Male Excel vs Defy Medical: Which Online TRT Clinic Fits You?

Male Excel vs Defy Medical is a choice between a $99 membership with at-home intake and a pay-per-service clinic with more fully itemized baseline labs. Male Excel's injection subtotal is $2,727 for year one, not an all-in quote. Defy's advertised average is lower, but your plan may differ. Fertility plans or incomplete evaluation come first.

By TRT Provider Guide · Last verified: September 2026 (sources checked September 16, 2026) · Public-source editorial research, not a clinical review

Affiliate disclosure: TRT Provider Guide has an affiliate relationship with Male Excel, which can pay us for referrals. We have no commercial relationship with Defy Medical. The provider links on this page are ordinary, untracked links, not affiliate enrollment links. Compensation does not determine our conclusions. Read our full disclosure.

One useful starting number is about $227 a month: Male Excel's injection subtotal averaged over year one. It is not the final crossover price, because shipping and other unquoted charges still matter. Below, we show where that number comes from. We also cover the lab-disclosure gap, the refund fine print, and the situations where you should skip both. 1 2 14

A few conditions change the answer:

• Neither clinic bills insurance; Defy offers a superbill for possible reimbursement. 7 17
• Both name compounding-pharmacy partners. Male Excel does not transfer prescriptions to your chosen pharmacy; Defy restricts out-of-state retail fills for testosterone. That does not prove every Defy product is compounded. 8 7 21 17
• Male Excel lists 11 states where it does not prescribe hormone treatment. 3 9
• If you want kids soon, start with a fertility-aware clinician. If low testosterone has not been properly evaluated, resolve that before choosing a treatment plan. 23 26

Male Excel is the better fit if:

• You want to start from home.
• You like a fixed membership fee with refill reminders built in, while medication bills separately.
• You want easy access to your provider between visits.

Skip Male Excel if:

• You live in one of its 11 excluded states.
• You need the lowest confirmed long-run bill and have not compared complete quotes.
• You need a fully itemized baseline lab plan before paying and have not received one.

Defy Medical is the better fit if:

• You want to pay only for what you use.
• You want a thorough blood panel up front.
• You want more testosterone formats, such as pellets or nasal gel; availability needs a clinical and state check.

Skip Defy if:

• You can't easily get a recent physical exam from another clinician.
• You don't want to track and reorder your own refills.

Male Excel vs Defy Medical at a glance

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.

What we actually verified (short version): On September 16, 2026, we checked the public prices, test lists, pharmacy disclosures and written terms cited below, then compared medical claims with AUA and Endocrine Society guidance and current DEA and FDA material. We did not buy care, open accounts or call either company. Reading a company claim is not independent proof that care is delivered that way. Full details below.

Educational information, not medical advice. This page doesn't diagnose low testosterone or decide whether you qualify for treatment. For sudden chest pain or trouble breathing, call 911; unexplained limb swelling, pain, warmth or redness needs prompt medical assessment. 37

This comparison concerns U.S. adult men considering evaluation or treatment for testosterone deficiency. It is not a guide to adolescent care, treatment for women, gender-affirming hormone care or performance-enhancing drug use.

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What's the real difference between Male Excel and Defy Medical?

Male Excel is a membership program: $99 a month for provider and support access, with medication billed separately in 60-day supplies. Defy Medical is pay-per-service, with separate charges for consultations, tests and medication instead of a membership. Almost everything else — cost, effort and flexibility — follows from that one split. 1 15 17

Male Excel: the done-for-you model

Male Excel (Male Excel Inc., doing business as Excel Medical, in Charlotte, North Carolina) runs a structured program called the Excel Advantage, which it attributes to chief medical officer Dr. Peter Fotinos. Its terms say clinical care comes from its affiliated medical group, not the platform company. Its company site describes a network including doctors, nurse practitioners and other health professionals, so don't assume every visit is with a physician. 7 8 5

Here's the rhythm, per Male Excel's own pages:

• An at-home blood test and an online consult to start
• Check-ins every 60 days
• Blood tests every 6 months
• Medication shipped in 60-day supplies, with a reminder before each refill. 3 5

The $99 membership covers unlimited e-visits with your medical provider and unlimited messaging with its support team. Its homepage also says six-month blood testing is included. These are provider-stated benefits, not response times we tested; ask which tests are included and whether extra or repeat tests cost more. 1 9 7

Defy Medical: the pay-as-you-go model

Defy Medical, LLC is a Tampa, Florida clinic that names Dr. Justin Saya as its Medical Director. It treats patients by telemedicine and at its Tampa office. 22 15

You start by filling out a contact form. A Patient Advocate calls you and walks you through the new-patient requirements. Defy advertises extended one-hour consultations; confirm the length and clinician type for the appointment you book. 16 15

After that, you're in the driver's seat:

• You order labs, medication and supplies through Defy's patient portal.
• You book follow-ups and labs at least every 6 months, or on the schedule in your treatment plan. Ask about any earlier first follow-up. 17
• You pay for each item when you buy it.

Which model suits which kind of person?

One long-time Defy patient on the ExcelMale forum put it simply in 2021: he's happy, but he has to keep track of when to order his own meds. The poster, “Vince,” wrote that on August 16, 2021 and said he did not work for Defy or ExcelMale. That is a historical patient report, not a current service test. 42

That's the trade in one sentence. Defy rewards men who like control. Male Excel suits men who want more reminders built into the system. Neither model removes your role in keeping up with care.

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 eligibility, or guarantee a prescription.

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Which is cheaper: Male Excel or Defy Medical?

Male Excel's published injection subtotal is about $600 higher in year one and about $1,100 higher per later year than Defy's advertised average. That is a comparison of a subtotal with a company estimate, not proof of what either clinic will charge you. A higher Defy quote can reverse the result, so compare the same 12 months and every required charge. 1 2 14

Here's the side-by-side. Male Excel's numbers come from its published starting line items. Defy's numbers are Defy's own averages, not quotes, and the two clinics' baskets aren't identical. The arithmetic is ours. The higher-cost column is a what-if scenario, not a current Defy offer.

