built on daily doses: a small shot under the skin with a short, thin needle, or a cream twice a day. It says this avoids the "roller coaster" of weekly shots ². Patient reactions split. On Trustpilot this month, one reviewer praised the steady daily dosing; another said drawing thick oil through thin syringes every day was a real hassle ²¹.

That's the company's rationale, not a settled medical fact. The guidelines don't require any one schedule. What matters on any schedule is that your clinician checks your levels, your hematocrit, and how you feel.

If you'd rather inject once a week or use an auto-injector, Male Excel's daily model isn't built for you. Find My TRT Path can help you sort other care routes.

Pellets

1st Optimal offers pellets. Male Excel says it does not offer them because an implanted pellet cannot be quickly adjusted or removed ⁹¹³. 1st Optimal's public page does not identify the exact pellet product or its approval status, so ask which product would be used before assuming it is FDA-approved or compounded.

Why is thyroid medicine in Male Excel's prices?

Every Male Excel testosterone price card includes a daily thyroid tablet, and the prices are quoted "for 10mL of testosterone and 60mg/60-count of thyroid medication" ¹. Male Excel says thyroid "helps with testosterone effectiveness" ¹.

That's a second prescription drug, with its own boxed warning. Male Excel prints that warning itself: thyroid hormone shouldn't be used for weight loss in people with a normal thyroid, and large doses can be dangerous ². It also notes its desiccated thyroid "is not an Orange Book product" ². The FDA has said animal-derived thyroid products like this are not FDA-approved ²⁷.

Male Excel is upfront about including it. So ask two questions before you start: Is my thyroid actually low? And what's my price without the thyroid tablet?

"Triclozene" and "boosting options" are not TRT

• Male Excel's Triclozene is an oral non-testosterone blend, but Male Excel's current pages conflict on the exact drug name: the pricing page says clomiphene citrate, while another current Male Excel TRT page describes enclomiphene citrate ¹³¹. Those are not interchangeable names. Neither is testosterone replacement, and the exact prescribed drug should be confirmed before treatment.
• 1st Optimal's "Boosting Options" aren't named on its plans page ¹².

Neither is testosterone replacement. Don't let anyone call them "natural TRT." If one is offered, get the exact drug name in writing.

For more on delivery forms and their tradeoffs, see our TRT treatment options guide.

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Which one tests you more thoroughly before prescribing?

1st Optimal publishes a more detailed pre-prescribing checklist: a clinical diagnosis of low testosterone, labs including free testosterone, SHBG, LH, estradiol, liver tests, hematocrit, and PSA, a one-on-one video visit, and a fertility discussion. Male Excel starts with a mailed finger-prick test for five markers and says its membership includes testing every six months.

This is 1st Optimal's strongest row, and we'll say so plainly.

What 1st Optimal says it checks

Its Clinical Policy lists what must happen before a physician prescribes testosterone ¹⁸:

• A clinical diagnosis of low testosterone (hypogonadism — when the body doesn't make enough testosterone), based on history, symptoms, labs, and a questionnaire.
• A one-on-one video consultation.
• Labs including total and free testosterone, SHBG (a protein that binds testosterone), albumin, LH (the brain's signal to the testes), estradiol, liver enzymes (ALT, AST), hematocrit (the share of your blood made of red cells), and PSA (a prostate blood marker).
• A discussion of your fertility goals.
• A commitment to follow-up testing.

It also states its physicians "only prescribe testosterone to men who are clinically diagnosed with low testosterone and are experiencing symptoms," and that it doesn't provide testosterone care for bodybuilding alone ¹⁸. That's a strong, clear policy.

What Male Excel says it checks

Male Excel's starting kit is a dried blood spot — a finger-prick you mail back. It tests testosterone, estradiol, DHEA-S, thyroid, and PSA. Results come about five business days after the lab gets your kit ³⁸. Male Excel says its membership includes testing every six months, with provider reviews every 60 days ⁴.

The published starting kit doesn't list a CBC (complete blood count, which includes hematocrit). Testosterone can raise hematocrit, so it needs watching. Ask Male Excel how and when your hematocrit will be checked, before and during treatment.

