How Fontaine MD’s TRT Program in San Diego Helps Men Regain Energy & Libido Naturally
Understanding Testosterone and Its Role in Men’s Health
Testosterone is a vital hormone that plays a central role in men’s physical, emotional, and sexual well-being. Produced primarily in the testes, testosterone regulates everything from muscle mass and bone density to mood and sex drive. It also supports cognitive function and red blood cell production.
Natural Decline with Age
Testosterone levels naturally decline with age, typically beginning in a man’s 30s and decreasing about 1% per year thereafter. While some men maintain adequate levels well into later life, others may experience symptoms of low testosterone (also known as hypogonadism) earlier or more severely than others.
This decline can be influenced by lifestyle, chronic illness, obesity, and other hormonal imbalances. The result? Men in their 40s, 50s, and beyond may start to notice a combination of physical, emotional, and sexual changes.
Common Symptoms of Low Testosterone
Men with low testosterone may experience a wide range of symptoms, including:
Persistent fatigue or lack of motivation
Decreased libido and sexual performance issues
Difficulty building or maintaining muscle mass
Weight gain, particularly in the abdominal area
Depressed mood, irritability, or brain fog
Reduced bone density and joint pain
Decreased body hair or testicular shrinkage
These symptoms often develop gradually, making it difficult for many men to recognize that low testosterone may be the root cause.
A Widespread Issue with Misunderstood Causes
Low testosterone is more common than many realize. Estimates suggest that up to 40% of men over age 45 have levels considered below normal Bhasin et al., JAMA, 2018. Despite this, many men go undiagnosed or are misdiagnosed with depression, sleep disorders, or simply told that their symptoms are “part of aging.”
Recognizing the signs of low testosterone is the first step toward reclaiming energy, vitality, and sexual health. A comprehensive evaluation by a hormone specialist, like those at Fontaine MD in San Diego, can determine whether testosterone therapy may be appropriate.
What Is TRT? An Overview of Testosterone Replacement Therapy
Testosterone Replacement Therapy (TRT) is a medical treatment designed to restore testosterone levels in men diagnosed with low testosterone (hypogonadism). By supplementing the body with bioidentical or synthetic testosterone, TRT aims to relieve symptoms associated with hormonal deficiency and improve overall quality of life.
How TRT Works
TRT delivers testosterone into the body through one of several administration methods. The goal is to raise circulating testosterone levels to a healthy, physiologic range—not to achieve unnaturally high levels or “supercharge” performance.
Treatment may involve:
Injections (intramuscular or subcutaneous): Administered weekly or biweekly
Topical gels or creams: Applied daily to the skin
Pellets: Implanted under the skin, providing slow release over months
Patches: Adhered to the skin and replaced daily
Each method has advantages and drawbacks, and the best option varies depending on a patient’s lifestyle, symptoms, and absorption rate. Clinics like Fontaine MD use comprehensive evaluations to determine the ideal approach for each individual.
Who Is a Candidate for TRT?
TRT is typically prescribed to men with:
Consistently low total or free testosterone confirmed by lab testing
Symptoms of testosterone deficiency that impact daily life
No contraindications such as uncontrolled prostate or cardiovascular conditions
Men experiencing fatigue, low libido, and mood disturbances should undergo proper screening before starting any hormone therapy. Over-the-counter testosterone boosters or unmonitored treatment can be ineffective or even harmful.
FDA-Approved and Evidence-Based Use
TRT is FDA-approved for treating diagnosed hypogonadism due to medical conditions or age-related decline. Its use has been widely studied in controlled clinical trials. When managed by trained professionals, TRT can significantly improve energy, libido, muscle mass, and emotional well-being Snyder et al., NEJM, 2016.
However, it’s not a one-size-fits-all solution—and it’s not a replacement for healthy lifestyle habits. TRT should always be part of a broader approach that includes nutrition, exercise, and sleep optimization.
Fontaine MD: A San Diego Clinic Specializing in Hormone Optimization for Men
Fontaine MD Integrative Medicine & Aesthetics is a medical clinic located in San Diego, California, that focuses on preventive care, anti-aging therapies, and hormone optimization for men and women. With a particular emphasis on testosterone replacement therapy (TRT), the clinic takes a whole-person approach to identifying and treating the root causes of hormonal imbalance.
