Frequently Asked Questions

Welcome to Focused Mens Health of St. Augustine. We are North Florida’s premier health and wellness center for men only.  We specialize in testosterone replacement therapy, erectile dysfunction, weight and direct medical care.  Our office is conveniently located and our all-male medical providers are available to answer your questions and concerns in a private and discrete setting. 


Our practice is relaxed yet professional.  We offer services and treatments specifically personalized to address your specific needs. We provide the personal attention and individual service because we’ve been where you are now.  With more than 18 years in the medical field, our licensed practitioners can help you treat the physical, sexual, endocrinal and hormonal issues that all men face.

What is happening to me?  

There is a good chance that your testosterone levels are in a progressive decline. It happens.  More often than you realize.  These changes in testosterone production increase in men with age and can be dramatic.  The coined term is male menopause, male climacteric, andropause, or more appropriately, partial androgen deficiency in the aging male (PADAM). This drop in T levels can cause insomnia, depression, anxiety, lethargy, hair loss, cognitive issues and many other sign that you may be chalking up to 'getting older'.  


What are the benefits of hormone replacement therapy? 

Testosterone therapy has a number of benefits.  Improving bone density, lean body mass as an effect of decreased fat mass and possibly increased strength.  Sexual performance also improves.  Studies show that 'sex drive' improves by HRT as well.


What is Low T? How do I find out if it's low?

Testosterone is a hormone produced by testicles.  It directly relates to the male sex drive and physical appearance including muscle mass and body fat.  It also affects libido, emotions and the body.  Remember testosterone depletes with age but that does not mean you have to suffer in silence.  Losing testosterone occurs naturally as men age but losing the desire for sexual intimacy is not a normal part of the aging process.  Signs of Low T include:

  • Low or no sex drive

  • Problems having an erection

  • Low sperm count

  • Sleep problems such as insomnia

  • Decrease in muscle size and strength

  • Bone loss

  • Increase in body fat

  • Depression

  • Trouble concentrating


In order to determine if you are suffering from Low T, a simple blood test can provide the anwers.  Of course, it would be important to check for other factors which may be causing symptoms.  A thorough physical and review of overall health can help determine the best course of action. 

If you are experiencing the signs of low testosterone, changing lifestyle, eating habits, exercising, lowering alcohol intake, quitting smoking and other factors may help.  However, it may mean that you are also a candidate for hormone therapy.  Find out more about how you can get help for Low T. 


What are the treatment options for erectile dysfunction?

Erectile dysfunction (ED) is a common type of male sexual dysfunction.  It becomes more common as men age and it might be more common than you think in today’s younger men.  Focused Mens Health can offer several different treatment Options for Erectile Dysfunction.  The treatments vary depending on personal preferences, medical coverage, health conditions, age and lifestyle .  How you proceed is a very personal decision.  We can discuss the options shown below in greater detail. 

  • Physical Therapy

  • Oral Medications

  • Injections

  • Vacuum Erection Devices

  • Intraurethral Suppositories

  • Penile Implants

The treatment plans are very diverse.  You should know all the facts and proceed accordingly.  Focused Mens Health specializes in the treatment for erectile dysfunction. If you are considering a surgical procedure, schedule a private consultation before making any decisions.   Let’s talk over what works best for you.


Can testosterone therapy make me feel more energetic?

If you believe you are suffering from abnormally low T, increasing your testosterone levels can help boost energy.  It can also restore your sex drive.  Other more visible benefits are a noticeable drop in body fat and increased muscle mass.  You can also expect:

  • Increased energy and mental clarity.

  • Increased muscle tone and reduction in fat stores.

  • Restoration of sexual function and erections.

  • Increased libido.

  • Lower cholesterol levels and risk for heart disease.

  • Overall better sense of well-being and feeling of motivation.


What Is BHRT?

An individualized approach to hormone replacement therapy, using biologically identical hormones (BHRT), pinpoints a person’s exact hormone levels, and what hormones are needed to balance their hormone deficiency. The differences between synthetic and biologically identical hormones are in their chemical structures and functionality. Biologically identical hormones have the same chemical structure as the hormones created naturally in the human body.

What Are BHRT Fused Pellets Implants?

Fused pellet implants are compounded using biologically identical hormones (most often Estradiol or Testosterone). The hormones are pressed / fused into very small cylinders. College Pharmacy also compounds DHEA, Pregnenolone, Progesterone, Biest, and Testosterone with Anastrozole fused pellet implants.

Where Are BHRT Fused Pellet Implants Inserted?

Pellet insertion is a relatively simple in-office procedure done under local anesthesia. The pellets are inserted subcutaneously (under the fatty lining of skin), either in the lower abdomen or the upper buttocks through a very small incision. The incision is then closed with surgical glue or sterile-tape strips. If inserted correctly, patients cannot feel the implants under their skin. Implants placed under the skin consistently release small, physiologic doses of hormones, which have been shown to have many benefits.