What the medical guidelines actually require

Neither company's intake is a diagnosis on its own. Here's the standard:

• The AUA calls total testosterone below 300 ng/dL a "reasonable cut-off" supporting the diagnosis. The diagnosis should be made only after two early-morning tests on separate days, and only when there are also symptoms or signs ²³.
• The Endocrine Society calls for symptoms or signs plus consistently low testosterone, confirmed with repeat morning testing ²⁴.

One number is never a diagnosis. And we can't read your personal results for you.

"Normal" vs "optimal" — both companies use it

Both companies lean on the idea that "normal" isn't good enough. Male Excel says "most men still experience negative symptoms with normal testosterone levels" ¹, and its blog says its providers treat symptoms as more important than blood tests ⁹. 1st Optimal's men's page says "'normal' and 'optimal' are not the same thing" ¹³.

We get it. "Your labs are fine, you're just getting older" is a lousy thing to hear when you feel terrible. But feeling off can have many causes. The right answer is a proper evaluation — not a testosterone prescription by default. If your low T hasn't been confirmed the way the guidelines describe, get that done first.

➜ Not sure your testing meets that standard? Map your next step with Find My TRT Path →

Our blood tests for TRT guide explains each marker.

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Does Male Excel or 1st Optimal serve your state?

Male Excel prescribes hormone treatment in every state except 11: Alabama, Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Minnesota, Mississippi, New Hampshire, and Rhode Island. 1st Optimal doesn't publish a state list and asks you to email for one. Federal rules allow testosterone to be prescribed by video without an in-person visit through December 31, 2026, but state rules can still require one.

Two cautions.

First, "not excluded" doesn't mean "approved." Clinician licensing varies, and where you physically are during your visit matters. Confirm your location with the company before any charge.

Second, Male Excel's own sites don't fully agree. The Male Excel FAQ (updated September 2026) lists 11 excluded states ³. The parent company's Excel Medical homepage still shows an older list, dated June 17, 2025, with five exclusions ¹⁰. Go by the newer Male Excel FAQ, and confirm.

The telehealth rule to know

Testosterone is a Schedule III controlled substance in the U.S. — it's legally tracked and always needs a valid prescription ¹. A temporary federal rule lets DEA-registered clinicians prescribe it by audio-video visit without seeing you in person first, through December 31, 2026 ²⁵. What happens after that depends on rules not yet final.

We won't tell you to rush. That would be fake urgency about your health. But it's fair to ask either company: "If the rules change in January, what happens to my refills?" Male Excel already notes that DEA and state law may require an in-person exam ².

➜ Check Male Excel's current state list →

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Will either one affect your ability to have kids?

Yes, it can. Testosterone from either company can lower sperm production, sometimes severely, and the Endocrine Society advises against starting testosterone in men planning a pregnancy soon. Pills like clomiphene are sometimes used instead, but they aren't testosterone replacement. If children are in your near-term plans, see a urologist or reproductive urologist first.

Here's how it works. Your brain signals your testes to make testosterone and sperm. When testosterone comes from a shot or cream, the brain turns those signals down. Sperm production (spermatogenesis) can drop, sometimes to zero ²⁴³⁰.

Nobody can promise you'll become infertile. Nobody can promise you'll recover on a set timeline, either. And testosterone is not birth control.

Credit where it's due: Male Excel prints in its own safety text that its testosterone "may lower your sperm count" ². 1st Optimal's Clinical Policy says it discusses fertility goals before prescribing and may offer other options ¹⁸. Those are good signs. They're not fertility guarantees.

If kids are on the table, start with a fertility-aware specialist — not a subscription. Our TRT and fertility guide lists the questions to bring.

There's no button in this section on purpose.

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Are Male Excel and 1st Optimal legit?

Both are operating U.S. telehealth companies that display LegitScript certification on their sites and publish legal terms. When checked, Trustpilot showed Male Excel at a 4.5 TrustScore with roughly 6.5K reviews and 1st Optimal at 3.7 from seven reviews. Neither a badge nor a star rating proves medical quality; these are customer-experience signals only.

Male Excel at a glance

Male Excel's current site identifies Craig Larsen and Leif Wombwell as co-founders and Peter Fotinos, MD, as part of its medical leadership ²⁹. Its Terms describe telehealth care delivered through affiliated medical groups and identify AEMA Labs within the service structure ⁵.

