- What are the symptoms of Testosterone Deficiency Syndrome?
The characteristic symptoms of Testosterone Deficiency Syndrome are decreased sex drive, erection problems, loss of energy, depression, weight gain, brain fogs, memory loss, irritability and night sweats.
- Why do men get Testosterone Deficiency Syndrome?
Testosterone levels in men tend to drop over time after they peak in their 20s. For some men this alone may be enough to drop their levels into unhealthy territory. More alarmingly, average testosterone levels in men have been dropping over the past few decades.
Many factors in daily life can lower testosterone levels as well. Smoking and obesity are perhaps the most common changable causes of testosterone deficiency. However, stressful environments, environmental exposure to chemical byproducts, and unavoidable trauma or surgery to essential production regions can all effect the production of testosterone in the body.
- How many men live with the condition in the UK?
A recent International web survey of 10,000 men indicated that 20% of the 10 million men across the UK over the age of 50 are likely to be suffering from Testosterone Deficiency Syndrome.
- How much will my appointment cost?
New patient - Full Assessment (One hour) - London - £500, Manchester - £300
An in depth review of your health and any men’s health treatments needs, with special emphasis on your hormonal health status, in particular in relation to testosterone. The full hour appointment allows plenty of time for you to discuss and get advice on testosterone deficiency, ED/impotence or prostate health issues. The session includes advice on any further tests needed and, where treatment is required, agreement of a treatment plan. Where your plan includes a trial of testosterone treatment, this can begin the same day. For ED, in many cases it will be possible to provide initial treatment on the basis of this first appointment. A blood test (£215 - see below) is required before the appointment, the results of which form a key part of the screening. For London appointments, this test can take place the same day.
New patient – General appointment (30 minutes) - London - £295, Manchester - £195
Expert advice on men’s health issues relating to testosterone deficiency, ED/impotence and prostate health. The session includes advice on any further tests needed and, where treatment is required, agreement of a treatment plan. For ED, in many cases it will be possible to provide initial treatment on the basis of this first appointment. Should testosterone deficiency be suspected, a blood test and further consultation will be required before a treatment trial can be commenced, if indicated.
Blood Test, Laboratory Profile and Androscreen© - £215
Ahead of a New Patient - Full Assessment consultation, patients complete an Androscreen© questionnaire detailing their medical history and provide a fasting blood sample for a full laboratory profile. This includes detailed hormone analyses, prostate-specific antigen (PSA) test, biochemistry, and haematology. Please note that these must be paid for before booking your appointment with a Centre for Men's Health specialist.
Follow up appointment - London - £325, Manchester - £175
A review and discussion of your symptoms and treatment plan. Can also include treatment in the form of a repeat testosterone injection where this is part of your treatment plan. These consultations, together with a blood test & laboratory profile are required every 2-6 months to monitor and optimise the results of your treatment and are part of a general, on-going men's health maintenance programme.
- What is your appointment cancellation policy?
If you need to cancel your appointment for treatment you must notify the Centre by telephoning 0207 486 2277 at least 48 hours (2 working days) before your appointment. Please note: If you miss your appointment and have failed to notify us 2 working days before your appointment you will be charged an administration fee of £70. This will be taken from the debit/credit card details you supplied upon booking your appointment or will be added to the fees for your next appointment. There may be occasions when appointments are cancelled by the Centre for Men's Health. In this event no fee will be charged and we will always provide as much notice as possible of cancellation.
- Do I need to be screened at the Centre for Men's Health before I can start treatment?
Yes. Previous blood tests you may have had taken elsewhere will not identify the detailed hormonal, biochemical, haematological and urinary profiles that we require for a correct diagnosis. The specialist laboratory we use is unique in being able to integrate its results into our purpose-built software system.
- Locations of Centre For Men's Health Blood Testing Clinics across the UK
There are currently 11 clinics around the UK situated in Glasgow, Newcastle, Doncaster, Manchester, London, Stoke On Trent, Derby, Birmingham, Bristol, Southampton and Ashford where fasting blood samples can be taken for a full laboratory profile. Contact details will be provided by our practice management team after the payment for the blood test/laboratory profile has been received. Alternatively, if you find it more convenient, we can send you a remote blood sampling kit and you can get any local GP, hospital, or private medical facility to take the sample for you, but at your own expense.
- How long is the course of treatment?
Testosterone Replacement Therapy is a treatment not a cure for Testosteron Deficiency Syndrome. Treatment is generally a long term process. Following a minimum 3 month trial period, 6 monthly check ups are usually required to monitor both the safety and effectiveness of treatment.