The three-year cost fork

How we got there:

• Male Excel injection, year one: $99 + (12 × $99) + (12 × $120) = $2,727. This is an annualized starting-price subtotal, not a complete first-year bill.
• Male Excel cream: the same formula, with 12 × $132 for medication.
• Defy current published illustration: under $175 a month for year one, about $125 after. We verified those figures in Defy's cost article on September 16, 2026. They are not two selectable fixed-price plans. 14
• Higher-cost scenario: $250 × 12 = $3,000 in year one; $200 × 12 = $2,400 per later year. Use this column to see how a higher quote changes the result; it is not an additional advertised plan.

What the subtotal leaves out: Male Excel's homepage says six-month testing is included in membership, but the exact repeat diagnostic tests, baseline blood count and any extra-test fees still need confirmation. Its terms allow extra charges for an unsuitable sample. We could not confirm whether the $99 start overlaps a membership month, so this model counts it separately. Do not count a bundled item twice. 9 7 1

The one number to remember: about $227 a month

Male Excel's injection subtotal works out to about $227 a month in year one and about $219 a month after that, at unchanged starting prices.

So here's the simple test. Compare both complete quotes, not Defy's quote against Male Excel's incomplete subtotal. The precise starting benchmarks are $227.25 a month in year one and $219 after. Add each clinic's required physicals, shipping and other unquoted charges before deciding which costs less.

On Defy's advertised average, the number is below that benchmark. In our higher-cost scenario, Male Excel's subtotal is $273 lower in year one, while the example Defy budget is $228 lower each year after. Those differences do not establish actual savings.

What can push a Defy bill up is what gets added to your plan:

• extra visits
• extra labs
• add-on medications, if prescribed

Defy says cost varies with the treatment plan. No added medicine should be assumed necessary just because it appears in an estimate. 14

Ask Defy for a quote on the exact plan you'd likely get. Then use our quote worksheet to line the two up.

The money that leaves your account (not the monthly average)

Monthly averages hide how you're actually charged.

At Male Excel:

• You pay $99 up front for the consult and home test.
• If you're prescribed treatment, medication bills in 60-day blocks: from $240 per order for injections or $264 for cream at the listed starting rates, plus shipping and handling.
• The $99 membership bills monthly on top.

One more timing detail. Six 60-day supplies cover 360 days, not 365. If a seventh injection order ships before your one-year mark, your first-year card charges could reach about $2,967 before shipping and other extras: $99 + (12 × $99) + (7 × $240). That extra isn't a hidden fee. It's supply you'd use in year two. Actual start, refill and billing dates determine whether that seventh order falls inside your first year.

At Defy, you pay as you go:

• TestDefy's public self-order initial men's panel is $299.
• Its public self-order follow-up TRT panel is $275.
• Those are not verified patient-account prices and do not include a clinician's review. Ask Defy whether they match your quoted labs. 18 19 20
• Consultations, medication, supplies and shipping are charged when you buy them.
• If you cancel a visit with less than 24 hours' notice, or don't show up, Defy's terms say you may owe the full consultation fee.

Defy says financing is available for qualifying patients. 14

Does Defy's average hold up?

We ran a rough check using Defy's own public self-order lab prices. Under $175 a month is under $2,100 a year. An initial panel plus one follow-up totals $574; an initial plus two follow-ups totals $849. That leaves under $1,526 or under $1,251, respectively, for everything else in that budget. These are lab-only illustrations, not verified patient fees or a required schedule. 18 19

That calculation cannot validate Defy's average without consultation and medication prices. Its terms call for labs and consultations at least every six months or as documented in the plan, so one follow-up may not cover the first year's required care. Ask how many panels and visits your quote includes. 17

The honest part: Male Excel has the higher published subtotal

Male Excel's published subtotal is higher than Defy's advertised average. If the lowest long-run bill is your top priority, get Defy's complete quote before choosing Male Excel. A clinic without a membership fee is not automatically cheaper. Start with our lists of TRT providers with no membership fee and our Defy Medical TRT cost breakdown. 1 14

The extra membership charge is real even without a reviewer's opinion. It is $1,188 over 12 months before medication and other charges. 1

But Male Excel's flat membership does buy a defined access package rather than a separate fee for each included e-visit. Compare the features you would actually use; paying per service does not mean Defy charges separately for every support message. Male Excel lists:

• unlimited e-visits with your provider
• unlimited messaging with its support team
• check-ins every 60 days
• refill reminders
• an at-home starting kit, subject to any additional testing or in-person exam your clinician requires
• six-month testing described as included in membership; confirm the exact panel 1 3 9

Male Excel also publishes a written results guarantee; we did not confirm a comparable Defy guarantee. The guarantee is limited, and we cover its terms below. The roughly $94 monthly gap between Male Excel's ongoing injection subtotal and Defy's advertised $125 average is illustrative — not a fixed surcharge that buys a proven better result. 6 17 14

If a fixed access fee, refill reminders and an at-home starting test are worth that trade to you, review Male Excel’s intake next.

→ Start Male Excel's online assessment The assessment is free. The paid first step is a $99 online consult and at-home test. Neither guarantees a prescription.

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Which is easier to start: Male Excel or Defy Medical?

