Testosterone Replacement Therapy (TRT)

Testosterone Replacement Therapy (TRT) – How can it help?

Testosterone replacement therapy (TRT) is a safe and effective treatment to combat symptoms of testosterone deficiency and restore a man’s hormonal health. The Centre for Men’s Health has been the leading UK clinic in testosterone replacement therapy for 30 years.

The Centre has pioneered the use of testosterone replacement therapy (TRT) at our clinics in London and Manchester. In this time our specialist doctors have helped thousands regain their health, vitality, and return to a fulfilling sex life with hormone replacement therapy for men.

Andropause, Male Menopause or Low T?

Testosterone Deficiency Syndrome goes by many other names. These terms are used to describe a medical condition where a low or insufficiently active level of testosterone has led to symptoms or signs. Common terms for this include male menopause, andropause, hypogonadism, low testosterone/Low T, and Testosterone Deficiency Syndrome. All of these refer to the same underlying medical issue.

The Centre generally uses the term Testosterone Deficiency Syndrome (TDS)/Testosterone Deficiency, as we believe this most accurately describes the condition and its cause. Some clinics refer to the condition as “male hormone imbalance”, but this is not a term we use at the Centre for Men’s Health.

Why are healthy testosterone levels important?

Testosterone is a key hormone in men.  It is vital to the development and maintenance of male sexual characteristics and function. Normal active testosterone levels help to maintain sex drive and fertility in healthy men. Research shows it even helps maintain psychological health.

Testosterone key to wider health

The testosterone hormone is increasingly being recognised as important to a wide range of health related areas. This includes contributing to maintaining healthy and active energy levels and preventing bone breakdown.

Research at our testosterone replacement therapy (TRT) clinics indicates that 20% of men (2 million) across the UK over the age of 50 suffer from testosterone deficiency syndrome. However, only 1% have been diagnosed and are being treated.

Low Testosterone Levels

Many structures in your body require the male hormone testosterone to function. When testosterone is not available to them, either by low levels or lack of free molecules, then the effects of testosterone deficiency syndrome may be felt. Testosterone Deficiency Syndrome (also known as TDS, andropause, low T or male menopause) results in symptoms including decreased sex drive (libido), erection problems, fatigue, depression, weight gain, poor concentration, night sweats, short term memory loss and irritability (Carruthers, 2016).

Symptoms of Low T/Male Menopause

Before and after TRT

Alongside having a revived sex drive, renewed energy, and stamina, after receiving testosterone replacement therapy our patients often report  benefits including feeling younger, stronger, happier, and less irritable. Treatment with TRT has helped muscle aches disappear, memory improve, and many report increased energy and assertiveness.

“The treatment made such a difference to me – it was like turning the clock back 20 years or being re-born. I got my life back.” Dan

“I have a greater desire for living, my circulation has improved, I sleep better and consequently I am less irritable at home. I have also lost a lot of midriff fat and I have more muscle. I don’t get as many colds and when I do they aren’t as severe. I feel so much healthier.” David (Read David’s testicular atrophy story in full)

The benefits of TRT have also been confirmed by many researchers worldwide, with positive effects on a range of aspects of men’s health, from relief from depression to increased lean muscle and decreased fat mass as well as improved sexual desire and activity and erectile function.

Testosterone deficiency/low T diagnosis

At the Centre, our team of doctors make use of the full range of information available to them from a review of symptoms, medical history, physical examination and blood test results. They then reach a conclusion on whether the patient is likely to be suffering from testosterone deficiency syndrome or whether some or all of the symptoms may be due to other causes.

Some of the key symptoms reported by patients suffering from testosterone deficiency syndrome/low T, such as fatigue, can also be the result of diseases such as diabetes. It is important to exclude these before any diagnosis of testosterone deficiency syndrome is made and patients can proceed with testosterone replacement therapy or other forms of treatment.

Detailed blood test and check up

Patients attending the Centre for Men’s Health’s clinics in London and Manchester have a very thorough blood test before their first visit. This enables the medical specialist seeing them to review not only the level and status of the patient’s sex hormones, such as testosterone, but also the complex range of factors regulating their action, together with tests of blood fat, liver, kidney, and prostate function, and red and white blood cell counts. 

At the appointment, a full assessment or “work-up” of each patient is carried out. During the hour-long appointment, as well as discussing in detail the blood test results, the doctor also reviews the patient’s symptoms, medical history and current health status and concerns. He also carries out a physical examination, including a check on the prostate. 

A key part of this information gathering process is a review of the results of a detailed questionnaire completed by the patient. The Ageing Males’ Symptoms (AMS) questionnaire covers three areas – physical and somatic, psychological and sexual function. The information from this internationally validated questionnaire is used by the doctor in establishing a measure of the severity of symptoms. This is an important part of the assessment of whether the patient has testosterone deficiency syndrome/low T and to see whether he might benefit from male hormone treatment including testosterone replacement therapy (TRT). The questionnaire is available here if you would like to assess your symptoms. Do remember, however, that the questionnaire results require careful medical assessment alongside other key information before any diagnosis can be made.