Trustpilot showed a 4.5 TrustScore and roughly 6.5K reviews when checked. The profile says Male Excel asks customers for reviews. Recent reviews include praise for clear consultations and service, along with complaints about pricing, communication, billing, and fulfillment ²¹. Those reports can flag service questions to ask; they do not establish medical quality or typical outcomes.

"The process was explained in detail. All my questions were answered." — John, verified Male Excel reviewer, Trustpilot, September 2026 ²¹

1st Optimal at a glance

1st Optimal is based in Clarkston, Michigan. Its Clinical Policy says physicians work for an independent, physician-owned medical group ¹⁸. It also names an affiliated pharmacy and publishes a detailed clinical policy.

Trustpilot showed seven reviews and a 3.7 TrustScore when checked. Trustpilot also says the company has no recent history of asking for reviews, so the small sample may not represent the broader patient base ²².

"The health coaches are all so knowledgeable." — 1st Optimal reviewer, Trustpilot, September 5, 2025 ²²

Seven reviews isn't a warning sign by itself. It just means there's very little independent Trustpilot feedback compared with Male Excel. The outcome stories on 1st Optimal's own site are provider-hosted marketing, not independent reviews.

These quotes describe individual service experiences. They are not evidence of medical results, safety, or what's typical.

What other sites get wrong about Male Excel

If you've been reading reviews, you may have seen these. Here's what Male Excel's own pages actually say:

How to check any clinic yourself

1. Look up the certification badge on the issuer's own website.
2. Once you're assigned a prescriber, check them on your state medical board's site.
3. Ask which pharmacy fills your prescription and whether the product is FDA-approved or compounded.
4. Find the cancellation and refund terms before you pay.

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Who should choose neither one — yet?

Hold off on both if low testosterone hasn't been confirmed with repeat morning tests, if you want children soon, or if you need insurance. A history of prostate or breast cancer, a high hematocrit, untreated severe sleep apnea, a recent heart attack or stroke, or signs of a pituitary or testicular problem also call for an in-person clinician first.

Go to the right door instead of a subscription if any of these fit:

• Low T isn't confirmed → your primary care doctor or a urologist, for proper testing.
• You want kids soon → a urologist or reproductive urologist.
• Prostate or breast cancer history, high hematocrit, untreated severe sleep apnea, or a recent heart attack or stroke → your doctor or a specialist. Some of these can be reasons not to start testosterone at all ²³²⁴.
• Suspected pituitary or testicular problem, or symptoms that came on fast → endocrinology or urology.
• You need insurance or Medicare to pay → an in-network doctor. Neither company takes insurance.

Call 911 for chest pain, sudden trouble breathing, stroke signs, or leg swelling with chest pain or shortness of breath.

➜ Still unsure where you fit? Find the care route that fits your situation with Find My TRT Path →

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So which one should you choose?

Choose Male Excel if you want testosterone therapy with a price you can see first, no minimum term, and daily doses or a cream. Choose 1st Optimal if you want a detailed lab workup and coaching and can accept a possible 120-day commitment and an unpublished medication price. Choose neither yet if your diagnosis, fertility plans, health history, or insurance needs point elsewhere.

This is our editorial conclusion, drawn from the verified facts above using How We Review TRT Providers.

➜ Prefer to see the price first and skip the lock-in? Explore Male Excel's care options →

➜ Want the deep workup and coaching? Book 1st Optimal's free intake call → (We earn nothing from this link. Bring the questions below.)

➜ Still weighing it? Compare your care-route options with Find My TRT Path →

These are editorial next steps, not medical eligibility decisions. "Start here" means where to look first — not an instruction to begin any medicine.

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What should you ask before you pay?

Get a written, itemized quote from either company before you pay anything. The most important answers are your all-in monthly cost, your minimum commitment, the exact medications in your plan, and which pharmacy fills them.

Five questions for Male Excel

1. What's my all-in 60-day price, including thyroid medication and shipping?
2. Is the thyroid tablet required for me? What's my price without it?
3. How and when will my hematocrit be checked?
4. If my dose changes, what's my new 60-day price?
5. Do you treat men where I live — and what happens to refills if federal telehealth rules change in January?

Five questions for 1st Optimal

1. What will my testosterone cost each month at a typical starting dose?
2. Am I committing to 120 days, and on which dates will I be charged?
3. Is my first lab panel included in the $169? How often are follow-up labs repeated, and what do they cost?
4. How much is the enrollment deposit, and when is it refunded?
5. Do you treat men in my state?