Male Excel's published starting path has fewer outside steps: a $99 online consult and mail-back finger-prick kit, without a separate physical listed as routine. That is not a promise that you will never need an in-person exam or additional labs. Defy Medical lists a recent physical, blood tests and medical history before the first consultation. 2 3 16

From first click to a clinical decision

Defy's physical-exam rule, in plain English

Defy lists a recent physical exam as a new-patient requirement. Ask whether an exam you already had qualifies and which form the clinic needs. You may need a visit with your own clinician, but that does not mean every new patient must buy a new, uninsured urgent-care exam. 16

After you start, the requirement continues:

• Defy's current terms ask for a signed physical exam form at least every 24 months, or as documented in your plan. 17
• Defy says a Getlabs vitals check can qualify for physical-exam renewals for eligible patients. Do not assume a renewal option replaces your new-patient exam; ask first. 43

What "no outside physical" means at Male Excel

Male Excel's getting-started path is the online consult plus home test. There's no separate exam listed as a routine first step. Its site does add that, based on DEA and state laws, your treatment plan may require an in-person medical exam. So ask during your consult whether that applies to you. 2 3

A note for current patients: Ask whether either clinic will accept your recent outside labs and existing physical before buying replacements. Male Excel says switching patients go through its onboarding process. Neither a transfer nor an old prescription guarantees a new prescription. 9 7 17

Male Excel doesn't prescribe hormone treatment in these 11 states: Alabama, Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Minnesota, Mississippi, New Hampshire and Rhode Island, according to its FAQ and homepage checked September 16, 2026. 3 9

Not in one of those states, and want an at-home starting test? Check Male Excel’s intake, then confirm any extra exam or lab requirement before paying.

→ Begin Male Excel's intake from home

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Should you choose Male Excel or Defy Medical?

Choose Male Excel for its at-home starting kit, membership-based access and built-in refill reminders. Compare Defy Medical for pay-per-service care, a more fully itemized baseline panel and a wider published list of testosterone formats. If fertility or an incomplete diagnosis is the main concern, resolve that with the right clinician before choosing treatment. 1 3 18 15 23

Find your row:

Found your row? Take the matching next step.

→ This fits me — open Male Excel’s assessment

→ This is me — contact Defy's new-patient team (Direct link; no commission. A Patient Advocate contacts you. It isn’t an instant quote.)

Still between rows? Map your situation with Find My TRT Path.

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What testosterone will you actually get at each clinic?

Male Excel advertises compounded testosterone as daily injections or twice-daily cream; its price cards also include thyroid tablets. Defy lists injections, topicals, pellets and nasal gel, but its pharmacy list does not establish that every product is compounded. Get the exact medicine, manufacturer or compounder, and dispensing pharmacy before deciding. 9 1 4 15 21

Other medicines are separate treatment decisions

Thyroid medicine, estrogen-lowering drugs and medicines that stimulate testosterone production are not testosterone replacement. A price bundle does not establish that you need an added drug. 23 34 36

What "compounded" means for you

A compounded medicine is mixed or altered for a patient's needs rather than approved by the FDA as that finished product. The FDA says compounded drugs are not FDA-approved, and it doesn't review them for safety, effectiveness or quality before they're sold. That's a regulatory category, not an accusation. 27

The American Urological Association's guideline says clinicians should prescribe commercially manufactured testosterone rather than compounded testosterone when possible. That is a conditional recommendation, not a statement that every compounded prescription is inappropriate. 26 44

If an FDA-approved product filled at your own pharmacy matters to you, primary care or a local urologist is a more direct starting point. Male Excel's advertised compounded program does not meet that preference. Defy's out-of-state retail restriction matters, but we cannot rule out all FDA-approved products from its pharmacy list alone; ask about the exact product and dispensing arrangement. See TRT providers that take insurance if coverage also matters. 7 9 17

If you're considering compounded treatment, compare how each pharmacy is disclosed. Defy lists three by name, and Male Excel's company site lists two. Those are provider disclosures, not independent checks of each pharmacy's current license, inspections or the bottle you would receive. See also our compounded testosterone guide. 21 8

Both companies use “bioidentical” language. That word does not establish FDA approval, superior safety or equivalence to an approved product. 9 15 27

Daily microdosing vs. a more traditional schedule

Male Excel's program is built around small daily doses. Defy describes personalized treatment with formats ranging from injections to pellets. These are provider-stated approaches, not a comparison proving one schedule is safer or more effective. 5 15

The schedule affects your daily routine, but it is a clinical choice too. Daily dosing means a daily routine. We don't give dosing advice; your prescriber sets the plan. Compare TRT providers with daily injections and TRT treatment options.

The thyroid tablet in Male Excel's price

Every Male Excel testosterone price card includes a daily desiccated thyroid tablet. Male Excel says thyroid support helps some patients, but that does not establish that every man considering TRT needs thyroid medicine. Its homepage now says thyroid is used when clinically appropriate. Its safety text says its thyroid product is not an Orange Book product; that statement is not proof of FDA approval. 1 9

The FDA separately says animal-derived thyroid medicines are unapproved. Its current notice also says animal-derived thyroid products are biological products and are not eligible for compounding under the usual federal drug-compounding exemptions. The agency describes risk-based enforcement while working on guidance and possible approved products. That does not tell us which exact thyroid tablet Male Excel would dispense to you. Ask for its product name and manufacturer or compounder. 28

Before you start, ask Male Excel three things:

• Is the thyroid tablet optional for me?
• What diagnosis and testing support it? Its five-marker home kit measures Free T3, not a full thyroid panel.
• What exact thyroid product would I receive, and what would my price be without it? 2 1 28

Creams and household safety

Topical testosterone can transfer to partners and children through skin contact. Male Excel publishes a secondary-exposure warning. That disclosure is useful, but it is not an FDA-approved label for the compounded cream. 4 25 27

Male Excel's pages describe different application areas: its cream FAQ versus its safety text. Ask your prescriber to resolve that mismatch in written, product-specific directions and explain transfer precautions. Because its terms also say medication won't come in child-resistant packaging, store everything securely out of kids' reach. 4 7

Triclozene, clomiphene, enclomiphene and hCG aren't TRT

Clomiphene-type drugs try to nudge your body to make more of its own testosterone. They don't replace it, and they aren't interchangeable with testosterone therapy. Male Excel's pricing and Triclozene pages disagree about whether its pill contains clomiphene or enclomiphene, so get the exact ingredients in writing before comparing that option. 1 10

Clomiphene is FDA-approved for certain ovulation problems in women; use in men is off-label. Enclomiphene is not an FDA-approved drug. FDA-approved hCG products have indications that include selected cases of male hypogonadotropic hypogonadism — low testosterone due to a deficient pituitary signal — not a blanket approval to preserve fertility during TRT. These are separate prescription decisions. 34 35 36

If that's what you're weighing, see our clomiphene provider guide and discuss fertility plans with a specialist.