Meet Dr. James Fontaine, MD
Dr. James Fontaine is the founder and medical director of Fontaine MD. He is a board-certified physician in both Preventive Medicine and Anti-Aging/Regenerative Medicine, with advanced training in bioidentical hormone replacement therapy (BHRT). Dr. Fontaine has a background in emergency medicine and military medical service and now focuses on functional and integrative medicine to help patients optimize health as they age.
His practice philosophy emphasizes evidence-based protocols, personalized care, and preventive strategies that go beyond symptom management.
Clinic Location and the San Diego Community
Fontaine MD is located in San Diego’s UTC (University Town Center) area, conveniently serving nearby communities such as La Jolla, Del Mar, Carmel Valley, Pacific Beach, and Rancho Santa Fe. The clinic is easily accessible from I-5 and CA-52 and caters to busy professionals, active retirees, and men seeking customized hormone care in a private, clinical setting.
A Functional and Personalized Approach to TRT
Unlike some "low T" clinics that take a one-size-fits-all approach, Fontaine MD begins with an in-depth diagnostic workup and develops a tailored treatment plan based on:
Comprehensive hormone panel (including testosterone, estradiol, SHBG, DHEA, thyroid)
Evaluation of sleep quality, stress levels, and nutrition
Analysis of gut health and inflammation
Consideration of lifestyle and long-term health goals
Dr. Fontaine often incorporates advanced diagnostics, such as micronutrient testing or cardiovascular screening, to provide a clearer picture of overall health before beginning TRT.
What Patients Are Saying
Patients regularly highlight the clinic’s professionalism, thoroughness, and personalized service. One 5-star Google review reads:
"After struggling with low energy and declining motivation, I came to Fontaine MD. Dr. Fontaine took the time to explain everything and designed a program that actually works. I feel like myself again."
This patient-centered approach is a cornerstone of Fontaine MD’s TRT program and reflects its commitment to long-term, sustainable outcomes—not just symptom suppression.
Fontaine MD’s TRT Program: What to Expect
Fontaine MD’s testosterone replacement therapy (TRT) program is designed to be comprehensive, personalized, and medically supervised. The clinic follows a methodical, evidence-based process that ensures safe hormone optimization while prioritizing long-term health outcomes. From the initial consultation to ongoing monitoring, patients receive individualized care that goes well beyond prescribing testosterone alone.
Initial Consultation and Advanced Lab Testing
Every TRT journey at Fontaine MD begins with a detailed consultation. During this visit, Dr. Fontaine or a trained member of his clinical team gathers information on:
Medical history and lifestyle habits
Specific symptoms and concerns (fatigue, low libido, mood swings, etc.)
Sleep quality, stress levels, nutrition, and exercise habits
Patients then undergo comprehensive laboratory testing, which typically includes:
Total testosterone
Free testosterone (the biologically active form)
Estradiol (to monitor estrogen conversion)
Sex Hormone Binding Globulin (SHBG)
DHEA, cortisol, and other adrenal markers
Thyroid function (TSH, T3, T4)
Complete blood count and metabolic panel
This robust data set helps identify whether symptoms are due to low testosterone alone—or if other hormone imbalances, nutrient deficiencies, or inflammation are also contributing.
Personalized TRT Protocols
Once low testosterone is confirmed, Dr. Fontaine creates a customized treatment plan tailored to the patient's biology, symptoms, and goals. Key components include:
Bioidentical testosterone: Fontaine MD primarily uses bioidentical hormones, which match the molecular structure of naturally occurring testosterone.
Preferred delivery methods: Options include intramuscular or subcutaneous injections, topical gels, or testosterone pellets, depending on patient preference and clinical indicators.
Estrogen control: As testosterone can convert to estrogen (via aromatization), estradiol levels are closely monitored and managed.
Adjunctive therapies: Human chorionic gonadotropin (hCG) may be prescribed to preserve fertility and testicular volume. Nutritional supplements or thyroid support may also be recommended.
