How Virtual TRT Clinics Are Increasing Pressure on Testosterone Supply in Canada

by
Virtual TRT Clinics in Canada

Testosterone shortages in Canada have become a recurring issue for more than a decade. At the same time, access to testosterone therapy (TRT) has expanded quickly, especially through virtual TRT clinics offering low-friction, nationwide care.

Health Canada shortage data shows that the supply side of the system is already unstable, with repeated and overlapping disruptions affecting the same testosterone products. Meanwhile, changes in how testosterone is prescribed and accessed appear to be increasing the number of patients receiving ongoing therapy. Some evidence also raises questions about how consistently clinical guidelines are being applied in some virtual clinics.

These trends point to a growing mismatch: a supply system with limited flexibility is now meeting broader and more consistent demand. Understanding how these dynamics interact helps explain why testosterone shortages continue to recur and why they remain difficult to resolve.

Testosterone Shortage Data Shows a Fragile Supply System

Looking across Health Canada shortage reports by product, a consistent pattern emerges. The same testosterone products—especially injectables like cypionate and enanthate—move in and out of shortage repeatedly. Many show multiple disruptions over several years, with periods of recovery followed by new shortages.

There are also times when different testosterone products are in shortage at the same time. In some cases, both injectable options are constrained simultaneously. When that happens, switching becomes difficult, with limited alternatives, prescription changes, and uneven pharmacy availability.

Duration is another issue. These shortages often last weeks to months, and in some cases longer than a year. Recovery is uneven, and products don’t always return to stable supply before the next disruption begins.

Across products and over time, the pattern is cyclical, overlapping, and persistent.

Canada’s testosterone supply is stretched thin.

Why Testosterone Supply Breaks Down in Canada

The way testosterone supply is structured in Canada helps explain why these patterns keep repeating.

Injectable testosterone in Canada is supplied by only two manufacturers, each producing a different formulation. That limits redundancy, especially when both products are affected at the same time.

These are also older generic medications with relatively low profit margins, which limits incentives for new manufacturers to enter or expand production.

The result is a system with little flexibility. When disruptions happen, they take longer to resolve, and even small shifts in demand can trigger the repeated and overlapping shortages seen in the data.

Virtual Clinics Are Expanding Access and Demand

While supply has remained limited, access to testosterone has changed quickly over the past few years.

Since the COVID-19 pandemic, virtual care has expanded significantly across Canada as new billing models and regulatory flexibility made it easier to deliver care remotely. Testosterone therapy has been a major part of that shift, especially within direct-to-consumer men’s health platforms.

Virtual TRT clinics are designed to remove friction. Patients can complete an online intake, get lab requisitions, and receive prescriptions without needing in-person visits. Follow-ups are handled remotely, and medications are shipped directly to patients.

While there are no centralized figures for how many Canadians are receiving testosterone through virtual clinics, all signals point to rapid growth. One platform reports serving over 150,000 Canadian men. Others have scaled quickly, with reported growth rates exceeding 3,000% over three years. Most operate nationally, with models built for ongoing, subscription-based care.

Even without exact numbers, the direction is clear: more people are taking testosterone, and more people are staying on it long-term.

Questionable Prescribing Practices in Virtual Clinics

Alongside expanded access, there are also concerns about how some virtual TRT clinics prescribe testosterone.

Studies of direct-to-consumer platforms in the United States have found that some prescribe testosterone to men who do not meet clinical criteria for hypogonadism. In some cases, diagnostic standards are not consistently applied, and follow-up monitoring is limited.

Provider oversight also varies, with some clinics relying heavily on non-physician providers such as nurse practitioners, physician assistants, or naturopaths.

At the same time, demand is also driven by how testosterone is marketed today. It is increasingly framed as part of “optimization” or “biohacking,” tied to energy, physique, performance, and longevity. Online communities and “manosphere” content have played a role in amplifying interest and normalizing its use. This kind of framing has expanded interest beyond strictly medical indications.

Virtual care itself is not the issue. It can improve access, especially for patients who might otherwise avoid or delay care. But the combination of convenience, scale, and business models built around sustained treatment may expand prescribing patterns in ways that increase overall demand for testosterone.

Virtual Care Is Changing Shortage Patterns

The testosterone shortage patterns reveal a vulnerable system. What has changed is how consistent demand has become.

With traditional care, patients often dropped in and out of treatment due to access barriers, follow-up gaps, or delays. With virtual TRT clinics, patients are more likely to start therapy and stay on it, with fewer gaps between prescriptions and refills.

That shift means demand doesn’t ease when supply tightens. Fewer patients drop off treatment, so shortages last longer and affect more people at once.

A Fragile Supply Facing Growing Demand

Canada’s testosterone supply challenges are structural: limited manufacturers, low-margin generics, and minimal buffer capacity. Health Canada shortage data shows a system that has been unstable for years, with recurring and overlapping disruptions affecting the same products.

Meanwhile, virtual TRT clinics have expanded access to testosterone, creating a larger and more consistently treated patient population.

If virtual care continues to grow, pressure on supply will become more sustained. The question is not just whether shortages will happen, but how often they occur, how long they last, and how many people are affected.

Without changes on the supply side, such as more manufacturers, greater redundancy, or stronger inventory buffers, the current cycle of testosterone shortages is likely to continue and may worsen.

Share on Facebook