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How thoroughly do Male Excel and Defy Medical test you?

Defy's published initial panel identifies a complete blood count, SHBG and LH; Male Excel's starting finger-prick kit lists five markers and no blood count. Male Excel also advertises a 54-marker member panel and included six-month testing, so its care cannot be reduced to the starting kit. Ask how baseline blood count and repeat morning testosterone testing are completed before treatment at either clinic. 18 2 9 26

First, a few plain-English definitions:

• Total testosterone: all the testosterone in your blood.
• Free testosterone: the part not bound to blood proteins; clinicians use it in specific situations, not as a diagnosis by itself.
• SHBG (sex hormone-binding globulin): a protein that grabs testosterone and affects how much is free.
• LH (luteinizing hormone): a signal from the pituitary gland near the brain to your testes. It helps show why testosterone is low.
• Hematocrit: the share of your blood made of red blood cells. Testosterone can push it up, which thickens the blood.
• PSA (prostate-specific antigen): a prostate-related blood marker, not a diagnosis of cancer. 23 26 25

How each clinic's published tests line up with the guidelines

“Not listed” doesn’t prove a test is never ordered. It means the specific public disclosure does not answer the question. A 54-marker advertisement also does not establish which tests every new patient gets before a prescription.

Finger-prick kit vs. lab draw

Male Excel's kit is genuinely convenient: no venous blood draw or lab trip for that starting sample, and free return shipping. It still requires a finger prick. Defy's published lab-drawn panel covers more ground: metabolic panel, lipids, TSH (a thyroid test) and IGF-1, on top of the hormones. A wider panel is not proof that every included test is needed for every patient. 2 18 23

Neither approach proves you have low testosterone on its own. That takes compatible symptoms or signs, repeat appropriate testing and a clinician's judgment. The Endocrine Society specifies repeat morning fasting testing with reliable assays; free testosterone can help in selected cases. 23 24

Two questions that do most of the work

Ask Male Excel: “Before any testosterone prescription, how will you check hemoglobin and hematocrit, repeat an appropriate morning testosterone test, and test LH if indicated? Which tests are included in my price, and which require a separate draw?”

Ask Defy: "What will my initial consult cost, and what would my medication cost each month on the plan you'd likely recommend?"

Ask both: “Does my quoted evaluation include any required second morning sample, or will that be a separate order and fee? Which laboratory and assay will you use?”

Want an answer to the Male Excel question before you pay anything?

→ Request Male Excel’s free information call and ask about labs first

Confirm who will take the call. An information or support call is not the same as a clinical evaluation or a prescription. 13 7

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Do you need a low testosterone diagnosis for either clinic?

Medical guidelines require symptoms or signs plus consistently low testosterone, confirmed with appropriate repeat morning testing. Both Male Excel and Defy Medical use “optimal” treatment language, and Defy's consent allows treatment even when results fall within age reference ranges. A paid evaluation or questionnaire does not establish a diagnosis or guarantee a prescription. 23 24 7 17 1

What the guidelines actually require

The American Urological Association says to diagnose low testosterone only after two total testosterone measurements, taken on separate occasions and both in the early morning, and only when they come with symptoms or signs. 26 44

The Endocrine Society says the same thing in its own words: diagnose only with compatible symptoms and consistently low levels confirmed by a repeat morning test. In a July 16, 2026 statement, it repeated that symptoms alone aren't enough. It also noted that test results can vary between labs and methods, which can lead to wrong diagnoses in both directions. 23 24

No single number is a diagnosis. Not 300 ng/dL, not any other cutoff.

The AUA uses 300 ng/dL as a reasonable total-testosterone cutoff to support diagnosis, not a stand-alone verdict for every person. Assay quality, repeat results, symptoms and the wider evaluation still matter. These baseline rules are not instructions for an established TRT patient to stop medication and retest without a clinician. 26 23

What each clinic says about "normal"

Defy: Its signed treatment consent authorizes therapy "even where lab test results are within reference ranges for age." It also covers cases where other medical organizations don't recommend the same. 17

Male Excel: Its pricing FAQ says insurance stops covering men once levels reach "normal," and that most men still have symptoms at normal levels. It says its goal is "optimal" levels. 1

That's a real difference from guideline language. It doesn't make either clinic illegitimate, but you should know it before you start.

What to do if you've been told you're "normal"

Ask your own doctor whether repeat early-morning testing is indicated and how other causes of your symptoms will be checked. If low testosterone is confirmed, LH and other tests can help find the cause. If you'd like help sorting out the right first stop, the tool below walks you through it. Our testing guide and TRT eligibility requirements explain what a thorough workup includes. 26 23

→ Use Find My TRT Path to plan your next care question

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What if you want kids someday?

Testosterone therapy can lower sperm production, and guidelines advise against prescribing it to men currently trying to conceive. hCG and clomiphene-type drugs are separate treatment options, not fertility guarantees or interchangeable forms of TRT. If a baby is in your near-term plans, see a urologist or reproductive urologist first. 26 23 36 34

What the guidelines say

• American Urological Association: testosterone therapy should not be prescribed to men who are currently trying to conceive. Men interested in future fertility should get a reproductive health evaluation first and a clear talk about testosterone's long-term effect on sperm production.
• Endocrine Society: it recommends against starting testosterone in men planning fertility in the near term. 26 23

Male Excel's safety text warns about reduced sperm count with large doses. Do not read that as reassurance that prescribed testosterone cannot suppress sperm production: fertility concerns apply to testosterone therapy too. Recovery after testosterone exposure varies and cannot be promised on a set timeline. 4 26 23

What each clinic offers — and what it can't promise

Defy's intake includes an HCG-only option. Male Excel lists Triclozene, but its product page now says enclomiphene while its pricing page says clomiphene. Confirm the exact drug rather than assuming either product will protect fertility. 16 10 1

None of these is testosterone replacement. None comes with a fertility guarantee. Whether any of them fits you is a decision for a fertility-aware specialist, not a price comparison. 26 23 36 34 35

Questions to take to a specialist

• Should I get a semen analysis before starting anything?
• What's the plan if I want to conceive later?
• Is testosterone the right treatment for me at all right now?