Ongoing Monitoring and Adjustments
Fontaine MD emphasizes long-term safety and results through routine monitoring and open communication. Follow-up visits and lab work are typically scheduled every 3 to 6 months to:
Reassess testosterone, estradiol, hematocrit, and other relevant markers
Evaluate symptom changes and treatment efficacy
Adjust dosage, delivery method, or frequency as needed
Discuss lifestyle and health optimization strategies
This dynamic, feedback-based model ensures that TRT remains both safe and effective over time, adapting to each patient’s evolving needs.
Benefits of TRT: What the Research and Fontaine MD Patients Report
When prescribed and monitored appropriately, testosterone replacement therapy (TRT) can significantly improve quality of life for men suffering from low testosterone. Fontaine MD’s individualized TRT approach is designed to safely restore hormone balance and address the physical, emotional, and sexual symptoms that many men experience as they age.
Clinical Benefits of TRT
A growing body of scientific literature supports the benefits of TRT for men with confirmed hypogonadism. When testosterone is restored to optimal levels, men often report improvements in:
Energy and stamina
Testosterone has been shown to enhance energy metabolism and reduce chronic fatigue in men with low levels Snyder et al., NEJM, 2016.
Sexual desire and performance
TRT has consistently demonstrated improvements in libido, erectile function, and sexual satisfaction Testosterone Trials, JAMA, 2016.
Muscle mass and strength
Supplementing testosterone can help increase lean muscle mass and reduce fat mass, particularly when paired with resistance training.
Mood and cognitive function
Studies indicate reductions in symptoms of depression and brain fog, and improvements in motivation and confidence Bhasin et al., JAMA, 2018.
While individual responses vary, men with clinically low testosterone and persistent symptoms tend to see the greatest benefit from carefully managed TRT.
Patient Outcomes at Fontaine MD
Real-world feedback from Fontaine MD patients often echoes what the research shows. One patient wrote in a verified review:
"TRT at Fontaine MD completely changed my life. I didn’t realize how far off I felt until I started feeling normal again—more energy, better workouts, better sex. It’s like I got my edge back."
Another review highlighted the emotional impact:
"After a few months of treatment, I feel more focused and more like myself. I’m more engaged at work and more patient at home."
These outcomes are not guaranteed, but they illustrate the meaningful improvements possible with a well-designed program and proper medical oversight.
A Note on Realistic Expectations
While TRT can be transformative for many men, it is not a miracle cure. Not every patient experiences all benefits, and it may take several months to feel the full effects. Fontaine MD emphasizes setting realistic expectations from the outset and measuring success by sustainable functional improvement, not temporary spikes in hormone levels.
Are the Results “Natural”? Understanding Bioidentical Hormones and Whole-Body Approach
One of the most common questions men ask before starting testosterone replacement therapy (TRT) is whether the results are “natural.” At Fontaine MD, the answer lies in their use of bioidentical hormones and their commitment to restoring hormonal balance in harmony with the body’s physiology.
What Are Bioidentical Hormones?
Bioidentical hormones are chemically identical to the hormones naturally produced by the human body. In the case of TRT, bioidentical testosterone has the exact molecular structure as the testosterone your body makes on its own.
This differs from some synthetic or modified hormones, which may not interact with your body’s receptors in the same way. While both types can be effective, bioidentical hormones are often favored in integrative medicine for their compatibility and potential for fewer side effects when dosed properly.
Restoring Balance—Not Overcorrecting
Fontaine MD’s approach to TRT is not about artificially boosting testosterone to “superhuman” levels. Instead, the goal is to bring hormone levels back to a healthy, age-appropriate range, where symptoms are relieved and normal physiological function is restored.
Achieving this requires more than just prescribing testosterone—it involves identifying and addressing the full range of factors that influence hormone health.
A Whole-Body Strategy to Optimize Natural Function
Fontaine MD incorporates a broad, integrative strategy to support testosterone function naturally, which includes:
Optimizing sleep – Poor sleep reduces natural testosterone production; the clinic provides guidance to correct sleep hygiene
Reducing stress – High cortisol levels from chronic stress can suppress testosterone; Fontaine MD often includes adrenal support protocols
Targeted nutrition and supplementation – Nutrients like zinc, magnesium, vitamin D, and omega-3 fatty acids support natural testosterone synthesis
Metabolic health improvements – Weight loss and insulin sensitivity are addressed through dietary and lifestyle coaching, which can enhance the body’s own testosterone output
By combining medical therapy with these lifestyle-oriented interventions, Fontaine MD helps men not only feel better—but also function better in a sustainable, holistic way.
