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Men’s Health Care in Alberta: Testosterone, Erectile Dysfunction & Sexual Health


At Tilla Virtual Care Clinic, we provide confidential, evidence-based virtual care for men’s health concerns across Alberta. We assess and manage conditions such as low testosterone, erectile dysfunction, fatigue, sexual health concerns, and related metabolic or cardiovascular risk factors. Care is individualized, medically appropriate, and focused on safe diagnosis, treatment, and follow-up — without unnecessary testing or overprescribing.


Men’s Health Concerns We Assess and Manage


Low Testosterone (Testosterone Deficiency)

Low testosterone (also called hypogonadism or “low T”) occurs when the body does not produce adequate testosterone. This may result from testicular, pituitary, or hypothalamic dysfunction, or develop gradually with aging, obesity, and chronic medical conditions.

Common symptoms include:

      • Reduced sexual desire (libido) — the most consistent symptom
      • Erectile dysfunction
      • Fatigue or low energy
      • Loss of muscle mass and strength
      • Increased body fat
      • Mood changes, including depression
      • Reduced bone density
      • Sleep disturbances

Many of these symptoms are nonspecific and can overlap with other medical conditions, which is why proper testing is essential before considering treatment.


Erectile Dysfunction (ED)

Erectile dysfunction is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. ED is common and increases with age, but it is not a normal or inevitable part of aging.

ED is often an early marker of cardiovascular disease and shares many risk factors with heart disease.

Common risk factors include:

      • Age over 40
      • High blood pressure, high cholesterol, or heart disease
      • Diabetes
      • Obesity and metabolic syndrome
      • Low testosterone
      • Smoking and excessive alcohol use
      • Depression and anxiety
      • Certain medications
      • Physical inactivity

Men presenting with ED should be assessed for cardiovascular risk factors as part of routine care.


The Connection Between Low Testosterone and Erectile Dysfunction

Low testosterone and erectile dysfunction frequently overlap. Studies show that 12–47% of men with ED also have low testosterone, depending on the diagnostic threshold used.

Testosterone plays an important role in sexual desire and contributes to erectile function. However, ED can occur even with normal testosterone levels, particularly when caused by vascular disease, diabetes, or other medical conditions. Treatment decisions depend on identifying the underlying cause rather than assuming testosterone deficiency.


How We Diagnose Men’s Health Conditions

Diagnosis of Low Testosterone

A diagnosis of testosterone deficiency requires both symptoms and laboratory confirmation.

      • Two separate fasting, early-morning total testosterone levels are required
      • Levels are typically considered low below 10.4 nmol/L (300 ng/dL)
      • Some men may require free testosterone testing

These blood tests are typically covered by provincial health insurance when medically indicated.


Diagnosis of Erectile Dysfunction

ED is diagnosed based on symptoms and medical history. Evaluation includes assessment for:

      • Cardiovascular risk factors
      • Diabetes
      • Lipid abnormalities
      • Testosterone deficiency

This evaluation helps identify reversible causes and ensures treatment is appropriate and safe.


Treatment Options We Offer

Testosterone Replacement Therapy (TRT)

Testosterone therapy is considered only for men with confirmed biochemical deficiency and symptoms.

Potential benefits include:

      • Improved sexual desire
      • Modest improvement in erectile function
      • Correction of anemia in some men
      • Improved bone density
      • Small improvements in mood, energy, and body composition

TRT is not a treatment for normal aging and is not prescribed without clear indication.

Forms of testosterone include:

      • Intramuscular injections (most cost-effective)
      • Transdermal gels or patches
      • Subcutaneous pellets
      • Nasal gel

Coverage varies by province and drug plan. Injectable testosterone is typically the most affordable option.


Potential Risks of Testosterone Therapy

      • Erythrocytosis (elevated red blood cell count)
      • Small increased risk of blood clots
      • Possible worsening of sleep apnea
      • Possible increased risk of atrial fibrillation

Current evidence does not show an increased risk of prostate cancer or major cardiovascular events when appropriately prescribed and monitored.


Who Should Not Use Testosterone

      • Men planning fertility (testosterone suppresses sperm production)
      • History of prostate or breast cancer
      • Recent heart attack or stroke
      • Severe untreated sleep apnea
      • Elevated hematocrit

Monitoring

Men on TRT require reassessment at 3 months and then every 6–12 months to monitor:

      • Symptoms
      • Testosterone levels
      • Blood counts
      • Prostate health

Follow-up blood work is covered by provincial health insurance.