→ Find a fertility-first care route · Learn more: TRT and fertility · TRT providers for fertility

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What happens if you want to cancel, get a refund, or leave?

Neither clinic advertises a fixed-term care commitment, but both have binding terms and narrow refunds. Male Excel's 90-day guarantee can refund qualifying membership fees, not medicine; Defy's terms do not refund consultations or completed labs just because no prescription is issued. Male Excel also states a 30-day arbitration opt-out, while no comparable opt-out appears in the Defy terms we checked. 1 7 6 15 17

The fine print, side by side

Male Excel's terms place arbitration in your home county unless otherwise agreed; both companies' terms contain exceptions, including certain small-claims matters. The table describes the published wording, not a legal ruling that every waiver or cap is enforceable. Defy's general credit policy also allows a refund to the original payment method at its discretion in specified circumstances; that is not a promised cash refund for an unused lab order. 7 17

Male Excel's guarantee: the real conditions

Male Excel advertises that you'll see results in 90 days or get your membership fees refunded. Its guarantee terms say: 6

• It's for new members who follow the program for 90 days in a row.
• You must attend all scheduled appointments and follow your provider's recommendations. Proof may be required.
• You must request the refund within 30 days after day 90.
• "Improvement" is judged by Male Excel's own assessment and your provider's feedback.
• It covers membership fees for the first 90 days only, which is $297 at $99 a month (our math). Medicine isn't covered.
• Male Excel can change or end the guarantee without notice, though its terms say current enrollees keep the original terms.

It's a written refund policy, just a narrow one — not proof that the treatment will help you. Read the full guarantee terms before you rely on it.

Stopping auto-refill at Male Excel

Male Excel's refill system is convenient right up until you want out. Its own FAQ says you have 48 hours after the refill reminder to act before billing and shipment, while its homepage directs patients who want to pause to Member Support. We did not test cancellation or confirm that one request stops both membership and medication orders. 3 9

So ask for the exact cancel steps and cutoff in writing on your first call. Put your refill dates in your calendar, and remember the 48-hour window. Request written confirmation that both the membership and pending medication refills have been canceled, plus the effective date and any order already in progress.

How to get your records before leaving

Request your lab reports, visit notes, medication history and current treatment plan before a handoff. Ask the new clinician which records they need and how to send them securely.

Male Excel: Start with Member Support through its contact page or 833-625-3392 and ask how to submit a medical-records request to the treating medical group. Its telehealth consent says consultation patients may request records and that preparation and delivery charges may apply; it does not give a fixed dollar fee. 45

Defy: Its patient privacy notice says records requests should be made in writing and that copying, mailing or supplies may carry a fee. Ask the care team at 813-445-7342 or care@defymedical.com for the current form, secure delivery method and any fee before processing. We did not test either records-request process. 46 17

Cancelling a plan isn't the same as stopping a medicine

Talk to a clinician before you stop or change any hormone. Stopping billing is an account decision. Stopping testosterone is a medical one.

If a written 90-day promise matters to you, read the terms first, then begin.

→ Start with Male Excel — guarantee terms apply

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What do patients say about Male Excel and Defy Medical?

Both have large Trustpilot profiles: Male Excel showed 4.5 from 6,470 reviews, and Defy showed 4.8 from 4,136 on September 16, 2026. BBB listed Male Excel as accredited with an A+ and Defy as not accredited with a C. These are customer-platform snapshots, not clinical ratings or proof that a treatment will work for you. 38 39 40 41

One recent Defy review shown on its site, attributed to “LAWSON,DAVID A” with a September 11, 2026 visit date, praised a provider as on time and well informed about the patient's situation. That is one selected service report, not evidence of typical results. 22

An August 2021 ExcelMale discussion includes satisfied Defy patients, along with concerns about confusing emails, texts and calls. Treat anything that old as history, not a current service report. 42

Both Trustpilot profiles disclose paid subscriptions and review invitations. That does not establish that a reviewer was paid. The aggregate ratings also cover company services beyond a single adult-male TRT plan; neither ratings nor BBB accreditation verifies prescribing quality, licensing or a dispensing pharmacy. 38 39 40 41

Is Male Excel the same as ExcelMale?

No. ExcelMale is an online forum where many Defy discussions happen. Male Excel's own site footer says it isn't connected to Nelson Vergel, the EXCELMALE mark or the forum. 3 42

More detail: Male Excel reviews · Defy Medical TRT reviews

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Do Male Excel or Defy Medical take insurance, HSA, or FSA?

Neither bills insurance, and they differ on what you can do afterward. Male Excel's terms say you agree that neither you nor its partners will submit claims to insurers or government programs, although its price cards list treatment as FSA/HSA eligible. Defy won't file claims, but it will give you a superbill with billing codes to submit yourself, with no guarantee of payment. 7 1 17

Male Excel:

• Its terms say it doesn't accept commercial insurance and isn't enrolled in Medicare or Medicaid.
• By using it, you're choosing cash-pay care.
• Its terms also say you agree not to submit reimbursement claims for its services to any government program or commercial insurer.
• Its price cards list treatment as FSA/HSA eligible. Confirm with your plan administrator how that works for your account.

Defy Medical:

• It doesn't accept insurance of any kind.
• On request, it provides a superbill with CPT and ICD-10 codes (the billing codes insurers use) for possible out-of-network reimbursement.
• Payment isn't guaranteed.
• Whether HSA or FSA funds apply depends on your plan.

