My endo never even took a pre HRT blood sample. I to.d him I had been using dietary products, flaxseed, saw palmetto, spearmint, peppermint. He wasn't worried about it. I told him I had low T for several years. He asked me how I knew. I explained I never had a real strong sex drive but after having a vesectomy about 8 years ago it went to near zero. Otherwise he asked if I was healthy. We talked about how often I see my regular doctor for blood pressure and cholesterol meds. I guess since I see a doctor regularly he didn't have any concerns about starting. I had three months wait before my therapist wrote my referral letter, so he knew I was serious.
He started on a low dose E, finasteride, and spiro. Three months later I went back and he asked me how I was doing with it. I told him I was ready to transition. He upped my E dose to 4x the starting one and added medroxyprogesterone. It's been almost another three months so I just had to call in and get him to refill my Scripts. I did get a blood test this time. I got him to switch me to bioidenticle progesterone instead of medroxyprogesterone. Will start that soon.