Risks and Side Effects of TRT: What Every Patient Should Know
While testosterone replacement therapy (TRT) can offer significant benefits to men with clinically low testosterone, it’s not without potential risks. At Fontaine MD, patients receive thorough education about possible side effects and ongoing monitoring to ensure safety throughout treatment.
Understanding both the risks and risk mitigation strategies is essential for making an informed decision.
Common Side Effects of TRT
Though most side effects are manageable when TRT is properly monitored, they can occur, especially during the early stages of treatment or when doses are not individualized. Potential side effects include:
Acne or oily skin
Fluid retention or swelling, especially in the lower extremities
Increased red blood cell count (erythrocytosis), which can raise the risk of blood clots if unmanaged
Breast tenderness or enlargement (gynecomastia), often due to excess estrogen conversion
Testicular shrinkage and decreased sperm production – TRT suppresses the body’s natural testosterone production, which can impact fertility
Mood fluctuations, though some men experience improvements in mood and emotional stability
These side effects are not universal, and most can be anticipated and managed with proper oversight.
How Fontaine MD Mitigates These Risks
Fontaine MD follows a rigorous monitoring protocol to reduce the likelihood of complications. This includes:
Regular lab testing (typically every 3 to 6 months) to check testosterone levels, estradiol, hematocrit, and PSA (prostate-specific antigen)
Adjustment of dosage or switching delivery methods if side effects occur
Use of hCG (human chorionic gonadotropin) in select patients to preserve fertility and testicular volume
Aromatase inhibitors or lifestyle adjustments to manage estrogen levels if needed
Education and communication, encouraging patients to report any unexpected symptoms promptly
This proactive, personalized approach ensures that risks are minimized and benefits are optimized.
Controversies and the Current Scientific Consensus
In recent years, there has been debate about TRT’s long-term safety—particularly regarding cardiovascular health and prostate cancer risk.
Heart Health
Older studies raised concerns about TRT and cardiovascular events. However, newer research such as the TRAVERSE Trial (2023) — one of the largest and most rigorous trials to date — found no increased risk of major adverse cardiac events in men receiving testosterone therapy compared to placebo TRAVERSE Trial, NEJM, 2023.
Prostate Cancer
There is no conclusive evidence that TRT causes prostate cancer. However, testosterone therapy can accelerate the growth of undiagnosed prostate tumors. Fontaine MD conducts baseline PSA screening and regular prostate monitoring to ensure patient safety Morgentaler et al., Urologic Clinics of North America, 2016.
Informed, Personalized Decision-Making
Not all men are ideal candidates for TRT. Fontaine MD carefully screens for contraindications such as:
Untreated obstructive sleep apnea
Uncontrolled high hematocrit
History of hormone-sensitive cancer
Severe cardiovascular disease without clearance
In these cases, alternative strategies may be explored (covered in the next section).
Alternatives to TRT for Men with Low Testosterone
While testosterone replacement therapy (TRT) can be life-changing for many men, it’s not the only option—and it’s not appropriate for everyone. Fontaine MD takes a comprehensive, root-cause-focused approach and may recommend alternative or complementary strategies when TRT is contraindicated, declined, or not yet necessary.
Lifestyle Modifications to Boost Natural Testosterone
For men with borderline low testosterone or mild symptoms, lifestyle interventions can sometimes restore natural hormone production without medical therapy. Fontaine MD often incorporates these strategies before or alongside TRT:
Strength training and exercise – Resistance and high-intensity interval training have been shown to boost endogenous testosterone levels
Weight loss – Reducing body fat, particularly abdominal fat, improves hormonal balance and lowers estrogen conversion
Improved sleep hygiene – Deep, uninterrupted sleep supports natural testosterone production
Stress reduction – Chronic stress raises cortisol, which suppresses testosterone
Dietary adjustments – Ensuring adequate intake of zinc, magnesium, vitamin D, and healthy fats can support hormone health
These approaches take time and consistency, but they can be very effective, especially for younger men or those with early-stage symptoms.