A superbill isn't insurance billing. It's an itemized receipt you submit yourself. Your insurer decides whether to pay you back. 17

If insurance coverage is essential, start with TRT providers that take insurance. For tax-advantaged accounts, see TRT providers that accept HSA or FSA.

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Which states do Male Excel and Defy Medical serve?

Male Excel lists Alabama, Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Minnesota, Mississippi, New Hampshire and Rhode Island as excluded states. Defy advertises U.S. telemedicine but we did not confirm a complete current state-by-state treatment list. Confirm your physical location, the assigned clinician and the exact medication before paying either clinic. 3 9 15 7 17

Why you'll see different state counts online

Use the 11-state list on Male Excel's own current FAQ and homepage, then confirm during intake. Male Excel's terms also say you must be physically located in the state you select when you receive care. A travel address or mailing address does not settle where a clinician may treat you. 7 3 9

Defy's state limits

Defy's on-demand lab store (TestDefy) doesn't offer self-ordered lab tests in New York, New Jersey, Pennsylvania, Rhode Island or Massachusetts. That rule covers on-demand lab orders. It doesn't necessarily mean Defy can't treat you there. Ask its Patient Advocate about both. 18 19

Controlled-substance and licensing rules differ by state, which is why online clinics carve out some places. 32

If you're in one of Male Excel's excluded states, see Male Excel alternatives or TRT clinics near you.

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What's changing in late 2026 that could affect either clinic?

The current federal temporary telemedicine extension runs through December 31, 2026 and can allow qualifying controlled-substance prescribing by audio-video care without a prior in-person exam. It does not waive state law or guarantee that either clinic can prescribe for you. Ask each clinic what its exam and refill policy will be if the rules change. 32

Testosterone is a controlled substance

Testosterone is a Schedule III controlled substance in the U.S. It requires a valid prescription, and prescribing it remotely is regulated. An online questionnaire by itself is not a controlled-substance prescribing exception. 33 32

What's in effect now

The DEA and HHS extended the pandemic-era telemedicine flexibilities through December 31, 2026 under the Fourth Temporary Extension. For testosterone, the relevant flexibility generally involves a DEA-registered practitioner using audio-video telemedicine and meeting all other requirements. Clinicians still have to follow state law. 32

What's coming

A future rule could change the process, but a proposed policy or a projected publication date is not an operative prescribing rule. We did not verify a published replacement that removes or changes the December 31, 2026 end date for the temporary extension. Do not assume that 2027 requirements are settled. 32

What it could mean at each clinic

• Male Excel already notes that DEA and state law may require an in-person exam for your plan. 3
• Defy already requires a physical exam from a practitioner. That outside physical is not automatically the same as an in-person evaluation by the prescribing practitioner under controlled-substance rules. We can't say whether it will satisfy any future rule, and we won't guess. 16 32

Ask either clinic: "If federal rules change in January, what happens to my prescription and refills?"

Two other 2026 updates worth knowing

• Testosterone product labels. On June 18, 2026, HHS announced that FDA had requested updates to approved testosterone labels, including the age-related limitation and prostate-related safety language. A requested update is not proof that every product label has already changed. It does not replace a diagnosis or make compounded testosterone FDA-approved. FDA's 2025 changes also addressed increased blood pressure; check the current label for the exact prescribed product. 31 30 29 27
• Thyroid products. FDA's current notice describes unapproved animal-derived thyroid drugs, planned guidance and risk-based enforcement. That matters if your Male Excel plan includes its desiccated thyroid tablet. Ask for the exact product and check FDA's current notice. 28 1

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Should you switch from Defy to Male Excel, or the other way?

Switch when the model is the problem — for example, you're tired of managing orders at Defy or want to stop paying Male Excel's membership fee. Get your records and a handoff plan before changing providers. The new clinician still decides whether, and what, to prescribe; do not stop or change testosterone on your own. 7 17

Defy → Male Excel makes sense if:

• You want refill reminders and scheduled check-ins built into the program.
• You want a fixed membership fee for included access, with medication billed separately.
• You prefer a starting path without a routinely listed separate physical, while accepting that one may still be required.

Watch for the higher published subtotal, separate medication charges and the 11-state list. Male Excel says switching patients go through its onboarding process. Ask whether your existing labs are accepted and how care continues during the handoff. 9 1 3

Male Excel → Defy makes sense if:

• You want a pay-per-service quote because cost is the issue.
• You want Defy’s itemized baseline panel or a different listed testosterone format.
• You want an in-person option in Florida.

Watch for the physical-exam requirement and the patient prices that need a quote. A cheaper advertised average is not a confirmed lower bill. 16 14

How to switch safely:

1. Request your records and lab history.
2. Note your next refill and billing dates.
3. Tell the new clinic exactly what you're taking now.
4. Don't double up on medication.
5. Get written confirmation of any cancellation.

More detail: how to switch TRT providers.

Already on TRT and want more reminders built into your care? Share your current plan during Male Excel’s intake and ask how the handoff would work.

→ Switching? Start Male Excel's enrollment and share your current plan

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Who should choose neither Male Excel nor Defy Medical?

Start with a fertility-aware clinician if you want a baby soon, and with proper evaluation if low testosterone has not been confirmed. Primary care or urology is a more direct first stop for insurance billing or your own retail pharmacy. A high blood count, untreated severe sleep apnea, cancer history or recent heart attack or stroke calls for individualized medical evaluation, not a routine online enrollment decision. 23 26 7 17

If one of these is you, close this comparison. Seriously. We'd rather you got the right care than a click.

If your goal is athletic performance or physique, this comparison isn't built for that, and neither is our tool.

→ Find the care route that fits instead

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What should you get in writing before you pay?

The fastest way to compare Male Excel and Defy Medical fairly is to get both quotes in writing, for the same 12 months, on the same worksheet. A monthly average isn't a bill, and an unquoted item isn't free. Print this table, send the message below to both clinics, and fill in the blanks before you commit.