The two that do most of the work: For Male Excel — "What's my all-in 60-day price?" For 1st Optimal — "What does my testosterone cost, and am I committing to 120 days?"

A message you can send either company, word for word

Before I pay, please send me an itemized written quote for my first 90 days and first year. Please list separately: the membership or consultation fee, each medication (name, whether it's compounded or FDA-approved, and which pharmacy fills it), every required lab test, supplies, and shipping. Please confirm the dates I'll be charged, any minimum commitment, how to cancel and by when, what's refundable, and how I can get copies of my medical records and lab results. I understand a quote doesn't guarantee a prescription.

If a company won't put that in writing, you've learned something useful for free.

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Frequently asked questions

The short answers below cover the questions most likely to change this decision: total cost, cancellation, state access, product status, testing, insurance, and fertility. When a provider's public pages do not settle the answer, we say that instead of filling the gap with an estimate.

Is Male Excel cheaper than 1st Optimal? The public data cannot prove that for every patient. Male Excel's published starting injection model is about $2,727 for year one before shipping. 1st Optimal's membership alone is $2,028 before medication; if its stated included lab testing covers what you need, its unpublished testosterone would need to average under about $58 a month for that subtotal to stay below Male Excel's modeled starting total.

How much does Male Excel cost per month in total? About $219 a month for membership plus starting-dose injections, or $231 with cream, plus shipping — after a one-time $99 consultation and home test. Your price changes if your dose changes.

Does 1st Optimal's $169 membership include testosterone? The public pages do not say that testosterone medication is included. They say the membership includes care, lab testing, shipping, supplies, coaching, and reduced member pricing on treatments, while the testosterone price itself is not published.

Can I cancel Male Excel anytime? You can stop future charges — Male Excel states no contract. But its Terms say payments are final, except for a guarantee that can refund up to three months of membership fees ($297) if you follow the program for 90 days and don't improve.

Does 1st Optimal have a contract? Its pages disagree. The FAQ says month-to-month. The men's page says your membership runs for the length of your treatment. The Terms of Service say a 120-day minimum. Get the answer in writing before you pay.

What states does Male Excel serve? All states except Alabama, Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Minnesota, Mississippi, New Hampshire, and Rhode Island, according to its FAQ. Confirm your location before paying.

What states does 1st Optimal serve? It doesn't publish a list. Its FAQ asks you to email the company for the current list.

Is the testosterone FDA-approved? Male Excel describes its testosterone as compounded, and compounded drugs aren't FDA-approved. 1st Optimal's named pharmacy is a 503A compounding pharmacy; it doesn't state each product's status. Ask for the exact product name before you pay.

Why does Male Excel include thyroid medicine? Male Excel says thyroid "helps with testosterone effectiveness," and includes it in each testosterone price. It's a separate prescription with its own warnings. Ask whether you need it and what your price is without it.

Does either one take insurance? No. Both are cash-pay, and both accept HSA and FSA funds. Male Excel says it isn't enrolled in Medicare or Medicaid.

Do I need two blood tests to be diagnosed with low testosterone? According to the AUA guideline, yes: two early-morning total testosterone tests on separate days, plus symptoms or signs. One number alone isn't a diagnosis.

Will TRT affect my fertility? It can. Testosterone can lower sperm production, sometimes severely, and recovery isn't guaranteed. If you want children soon, see a urologist or reproductive urologist before starting.

Can I get testosterone prescribed online in 2026 without an in-person visit? Under a temporary federal rule, yes, through December 31, 2026 — if the prescription meets federal and state requirements. Some states or situations may still require an in-person exam.

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Still not sure which TRT care route fits you? Use our free Find My TRT Path tool.

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Sources

All provider pages were checked on September 25, 2026. Prices and policies are the companies' own statements; the cost models and fit conclusions are ours. Found a changed price or policy? Tell us through our corrections process — please don't send personal lab results or medical records.