Non-Testosterone Medical Alternatives
Fontaine MD may also consider non-TRT pharmacologic options, particularly for men who want to preserve fertility or avoid external testosterone supplementation:
Clomiphene citrate (Clomid)
An off-label oral medication that stimulates the pituitary gland to produce more luteinizing hormone (LH), thereby encouraging the testes to make more testosterone naturally. Often used in younger men or those planning to have children.
hCG (human chorionic gonadotropin)
Mimics LH to stimulate natural testosterone and sperm production. May be used alone or alongside TRT to maintain fertility and testicular size.
Selective estrogen receptor modulators (SERMs)
Medications that block estrogen feedback in the brain to promote testosterone production. Less common but sometimes used in specific clinical situations.
These therapies require careful supervision and lab monitoring, just like TRT, and are not appropriate for all patients.
When TRT Is Not Recommended
Fontaine MD may advise against TRT in cases where:
The patient has active or untreated prostate or breast cancer
There’s uncontrolled erythrocytosis (high red blood cell count)
The individual has severe heart failure or high risk of thromboembolic events
Sleep apnea is unmanaged or untreated
The cause of symptoms is not related to testosterone deficiency
In these situations, addressing the underlying health condition is the priority, with hormone therapy only introduced when appropriate and safe.
How Much Does TRT Cost at Fontaine MD in San Diego?
Understanding the cost of testosterone replacement therapy (TRT) is a key part of deciding whether it’s the right option for your health and lifestyle. At Fontaine MD in San Diego, TRT is delivered as part of a comprehensive, physician-managed program that emphasizes safety, personalization, and long-term outcomes—not just prescription access.
General Cost Range
TRT at Fontaine MD typically costs between $250 and $400 per month, depending on several factors:
Type and form of testosterone (injections, gels, pellets, etc.)
Frequency of lab testing and follow-up visits
Use of adjunctive therapies like hCG or aromatase inhibitors
Inclusion of advanced diagnostics or nutritional support
This monthly fee generally covers:
Initial and ongoing consultations with Dr. Fontaine or his clinical team
Regular hormone panels and lab work
Customized treatment plan and medication management
Prescription coordination and monitoring
Education and support for lifestyle optimization
Not Covered by Insurance
Most health insurance plans do not cover bioidentical hormone replacement therapy, especially when delivered through integrative or functional medicine practices. Fontaine MD operates on a direct-pay model, which allows for more time with patients, personalized care, and fewer restrictions than traditional insurance-based practices.
While the out-of-pocket cost may be higher than generic testosterone prescriptions through conventional providers, many patients view the program as an investment in long-term health and quality of life.
Value Beyond Medication
It’s important to note that Fontaine MD’s TRT program includes far more than hormone prescriptions. Patients benefit from:
Extended visits and in-depth evaluations
Ongoing physician access
Holistic guidance on sleep, nutrition, fitness, and stress
Close monitoring to ensure safety and symptom resolution
For men seeking expert, concierge-level care in San Diego, Fontaine MD offers a high-touch, medically rigorous alternative to low-cost “testosterone clinics” or online-only services.
Patient Experience: Real Reviews from Fontaine MD’s TRT Program
The quality of care at Fontaine MD is best reflected in the voices of its patients. Many men who have undergone testosterone replacement therapy (TRT) at the clinic share stories of restored vitality, improved well-being, and deeply personalized support—reinforcing the clinic’s reputation for excellence in hormone optimization.