How Long Do BHRT Fused Pellet Implants Last?

Fused Pellet Implants typically last between 3-5 months, depending on how rapidly the hormones are metabolized. After insertion of the pellets, vigorous physical activity should be avoided for 2-3 days, or as suggested by the healthcare practitioner. Some patients begin to feel symptom relief within 48 hours, while others may take up to two weeks to notice a marked difference. The pellets do not need to be removed. They are completely dissolved by the body.

Are There Any Side-Effects?

Generally, there are minimal side-effects associated with the pellet implant procedure. Complications include: minor bleeding, bruising, infection, and pellet extrusion. Other than slight bruising, the other complications are very rare. Hormone side-effects vary and should be discussed by your healthcare practitioner.

How Do I Know What Hormones I Need?

Before starting any hormone replacement therapy, patients should work directly with a knowledgeable healthcare practitioner to have hormone testing done to evaluate their personal hormone profile. Based on existing hormone levels and health history, the practitioner will make a hormone replacement recommendation. Once pellets have been inserted, hormone levels will be reevaluated prior to the insertion of the next round of pellets. After the first year of therapy, the practitioner may suggest testing less frequently based upon patient feedback and prior hormone levels.

How Can I Get BHRT Fused Pellet Implants?

BHRT Fused Pellet Implants require a prescription from a healthcare practitioner. It is very important to work with a practitioner that is well versed in BHRT as well as the actual pellet implant procedure. The placement of the pellet and the hormone dosing are extremely important in determining safety and efficacy. BHRT Fused Pellet Implants are most often made by special compounding pharmacies, such as College Pharmacy, using strict United States Pharmacopeia (USP) guidelines.


I am interested in learning more.  What is my next step?

There are many options available for treating erectile dysfunction.

 Always make the decision with proper medical help. The team at Focused Mens Health is highly trained and offers a range of treatment options. Confidential consultations are meant to assure each patient of the importance we place on advocacy, professionalism and concern.  Making sure that our clients feel comfortable and at ease is how we manage our practice.   Call today


What are the risks involved with hormone replacement therapy?

Understand the Limitations and Risks

The research shows that testosterone replacement therapy can benefit men suffering from low testosterone due to particular medical issues.  When evaluating the potential risks, note that testosterone treatment is about replenishing the levels of testosterone that was already 5 or 10 or even 15 years prior.  The actual hormone is virtually identical to the one the male body manufactures naturally.  In theory, everything should be as expected. But in practice, there are always some unpredictable side effects.

A possible side effect is thick or viscous blood.  If Hematocrit, which is the percentage of red blood cells in the bloodstream, goes up too high, there is a possible predisposition to stroke or clotting events.  Cautionary, yes but exhaustive studies found no cases of stroke or severe clotting related to testosterone therapy.  The risk still exists and being mindful of blood results and frequent monitoring are suggested.  Generally men suffer from chronic obstructive pulmonary disease, or those who have a red-blood-cell disorder may not be ideal candidates.

Another side effect is fluid retention or swelling in the body.  Patients with compromised kidney or liver function or congestive heart failure may not be ideal candidates for HRT.  The therapy may also impact skin.  An increase in oiliness can induce acne or pimples, sleep apnea and gynecomastia (breast enlargement) is highly uncommon.   

There are still some questions regarding the effectiveness of treatments in older men with low testosterone with no underlying medical condition other the  natural aging process.  The Testosterone Trials (TTrials), a study by the National Institutes of Health was conducted determine the effects of testosterone replacement therapy on several aspects of male aging.  Results showed that compared with placebo, supplemental testosterone did not improve memory or other aspects of cognitive function among nearly 500 men with age-related cognitive impairment, but it did increase hemoglobin levels and correct anemia from both known and unknown causes in 126 anemic men. Also, the treatment, compared with placebo, was associated with greater increases in bone density and strength, more so in the spine than the hip.  In earlier findings from the TTrials, supplemental testosterone resulted in increased sex drive and sexual function, and offered some benefit in terms of mood and depressive symptoms, but it had no effect on overall vitality and physical function (New England Journal of Medicine, Feb. 18, 2016).

In 2015, the U.S. Food and Drug Administration concluded that there is a possible increased cardiovascular risk associated with testosterone use. These studies included aging men treated with testosterone. Some studies reported an increased risk of heart attack, stroke, or death associated with testosterone treatment, while others did not.  This review prompted label changes to testosterone products to indicate potential cardiovascular risks.  There are a number of medical experts who have cited limitations and flaws in those studies, while also pointing to evidence that the therapy may have a positive effect on cardiovascular health.


Information on this site is provided for informational purposes only and not designed or intended to diagnose any illness

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