1. Male Excel. Hormone Treatment Costs. Membership, medication prices, 60-day billing, shipping, thyroid in price cards, dose-change pricing, insurance answer, Triclozene listings.
2. Male Excel. Testosterone Cypionate Injections. $99 consultation and test kit, daily subcutaneous dosing, safety information including sperm-count and thyroid warnings, in-person exam notice.
3. Male Excel. TRT FAQs (updated September 7, 2026). State exclusions, test-result timing, pharmacy information.
4. Male Excel. Homepage. Compounded bioidentical testosterone, 60-day dose reviews, six-month testing, Excel Advantage Guarantee summary.
5. Male Excel. Terms and Conditions (updated July 2026). No insurance or Medicare/Medicaid, "all sales are final," no transfer to another pharmacy, affiliated medical groups and AEMA Labs.
6. Male Excel. Excel Advantage Guarantee Terms. Eligibility, adherence, membership-only refund, 30-day request window.
7. Male Excel. Telehealth Informed Consent. 15-day written charge-dispute window.
8. Male Excel. At-Home Male Hormone Panel. Dried blood spot kit and five markers.
9. Male Excel. The Price of Testosterone Replacement Therapy (January 2026). Position on pellets and on symptoms versus blood tests.
10. Excel Medical. Homepage. Pharmacy partners WellDyne and AnazaoHealth; older state list dated June 17, 2025.
11. AnazaoHealth. About AnazaoHealth. 503A pharmacy in Tampa and 503B outsourcing facility in Las Vegas.
12. 1st Optimal. Functional Health Plans (updated September 9, 2026). Men's Hormone Care $169/month and plan benefits.
13. 1st Optimal. Men's Hormones (updated September 22, 2026). Treatment forms including pellets, "100% bioidentical," contract and billing answers, charge timing, hematocrit monitoring.
14. 1st Optimal. FAQs (updated August 7, 2026). Month-to-month answer, 1st/16th billing, charge timing, membership inclusions, cash-based model, HSA/FSA, state-list answer, made-to-order treatments.
15. 1st Optimal. Terms of Service (updated June 27, 2025). 120-day minimum, 7-day change-request notice, billing date, Belmar Pharmacy – Colorado (503A).
16. 1st Optimal. Refund and Returns Policy (updated February 25, 2026). Non-returnable prescribed treatments and telemedicine services.
17. 1st Optimal. 1st Month Deposit Policy (updated February 25, 2026). Deposit refunded only on a clinical ineligibility decision.
18. 1st Optimal. Clinical Policy & Disclaimer. Pre-prescribing criteria, lab list, fertility discussion, physician-owned medical group.
19. 1st Optimal Shop. Men's Health and Hormone Panels. $329.99, $511.10, and $857.99 panels.
20. 1st Optimal Shop. Men's Advanced Testosterone At-Home Testing Kit. $155.24.
21. Trustpilot. Male Excel reviews. Customer-experience source; approximately 6.5K reviews and a 4.5 TrustScore when checked, plus current review labels and recent service feedback.
22. Trustpilot. 1st Optimal reviews. Customer-experience source; 7 reviews and a 3.7 TrustScore when checked.
23. American Urological Association. Evaluation and Management of Testosterone Deficiency: AUA Guideline. 2018; validity confirmed 2024. Two early-morning tests, symptoms/signs, and the 300 ng/dL reasonable cut-off.
24. Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2018. Diagnosis, monitoring, fertility, conditions where therapy is discouraged.
25. HHS and DEA. Telemedicine Flexibilities Extended Through 2026 and Fourth Temporary Extension, Federal Register. Remote prescribing of Schedule II–V medicines through December 31, 2026.
26. FDA. Compounding and the FDA: Questions and Answers. Compounded drugs are not FDA-approved; 503A pharmacies and 503B outsourcing facilities.
27. FDA. FDA's Actions to Address Unapproved Thyroid Medications. Status of animal-derived thyroid products.
28. FDA. Testosterone Information. Current FDA testosterone safety information and 2026 labeling updates.
29. Male Excel. Our Story. Current co-founder and medical-leadership identities.
30. American Urological Association/American Society for Reproductive Medicine. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Amended 2024. Exogenous testosterone and fertility.
31. Male Excel. TRT Online. Current description of Triclozene using enclomiphene citrate and current program information.

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This page is educational information, not medical advice. It does not diagnose low testosterone, decide your eligibility, or guarantee a prescription. Testosterone is a Schedule III controlled substance in the United States and requires a valid prescription. If you have chest pain, severe shortness of breath, fainting, or a sudden severe headache, call 911.