Your same-period quote worksheet

Use the same start and end dates for both. If a clinic doesn't answer an item, leave it blank. Don't write zero.

A message you can copy and send to both clinics

I'm comparing care over the same 12-month period. Please send an itemized quote showing startup costs, required tests or exams, visit fees, any membership, each medication order, supplies, shipping and any other required charges. Please separate what's due now from later payments, and tell me what might change after my evaluation. Please also confirm who my treating clinician would be, whether you can treat me in my state, which pharmacy would fill my prescription, how cancellation and refills work, and how I can get my records.

Leave your lab values and health details out of this message. Save those for your consult.

Where the sources disagree (and what to do about it)

Online clinic pages change often, and old pages don't always get updated. Here's what we found that doesn't line up. None of it proves bad faith, but each one is a reason to get your answer in writing.

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How we compared Male Excel and Defy Medical

We checked the companies' public pricing, test lists, pharmacy disclosures and written terms on September 16, 2026, then compared medical claims with AUA and Endocrine Society guidance and current DEA, HHS and FDA material. We did not buy care, open accounts or test cancellation. Verified published facts, company claims, patient reports and our own conclusions are labeled separately.

What we actually verified

Public-source checks completed September 16, 2026:

• Male Excel pricing: the main-site $99 consult and home test, required $99 monthly membership, starting medication prices and 60-day billing. We also found a conflicting price page on its HRT subdomain; we did not combine those offers. 1 2 11
• Male Excel testing and states: its 11 excluded states; the five-marker home kit; its separate 54-marker member-panel advertisement; and its statement that six-month tests are included in membership. The full baseline and follow-up test lists still need patient-specific confirmation. 3 2 9
• Male Excel terms and drugs: the 48-hour refill-response window, guarantee, insurance restrictions, pharmacy-transfer restriction, packaging, refunds and arbitration clauses. We also found conflicting clomiphene/enclomiphene descriptions for Triclozene and checked the thyroid disclosures against FDA material. 3 7 6 1 10 28
• Defy costs and requirements: its advertised average; public self-order lab prices and test lists; recent-physical requirement; listed formats; and named pharmacy partners. Public lab-store prices were not treated as confirmed patient-care prices. 14 18 19 16 15 21
• Defy terms: the current store-hosted terms covering follow-up, physical renewals, insurance, refunds, missed visits, arbitration, liability and out-of-state retail prescriptions. Its “three (12) months” lab-order validity clause remains internally inconsistent. 17
• Records and customer sources: both published record-access notices, the current Trustpilot and BBB profiles, and the attributed historical forum discussion. These checks do not measure service quality or medical outcomes. 45 46 38 39 40 41 42

Provider-stated, not independently demonstrated: delivered care, response speed, monitoring in an individual case, “optimal” treatment goals, average patient costs and state-specific availability. A page saying a service is offered does not prove that every patient receives it.

Our calculations and editorial conclusions: annualized starting-price subtotals, the separate card-charge example, three-year illustrations, the $227.25 monthly benchmark, and which care model fits a defined preference. None is a matched patient quote, clinical score or guarantee of savings.

Not established by the public evidence: a complete first-year quote for either clinic; Defy's current consultation and medication fees; Male Excel's extra charges and first-payment overlap; which repeat diagnostic tests are included; the exact product any person would receive; and complete state-by-state prescribing access.

What we did not do: buy care, open a patient account, contact support, test refill or cancellation workflows, request medical records, or complete individual clinician and pharmacy license checks. We report company-listed names, not an independent license or pharmacy-quality certification.

We don't give providers numeric scores, and being on this page isn't an endorsement. Our full process is in How We Review TRT Providers, and our editorial standards explain how we handle sources.

Prices and policies change. If something here is out of date, tell us and we'll re-check it and update the date.

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Male Excel vs Defy Medical: FAQ

Male Excel and Defy Medical differ most in how you pay, how you start and how much of the care plan is published before intake. These answers summarize the details above; a complete written quote and a clinician’s evaluation still decide your next step.

Is Male Excel or Defy Medical better? It depends on what you value. Male Excel fits an at-home starting test, fixed membership access and refill reminders. Defy fits pay-per-service care, an itemized baseline panel and more listed testosterone formats. Defy's advertised average is lower, but compare complete quotes rather than treating $227 a month as a final price cutoff. 1 3 14 15 18

How much does Male Excel cost per month? A $99 monthly membership plus medication: from $120 a month for injections or $132 for cream, billed in 60-day blocks. A $99 consult and home test comes first. The injection starting-price subtotal is $2,727 in year one, or $227.25 a month, assuming 12 memberships plus a separate start fee. Shipping and other unquoted charges are not included; the listed medication packages include thyroid. 1 2 7

How much is a Defy Medical consultation? We did not verify a current public consultation fee. Ask Defy's new-patient team for the fee, clinician type, appointment length and refund terms before booking; do not assume you must become a patient before you can request a quote. 16 17

Does Defy Medical require a physical exam? Yes. Defy lists a recent physical exam as a new-patient requirement. Its current terms also require a signed physical at least every 24 months. Confirm the acceptable date and form for your first appointment; we did not verify the precise new-patient age limit for an outside exam. 16 17

Is Male Excel's testosterone FDA-approved? Male Excel describes its testosterone program as using compounded medication. Compounded drugs are not FDA-approved. Ask for the exact prescribed product; for an FDA-approved testosterone product, discuss commercially manufactured options with your clinician rather than assuming a compounded preparation has that approval. 9 27 26

Does Defy Medical use compounded testosterone? Defy names compounding-pharmacy partners, including APS, Empower and Hallandale. That does not establish that every product it prescribes is compounded or rule out an FDA-approved product. Ask which exact medication and pharmacy your prescription would use. 21 17 27

Does Male Excel prescribe hCG? We did not find hCG listed in the Male Excel program pages checked. Its non-testosterone Triclozene pages conflict: pricing says clomiphene, while the product page says enclomiphene. Confirm the actual ingredients with the clinician; neither drug is TRT, and no fertility outcome is guaranteed. 1 10 35 23