What Patients Are Saying
Verified online reviews and testimonials consistently highlight the professionalism, attentiveness, and outcomes delivered by Dr. James Fontaine and his team. Here are a few representative excerpts:
“After years of fatigue and low motivation, I finally found the right place. Dr. Fontaine took the time to understand what was really going on—not just with my hormones, but my overall health. Within months of starting TRT, my energy returned and I finally feel like myself again.” — Google review, 2023
“The team at Fontaine MD is incredibly knowledgeable and supportive. I’ve been on TRT before, but this is the first time I felt truly monitored and cared for. They adjusted my protocol based on how I felt—not just lab numbers. The results have been night and day.” — Verified patient review on clinic website
“More energy, better focus, and my workouts are stronger than ever. Plus, my relationship with my wife has never been better. I had no idea how much low testosterone was affecting me until I got it under control.” — Patient testimonial, FontaineMD.com
Themes Across Reviews
Across dozens of reviews, several themes consistently emerge:
Thorough evaluations and personalized care
Clear communication and education about treatment
Improved energy, mood, libido, and mental sharpness
A sense of being heard and understood—not rushed or dismissed
Ongoing support and responsiveness from the clinical team
Comfortable, Private Clinical Environment
Many reviewers also mention Fontaine MD’s clean, modern office in San Diego’s UTC area, emphasizing the discreet and comfortable setting—an important factor for men seeking sensitive treatment like TRT.
These first-hand experiences underscore why Fontaine MD has become a trusted provider for hormone health in the San Diego area.
Conclusion: Is Fontaine MD’s TRT Program Right for You?
Testosterone replacement therapy (TRT) isn’t about chasing youth—it’s about reclaiming balance, energy, and well-being when hormonal decline starts to affect quality of life. At Fontaine MD in San Diego, the TRT program is built on a foundation of personalized medicine, advanced diagnostics, and evidence-based care.
For men struggling with symptoms like low energy, diminished libido, mood swings, or brain fog, TRT may offer a path back to feeling—and functioning—like themselves again. But just as importantly, Fontaine MD ensures that any treatment is safe, medically necessary, and delivered within the context of whole-body health.
The program combines:
Bioidentical hormone therapy tailored to individual needs
Ongoing lab monitoring and dose adjustments
Supportive strategies for sleep, stress, nutrition, and fitness
Board-certified expertise and one-on-one physician attention
TRT isn’t a quick fix, and it isn’t for everyone. But for the right patient—especially under skilled medical supervision—it can restore vitality in a powerful, lasting way.
Next Steps: Schedule a Free Consultation with Fontaine MD
If you’re experiencing symptoms of low testosterone—such as persistent fatigue, low libido, weight gain, or mental fog—it may be time to explore whether hormone optimization is right for you. Fontaine MD offers a safe, medically supervised path forward through their comprehensive TRT program in San Diego.
How to Get Started
Fontaine MD offers free initial consultations to help you determine whether TRT or another hormone-related therapy may be appropriate. During this session, you’ll have the opportunity to:
Speak directly with a physician who specializes in hormone health
Review your symptoms and medical history
Learn about the lab testing process and what’s included in the program
Ask questions about risks, benefits, costs, and next steps
Alternatively, if you’re not ready to book but have specific questions, you can fill out the contact form to get in touch with the team confidentially.
Snyder PJ, Bhasin S, Cunningham GR, et al. (2016). Effects of Testosterone Treatment in Older Men. New England Journal of Medicine, 374(7), 611–624. https://www.nejm.org/doi/full/10.1056/NEJMoa1506119
Swerdloff RS, Wang C, Cunningham G, et al. (2016). Effects of Testosterone Treatment on Sexual Function in Older Men with Low Testosterone Levels. JAMA, 315(6), 570–581. https://jamanetwork.com/journals/jama/fullarticle/2499244
Bhasin S, Brito JP, Cunningham GR, et al. (2018). Testosterone Therapy in Men with Hypogonadism: An Endocrine Society Clinical Practice Guideline. JAMA, 319(5), 540–558. https://jamanetwork.com/journals/jama/fullarticle/2673113
Lincoff AM, Nissen SE, Wolski KE, et al. (2023). Cardiovascular Safety of Testosterone-Replacement Therapy. New England Journal of Medicine, 389, 2033–2045. (TRAVERSE Trial) https://www.nejm.org/doi/full/10.1056/NEJMoa2304140
Morgentaler A, Rhoden EL. (2016). Prevalence of Prostate Cancer Among Hypogonadal Men with PSA Levels ≤4.0 ng/dL and Normal Digital Rectal Examination. Urologic Clinics of North America, 43(2), 239–246. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324301/
National Library of Medicine. (2023). Testosterone - MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/003707.htm