- Do I need a referral from my doctor?
No. A referral from your doctor is preferable but not essential. The Centre for Men's Health provide an entirely confidential screening and treatment service. We are always happy to write to your doctor at any stage in your treatment if you wish us to do so.
- Do I have to come to London or Manchester for treatment and follow-up?
Yes. The services of the Centre for Men's Health can only be provided by visiting our Harley Street or Manchester centres. A 'same-day' results service is offered in London only, if laboratory tests can be carried out before 11am. For appointments in Manchester blood samples have to be taken at least a week before the consultation with the Specialist.
- Will my results be confidential?
Yes. At each visit you will be given full details of the screening and laboratory tests for your own records. All clinical data kept by the Centre for Men's Health is entirely confidential as required by the Health Care Commission.
- Can I get re-imbursement from my private medical insurance?
Testosterone treatment of this condition is not recognised by Private Health Insurance providers, and so cannot be re-imbursed via these schemes.
- I have my own test results. Can I use them instead of the Centre's?
This depends on what is covered in the tests and how recent they are. If you send us your results at least a week before your appointment, one of our consultants can check if they are sufficient for a full assessment. We usually accept outside results or find some way to incorporate them.
Generally, we prefer the comprehensive health panel that we include in our own testing, but there are some essential tests that we need if you are interested in using your own.
SHBG (Sex Hormone Binding Globulin)
FSH (Follicle Stimulating Hormone)
LH (Leutanising Hormone)
PSA (Prostate Specific Antigen)
- What causes erectile dysfunction?
There are many potential causes of erectile dysfunction, but an erection is created and three main sources. We focus on these root causes:
Psychological - Your nervous system is split into two general categories: sympathetic and parasympathetic. The sympathetic nervous system signals your body to tense up and ready itself for fighting, running, or some sort of strenuous activity. The parasympathetic nervous system sends the opposite signals to relax, digest, and prepare for sex. Anything that makes the sympathetic nervous system overwork (eg. stress, anxiety) can also make it harder for the parasympathetic system to do its work (eg. signal for an erection).
Cardiovascular - The male penis is a very vascular structure. Erections are created by increasing blood flow to the penis and restricting flow out of it. This mechanism requires both a healthy heart to pump the blood and healthy blood vessels that can respond to signals from the brain. Certain conditions like atherosclerosis can make these mechanisms respond more slowly and restrict necessary blood flow.
Hormonal - Erectile function is largely supported by the male sex hormone, Testosterone. Testosterone supports male libido in the brain and the vascular structures in the penis to respond and maintain their response when a signal does come from the brain. A deficiency in available testosterone to any of those structures can result in a lower libido and decreased erections.
- What is the treatment for erectile dysfunction?
In our clinic, we have many ways of treating erectile dysfunction depending on the cause.
We offer psychosexual support to help patients live a lifestyle more conducive to having errections.
We prescribe PDE-5 inhibitor medications. - At a cellular level, erections are caused by penis vasculature responding to a molecule called GMP. The GMP is released as a result of nervous system signalling and causes the arteries in the penis to expand. The end result of the vascular expansion is an errection. GMP is natually degraded by another molecule called PDE over time. GMP degradation normally results in lower concentrations of GMP and the penis returning to a flacid state. PDE-5 inhibitors, as the name suggests, block the actions of PDE. They result in higher and longer lasting concentrations of GMP in penis vascular cells. This means harder and longer lasting errections. Some commonly known PDE-5 inhibitors include Viagra, Cialis, and Levitra.
We offer testosterone replacement for those who are deficient. Testosterone is an important factor in maintaining libido in men. It also supports the neurological and biochemical mechanisms behind having an erection. By replacing testosterone in men who are deficient in the hormone we support these functions and help promote better general wellbeing. (Traish 2007)
- What are my options for medication and their price?
There are a wide array of treatment options available. However, most people choose either a long acting injectable testosterone or a topical gel.
Nebido - Testosterone undecanoate. Given as an intramuscular injection in the butox, this form generaly lasts from two to three months and costs £160 per dose.
Testogel - 16.2 mg/g Testosterone in gel. This form is applied daily directly to the skin. A pump of Testogel generally lasts a month and costs £70.
Both of these options are testosterone based and may suppress fertility. Other options like clomiphene citrate or Human Chorionic Gonadotropin can also be persued for those interested in preserving fertility.
Many other options are available. Please speak with your doctor if you have problems with your current treatment plan or are interested in other options.