Medications for Erectile Dysfunction (PDE5 Inhibitors)

Oral PDE5 inhibitors are first-line treatment for ED, effective in 60–70% of men.

Available options in Canada include:

      • Sildenafil
      • Tadalafil
      • Vardenafil
      • Avanafil

All are similarly effective. Tadalafil has a longer duration of action and may be taken daily at a lower dose.

These medications are generally not covered by provincial drug plans, though generic options are significantly more affordable.


Combination Therapy

For men with both low testosterone and ED:

      • Markedly low testosterone may warrant TRT first
      • Mildly low or low-normal testosterone should be managed with ED medication and lifestyle optimization
      • Combination therapy may be considered when ED does not respond to medication alone and testosterone deficiency is confirmed

Lifestyle and Preventive Health

Lifestyle interventions can significantly improve erectile function and testosterone levels and are an important part of care.

Evidence-based recommendations include:

      • Regular aerobic exercise
      • Weight management
      • Smoking cessation
      • Alcohol moderation
      • Optimizing sleep quality
      • Managing chronic conditions such as diabetes and hypertension

These interventions align with Canadian preventive health guidelines and may enhance treatment response.


What Is Not Recommended

Many supplements and alternative therapies marketed for ED or testosterone lack strong evidence.

      • Most supplements have not demonstrated meaningful benefit in clinical trials
      • Shockwave therapy and stem cell treatments remain investigational
      • Natural health products are regulated for safety, not effectiveness

We do not recommend unproven therapies as primary treatment.


Costs, Coverage, and What to Expect in Alberta

Typically covered:

      • Medical assessments
      • Diagnostic blood work
      • Monitoring labs
      • Surgical treatments (when referred)

Often not covered:

      • PDE5 inhibitors
      • Testosterone gels and patches
      • Counseling services
      • Medical devices
      • Coverage varies by province and private insurance plans.

Is Virtual Men’s Health Care Right for You?

Virtual care is appropriate for many men with sexual health or hormonal concerns. Some conditions may require in-person examination or referral, and this will always be discussed openly.


Book a Men’s Health Consultation

If symptoms such as low energy, reduced libido, or erectile dysfunction are affecting your quality of life, a structured medical assessment can help identify the cause and guide safe, evidence-based treatment.


Book a virtual men’s health consultation to discuss your concerns and next steps.


What men’s health concerns do you assess?

We provide virtual assessment and management for a wide range of men’s health concerns, including fatigue, low energy, sexual health concerns, testosterone-related symptoms, urinary symptoms, sleep issues, mood changes,  and chronic disease follow-up. Care is evidence-based and individualized, with time set aside to review concerns thoroughly.


I was told my lab results were “normal,” but I still don’t feel well. Can you help?

Yes. Laboratory results are only one part of a complete clinical assessment. Symptoms, medical history, and functional impact are equally important. When concerns persist, we focus on understanding the full picture and discussing whether further evaluation or management may be appropriate.


Will you order blood work during a men’s health visit?

When clinically appropriate, investigations may be recommended to support diagnosis or guide management. Testing is used thoughtfully and selectively, with the goal of clarifying concerns rather than ordering tests unnecessarily.


Are medications or other treatments offered?

Yes. When indicated, treatment options — including medications — are discussed as part of shared decision-making. Recommendations are guided by current evidence, patient goals, and safety considerations.


Do you prescribe testosterone therapy?

Testosterone therapy may be considered for select patients after appropriate clinical assessment and review of laboratory findings. Decisions are individualized and made in accordance with evidence-based practice and patient-specific factors.


Is this a replacement for my family doctor?

No. This service is not intended to replace primary care. Family physicians and primary care teams play a central role in long-term health management. This clinic is designed to complement existing care, provide additional support, or assist when access to timely assessment is limited.


How does this service differ from a walk-in clinic?

Visits are scheduled, focused, and allow adequate time for discussion and follow-up. Care emphasizes continuity, clinical reasoning, and individualized management rather than episodic or time-limited encounters.


Are men’s health visits available virtually?

Yes. Many men’s health concerns can be safely and effectively addressed through virtual care, including assessment, review of symptoms, and ongoing management.


Are services covered by Alberta Health Care?

No. Nurse Practitioner services provided in private clinics are not covered by AHCIP. Visits are paid out of pocket. Some patients may be eligible for reimbursement through extended health benefits or health spending accounts.


Who may benefit most from this service?

Men seeking dedicated time to discuss health concerns, review symptoms in detail, and explore management options in a structured, evidence-based setting — either alongside existing primary care or when access has been limited.