Testosterone replacement therapy is fully legal and available in Canada, but how you access it, and what kind of protocol you end up on, depends a lot on whether you go through the public system or a private clinic.
Here’s how it actually works.
The Two Paths to TRT in Canada
Path 1: Through Your Provincial Health System
The public system covers TRT for diagnosed hypogonadism: low testosterone with symptoms and confirmed bloodwork.
What you need:
- A GP referral to an endocrinologist (or a GP willing to prescribe directly in some provinces)
- Testosterone bloodwork confirming low levels: typically two morning total testosterone tests below the reference range, plus symptoms
- A confirmed diagnosis of hypogonadism
What to expect:
-
Blood work is covered by provincial health insurance
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Testosterone itself is covered by most provincial drug plans when prescribed for hypogonadism
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Wait times for endocrinologist referrals vary significantly by province:
- BC and Ontario: 3-12 months is common
- Alberta: generally shorter
- Quebec: longer wait times reported
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GPs in smaller centres or family health teams sometimes manage TRT directly, no specialist needed
The catch with the public system: Provincial prescriptions are often written for monthly or bi-weekly injections. This is the standard of care in the public system but is not optimal. Weekly or twice-weekly injections produce significantly more stable testosterone levels and are standard in most private clinics. The medication is the same; it’s the protocol that differs.
Path 2: Private TRT Clinics
Private men’s health clinics are the fastest-growing access point for TRT in Canada. They offer:
- Same-week or next-week appointments (no 3-12 month specialist wait)
- Optimized protocols from the start (weekly or twice-weekly injections)
- Ongoing blood work monitoring included in monthly fees
- Telehealth available in most provinces, no in-person visit required
Cost: $150-$350/month depending on the provider, which typically includes consultation, monitoring, and prescription.
Most Commonly Prescribed Testosterone in Canada
| Compound | Form | Notes |
|---|---|---|
| Testosterone cypionate | Injectable (100mg/mL) | The most common injectable. Sold as Taro-Testosterone Cypionate (DIN 02496003), 100mg/mL in 10mL vials. The Depo-Testosterone brand was cancelled post-market in July 2025 |
| Testosterone enanthate | Injectable (200mg/mL) | Now dispensed as a generic: Hikma Canada’s Testosterone Enanthate Injection USP (DIN 02536315), 200mg/mL. Delatestryl was cancelled post-market. Note the strength is double cypionate’s |
| AndroGel / Testim | Topical gel | Commonly prescribed; less popular among patients optimizing for stable levels |
| Natesto | Nasal gel | Less common; sometimes prescribed for fertility preservation |
Injectable testosterone is the standard for optimization-focused protocols. Gels are commonly prescribed in the public system but produce more variable absorption.
Important if you have read US TRT content: in Canada the two injectable esters are sold at different strengths, so the ester matters as much as the number. Testosterone cypionate is sold here at 100mg/mL only, and every cypionate product in Health Canada’s database is that strength. Testosterone enanthate is sold here at 200mg/mL: the only marketed enanthate is Hikma Canada’s Testosterone Enanthate Injection USP, DIN 02536315, at 200mg/mL. Getting them the wrong way round is a twofold error in either direction. A Canadian on 100mg a week of cypionate who assumes 200mg/mL and draws 0.5mL injects 50mg, half the prescribed dose. Someone on the enanthate generic who assumes 100mg/mL and draws 1mL for a 100mg dose injects 200mg, double it.
Do not take the concentration from any article, including this one. Read the number printed on your own vial and use that. Health Canada’s Drug Product Database at health-products.canada.ca lists the strength for any DIN.
Dosing and Injection Frequency
Standard TRT dose in Canada: 100-200mg/week of testosterone cypionate or enanthate.
Public system prescriptions are often written as 200mg every two weeks, a single large injection every 14 days. This is the same total weekly dose as 100mg/week split into two injections, but the bi-weekly approach creates large peaks (high T + high E2 in the days after injection) and troughs (low T before the next injection).
Weekly or twice-weekly injections are significantly better at maintaining stable levels. Private clinics typically start patients on weekly or twice-weekly protocols.
Use the TRT dose calculator to calculate your injection volumes. Enter your dose and the concentration printed on your own vial, which in Canada is 100mg/mL for cypionate and 200mg/mL for the enanthate generic, to get the exact mL per injection. The split dose calculator helps if you’re splitting your weekly dose across two injections.
Blood Work and Monitoring
The core panel for TRT management includes:
- Total testosterone (primary measure)
- Free testosterone (often more clinically meaningful)
- Estradiol (E2): estrogen management matters on TRT
- Hematocrit / hemoglobin: testosterone raises red blood cell count; monitor to avoid polycythemia
- LH / FSH: typically suppressed on TRT (relevant if fertility is a concern)
- PSA: baseline and periodic monitoring for men over 40
Blood work is typically done every 6-12 weeks when titrating, then every 3-6 months once stable. In the public system, blood work is covered by provincial insurance. Private clinics include monitoring in their monthly fee or charge separately.
Tracking Your TRT Protocol
Regimen logs your testosterone dose schedule, models your testosterone blood levels using pharmacokinetic data, and connects with Apple Health to surface how your metrics track against your protocol timeline.
Use the free testosterone calculator to estimate your free T from your total T and SHBG results.
Frequently Asked Questions
What concentration is testosterone cypionate in Canada?
100mg/mL. That is the only cypionate strength marketed in Canada: Taro-Testosterone Cypionate (DIN 02496003) is 100mg/mL in 10mL vials, and Depo-Testosterone was 100mg/mL as well. The 200mg/mL cypionate vials referenced in US dosing content are not sold here. Testosterone enanthate is a different story: the only marketed Canadian enanthate is Hikma Canada’s generic (DIN 02536315) at 200mg/mL, so do not carry the cypionate number across to it. Always read the concentration printed on your own vial before you calculate a volume.
Is Depo-Testosterone still available in Canada?
No. Health Canada’s Drug Product Database shows DIN 00030783, Depo-Testosterone 100mg/mL from Pfizer Canada, as Cancelled Post Market with a status date of 18 July 2025. Canadian prescriptions for testosterone cypionate are now generally filled with the Taro generic, which is the same 100mg/mL strength.
How do you get TRT prescribed in Canada?
Two routes. Through the public system you need a GP referral, bloodwork confirming low testosterone (typically two morning total testosterone tests below the reference range) plus symptoms, and a hypogonadism diagnosis. Endocrinologist waits run 3 to 12 months in BC and Ontario. Private men’s health clinics see patients within a week and typically charge $150 to $350 a month including monitoring.
Is testosterone covered by provincial health insurance in Canada?
Bloodwork is covered by provincial health insurance. The testosterone itself is covered by most provincial drug plans when it is prescribed for diagnosed hypogonadism. Private clinic fees are not covered.
What is the standard TRT dose in Canada?
100 to 200mg a week of testosterone cypionate or enanthate. Public system prescriptions are often written as 200mg every two weeks, which is the same weekly total as 100mg a week but produces larger peaks and troughs. Private clinics typically split the weekly dose across one or two injections for steadier levels. Your own dose is set by your bloodwork and your prescriber.
Why do Canadian TRT protocols use bi-weekly injections when weekly is better?
The every-two-weeks schedule reflects older standard-of-care prescribing in the public system rather than current thinking on level stability. Weekly or twice-weekly injections of the same weekly total hold levels steadier. The medication is identical; only the protocol differs. It is worth raising with your prescriber if you notice a clear dip before your next injection.
Medical disclaimer: This content is for informational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any hormone therapy.
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