What states does Male Excel not serve? Alabama, Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Minnesota, Mississippi, New Hampshire and Rhode Island, per its FAQ and homepage checked September 16, 2026. Confirm your physical location during intake. 3 9 7

Can I use my local pharmacy? Not under Male Excel's published standard process; its terms say it can't send your prescription elsewhere. Defy won't send testosterone prescriptions to retail pharmacies in other states. Ask Defy about the exact product and any in-state option rather than assuming that policy covers every medication or circumstance. 7 17

Can I get a refund if I'm not prescribed? Don't count on it. Defy's terms say consults and completed labs aren't refunded because treatment wasn't given. Male Excel's terms say sales are final, and its separate 90-day membership guarantee is not a refund promise for an unsuccessful initial evaluation. 7 6 17

How do I stop Male Excel auto-refill? Ask for the exact steps and cutoff in writing at your first visit. Male Excel says you get a reminder before each 60-day supply ends and 48 hours to act before billing. Contact Member Support and confirm that both the membership and any pending medication order are handled; do not assume cancelling one cancels the other. 3 9 7 12

Is Male Excel the same as ExcelMale? No. Male Excel says it isn't connected to Nelson Vergel or the EXCELMALE forum. 3

Can I get a second opinion from Defy without switching? Defy lists an Advice-Only service. Ask whether it can review your current treatment, which records it needs and what the consultation costs. Confirm the non-prescribing scope before booking; an advice appointment should not be treated as a medication or refill order. 22 46

Do either take insurance? No. Defy provides a superbill on request so you can try for out-of-network reimbursement yourself. Male Excel's terms say you agree not to submit claims to insurers or government programs, though its price cards list treatment as FSA/HSA eligible. Confirm any reimbursement or account eligibility with your insurer or plan administrator. 17 7 1

Does either clinic require two morning testosterone tests? We did not find a clear two-test requirement or inclusion promise in the public onboarding pages checked. Guidelines require compatible symptoms or signs and consistently low testosterone confirmed with appropriate repeat early-morning testing; the Endocrine Society specifies a fasting morning repeat. Ask the clinician how the workup is completed and billed. Do not stop existing treatment to repeat baseline testing on your own. 3 2 16 18 23 26

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Other comparisons: Male Excel vs Hone Health · Male Excel vs Taurus Meds · Male Excel vs TRT Nation · Male Excel vs Peter MD · Male Excel cost · Defy Medical TRT cost

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

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Sources

Public-source verification date: September 16, 2026. Provider pages support what each company publishes, not an independent test of its care. Guideline and regulator sources support medical and prescribing statements; customer platforms support only the attributed reports and profile snapshots.

1. Male Excel — Hormone Treatment Costs
2. Male Excel — At-Home Testosterone Test
3. Male Excel — TRT FAQs
4. Male Excel — Testosterone Lipoderm Cream
5. Male Excel — The Excel Advantage
6. Male Excel — Excel Advantage Guarantee terms
7. Male Excel — Terms and Conditions, updated July 2026
8. Excel Medical — Company and pharmacy disclosures
9. Male Excel — Membership, 360 Blood Panel, pharmacy and state disclosures
10. Male Excel — Triclozene product page
11. Male Excel HRT subdomain — Separate pricing page
12. Male Excel — Contact
13. Male Excel — Free consultation request
14. Defy Medical — What's the Cost of TRT at Defy Medical?
15. Defy Medical — Testosterone Replacement Therapy Online
16. Defy Medical — Get Started
17. Defy Medical — Terms of Service, effective April 2, 2026, on its patient store
18. TestDefy — Initial comprehensive hormone and wellness panel for men
19. TestDefy — Follow-up TRT Lab Panel for Men
20. Defy Medical patient store — Follow-up TRT Lab Panel for Men
21. Defy Medical patient store — Pharmacy Patient Contact Information
22. Defy Medical — Clinic, medical director and service disclosures
23. Endocrine Society — Testosterone Therapy for Hypogonadism guideline resources
24. Endocrine Society — Statement on Testosterone Replacement Therapy, July 16, 2026
25. Bhasin et al. — Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline, 2018
26. American Urological Association — Testosterone Deficiency Guideline; diagnosis, baseline testing, fertility, formulations and monitoring
27. FDA — Compounding and the FDA: Questions and Answers
28. FDA — Actions to Address Unapproved Thyroid Medications
29. FDA — Class-wide Testosterone Labeling Changes, February 28, 2025
30. FDA — Testosterone Information, including June 2026 requested label updates
31. HHS — FDA Requests Updates to Testosterone Therapy Labeling, June 18, 2026
32. DEA — Telemedicine Flexibilities Extended Through December 31, 2026
33. DEA — Drug Scheduling
34. DailyMed — Clomiphene Citrate prescribing information, Indications and Usage
35. Operation Supplement Safety — Clomiphene and Enclomiphene: Drugs, Not Dietary Supplements; current January 12, 2026
36. DailyMed — NOVAREL prescribing information, Indications and Usage
37. CDC — About Venous Thromboembolism: signs, symptoms and urgency
38. Trustpilot — Male Excel company profile
39. Trustpilot — Defy Medical company profile
40. Better Business Bureau — Male Excel profile
41. Better Business Bureau — Defy Medical, LLC profile
42. ExcelMale — Defy Medical Alternative; August 16, 2021 discussion
43. Defy Medical — Company announcement about Getlabs and physical-exam renewals
44. Mulhall et al. — Evaluation and Management of Testosterone Deficiency: AUA Guideline, Journal of Urology, 2018
45. Male Excel — Telehealth Informed Consent, medical-record access
46. Defy Medical — Patient Privacy Notice, records requests

TRT Provider Guide is an independent publisher, not a clinic, pharmacy, laboratory or insurer. This page is educational and isn't medical advice. See our medical disclaimer and privacy policy.