Frequently Asked Questions

BHRT uses hormones that are chemically identical to those your body produces naturally: testosterone, estradiol, progesterone, DHEA, and thyroid hormones. Bioidentical compounds are individually dosed and prepared by our Ontario compounding pharmacy partner Trutina to pharmaceutical-grade standards. Every protocol is physician-directed and titrated based on your bloodwork and clinical response.

Men and women experiencing symptoms of hormonal decline or imbalance, including fatigue, brain fog, low libido, weight gain, sleep disruption, mood changes, erectile dysfunction, perimenopause, menopause, or metabolic dysfunction. We treat patients across a wide range of conditions including low testosterone, PCOS, thyroid disorders, insulin resistance, and growth hormone deficiency. A discovery call helps determine whether BHRT is appropriate for your situation.

It begins with a 15-minute discovery call to discuss your goals and determine if we are the right fit. From there, your Vis Viva Onboarding ($895) includes two physician visits. Visit 1 (60 minutes) covers a comprehensive assessment, full symptom baseline, custom blood requisition, treatment initiation, and a written prescription with no additional Rx fee. Your compounded hormones are prepared by Trutina, our Ontario compounding pharmacy partner — pickup at any pharmacy or free FedEx shipping Canada-wide. Visit 2 (30 minutes, at 4–6 weeks) reviews your lab results, assesses early clinical response, and makes the first dose titration. All visits can be conducted virtually across Ontario.

Yes. All consultations are available virtually to patients anywhere in Ontario. Bloodwork requisitions are sent to your local lab (LifeLabs, Dynacare, or hospital lab), prescriptions are managed remotely, and compounded hormones are shipped directly from our Ontario compounding pharmacy partner Trutina to your door.

Most patients enrol in Vis Viva Onboarding ($895), which bundles your first two physician visits (60-minute initial assessment + 30-minute follow-up at 4–6 weeks), a custom blood requisition, review of bloodwork, a written prescription (no additional Rx fee), pharmacy concierge service, and free FedEx shipping Canada-wide through Trutina. For ongoing care, the Continuity Program is $3,500/year and covers scheduled consultations, year-round prescription management, blood analysis at every reassessment, and continuous Vis Viva Score tracking. À la carte rates are also published for patients who prefer single visits: Initial Consultation $585 (60 min), Follow-up $345 (30 min), Thyroid Optimization $405 (35 min), Brief Check-in $45 (15 min). Billed separately in all plans: laboratory costs (uninsured tests billed to you by the laboratory), compounded hormone medications (billed through the pharmacy), and functional testing such as VO2 max and DEXA (external referrals). This is a private medical practice. Consultations are not covered by OHIP. Fees are HSA-eligible and METC-eligible.

Yes. We publish à la carte rates for patients who prefer not to commit to a yearly program: Initial Consultation $585 (60 min), Follow-up Visit $345 (30 min), Thyroid Optimization $405 (35 min), and Brief Check-in $45 (15 min) for prescription adjustments and quick clinical questions. Continuity remains the recommended path for ongoing hormonal optimization because dose titration is a multi-month process — but à la carte exists for patients with focused or single-issue needs.

After you book your Vis Viva Onboarding or Initial Consultation, our patient portal automatically sends your intake forms; once they are complete, Dr. Xiao sends your personalized lab requisition. Most patients complete bloodwork at LifeLabs or Dynacare about a week before Visit 1, so Dr. Xiao can review actual results live during your consultation. Tests covered by OHIP are billed to OHIP; uninsured tests are billed to you by the laboratory at time of service.

Most patients begin to notice improvements in energy, sleep, and mood within 3–6 weeks of starting therapy. Your first follow-up with labs is at 4–6 weeks, where we assess early clinical response and make the first dose titration. Full hormonal optimization, including body composition changes, cognitive clarity, and libido, typically stabilizes over 3–6 months as protocols are titrated to response. We track progress across all three Vis Viva domains (Sensus, Pulsus, Virtus) at every follow-up.

When prescribed by a qualified physician, followed with bloodwork, and titrated to clinical response, bioidentical hormones have a well-established safety profile supported by peer-reviewed literature. Bloodwork is reviewed at reassessments, with the markers and timing chosen for each patient. Protocols are individualized and adjusted to your clinical response.

Testosterone (transdermal cream or Health Canada-approved gel), estradiol, progesterone, DHEA, desiccated thyroid (T3 & T4), growth hormone (HGH), and GLP-1 agonists. Health Canada-approved bioidentical products are prescribed where they meet the need; compounded formulations are custom-prepared by our Ontario compounding pharmacy partner Trutina. Every dose is individualized to your clinical profile.

Yes. One physician, Dr. Handsun Xiao, treats both: perimenopause, menopause, PCOS and thyroid conditions in women, and low testosterone, andropause, erectile dysfunction and metabolic conditions in men, with the same bloodwork-first approach and the same virtual consultations anywhere in Ontario.

Consultations are conducted in English or French. Mandarin consultations are available with AI-assisted translation. The website is in English, French and Chinese.

Both. Manus Solis prescribes Health Canada-approved bioidentical products, such as estradiol gel and patches and micronized progesterone, as well as compounded formulations prepared by Trutina, our Ontario compounding pharmacy partner. The choice depends on the hormone, the dose and the route that suits the patient; regulated products are used where they meet the need.

Conventional HRT typically uses synthetic hormones or conjugated equine estrogens (derived from pregnant mare urine) in standardized doses. BHRT uses hormones that are molecularly identical to human hormones — estradiol, progesterone, testosterone — custom-compounded to your exact dosing requirements. The key difference is individualization: BHRT protocols are titrated based on your bloodwork and clinical response, not prescribed in a one-size-fits-all dose.

Not at this time. Dr. Xiao is licensed through the College of Physicians and Surgeons of Ontario (CPSO) and can only prescribe to patients physically located in Ontario at the time of consultation. We serve the entire province through virtual consultations.

A comprehensive panel including total and free testosterone, estradiol, progesterone, DHEA-S, TSH, free T3, free T4, thyroid antibodies, fasting insulin, HbA1c, complete metabolic panel, lipids, CBC, liver function, PSA (men), and inflammatory markers. The specific requisition is tailored to your clinical presentation. Tests covered by OHIP are billed to OHIP; uninsured tests are billed to you by the laboratory. Results typically reach your chart within a few business days.

Hormonal optimization can meaningfully improve body composition. Testosterone supports lean muscle mass and reduces visceral fat. Thyroid optimization restores metabolic rate. Correcting insulin resistance improves how your body partitions fuel. BHRT is not a weight loss drug, but when hormones are optimized alongside nutrition and exercise, patients often see significant changes in body composition — measured by DEXA, not just the scale.

The Vis Viva Score is our proprietary framework for measuring health across three domains: Sensus (how you feel — energy, sleep, mood, cognition), Pulsus (what your blood reveals — metabolic markers, hormones, inflammation), and Virtus (what your body can do — VO2max, grip strength, body composition). Your score is tracked longitudinally at every reassessment, giving both you and your physician an objective measure of progress.

Yes. Our physician consultation fees qualify as eligible medical expenses under Health Spending Accounts (HSAs) and can be claimed as Medical Expense Tax Credits (METC) on your Canadian tax return. Compounded prescriptions are also eligible. We provide itemized receipts for all services.