Going ahead with testosterone treatment (TRT)

If, following a blood test and other investigations and information gathering the doctor considers that the patient may be suffering from testosterone deficiency syndrome he will discuss the benefits and potential risks of testosterone replacement therapy (TRT) or other testosterone treatment with him. If treatment is indicated and the patient wishes to proceed, then he will start a trial period of TRT or testosterone stimulation therapy.

Testosterone gel, cream or injections

TRT is usually given by testosterone gel, cream or long acting injections for the first two to six months. Testosterone replacement therapy (TRT) has been shown to be highly effective in relieving the symptoms of testosterone deficiency – in particular in restoring energy, health and sex drive.

TRT therapy is often needed long-term and can safely be continued in these forms if good symptom relief is maintained or changed to other types if needed.

How safe is hormone replacement therapy for men?

Testosterone treatment including TRT has been in use in the UK and other countries for over half a century over which time the safety of testosterone replacement therapy has confirmed been confirmed by research, including detailed studies at the Centre.

While some studies have raised concerns about the impact of TRT on a man’s risk of heart attacks or on their heart and circulation more generally, an in-depth review of research by the European Medicines Agency did not find any conclusive evidence that these were valid.

Similarly, despite concerns, first raised in the 1940s, about TRT and prostate cancer, a review of research by the British Society of Sexual Medicine has found no compelling evidence of any link between the two. However, every effort is made to exclude pre-existing prostatic cancer, by clinical examination, and a sensitive blood test to measure the levels of Prostate Specific Antigen (PSA) in advance of any course of testosterone replacement therapy.

To ensure the safety and effectiveness of treatment, including giving the right dosage, it is essential that the results of treatment are carefully monitored, both to establish the diagnosis and to monitor the treatment carefully, blood tests and laboratory measurements are required at regular intervals. After the initial consultation and diagnosis, detailed clinical examinations need to be carried out at 3-6 month intervals.

What forms of Testosterone Replacement Therapy (TRT) are available in the UK?

Testosterone replacement therapy (TRT) at the Centre comes in many forms. Usually it’s given by testosterone gel or injections. However, we provide a range of medications and treatment types to suit all lifestyles.

For the first two to six months we normally recommend a testosterone gel which is easy to apply.  This method can safely be continued for as long as you are happy with the daily applications. In the long term, some patients prefer the ease of long acting injections which are given six to 10 weeks apart. Another form of treatment is to boost the body’s own production of testosterone, using medications including Clomid (Clomiphene Citrate).

To make sure their male hormone treatment is safe and effective, our specialist doctors monitor our patients on an ongoing basis during testosterone replacement therapy. We carefully check the progress of your male hormone replacement therapy via our on-site pathology lab and blood testing services. You can discuss alternative treatment methods during regular follow up appointments and changing to alternative treatment types is straightforward.

Why have your Testosterone Replacement Therapy (TRT) at the Centre For Men’s Health?

Our male hormone specialists have spent 30 years developing a successful treatment model including testosterone replacement therapy for our patients. This makes our clinic one of the longest established UK healthcare providers of testosterone replacement and hormone therapy for men. Our regular TRT therapy clinics in London (Harley Street) and Manchester (Deansgate) provide a swift, confidential solution for men struggling with the symptoms of low testosterone.

We make sure our patients have the time they need to fully discuss the health problems they are facing and to work with our doctors to find the right treatment solution.

Making sure you have the best low T treatment

Diagnoses are based on a comprehensive blood test including a full hormone panel, review of symptoms, medical history and physical examination.  For those patients who go on to treatment, either with testosterone replacement therapy or other options, careful and regular monitoring is carried out. These tests enable us to make sure you have the best low T treatment as well as monitoring the safety of testosterone replacement therapy for you and the relief of your low T symptoms.

The clinic’s founder, Professor Malcolm Carruthers, has been a leader in developing hormone treatment for men and TRT in the UK and remains one of the world’s foremost experts in testosterone replacement therapy. Our specialist medical team — Professor Andrew Krentz, Dr Clive Morrison, and Dr Anand Patel — have many years of expertise in helping patients overcome the effects of low testosterone with hormone replacement therapy for men.

Important note: The Centre for Men’s Health does not offer transgender hormone therapy.

Sources:

European Medicines Agency, CMDh position, No consistent evidence of an increased risk of heart problems with testosterone medicines, 2014;

Corona G, Giagulli VA, Maseroli E, et al. Therapy of endocrine disease: testosterone supplementation and body composition: results from a meta-analysis study. Eur J Endocrinol, 2016;

Corona G, Rastrelli G, Morgentaler A, et al. Meta-analysis of the results of testosterone therapy on sexual function based on the IIEF scores. Eur Urol, 2017;

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Cost of Testosterone Replacement Therapy at the Centre for Men’s Health – London and Manchester TRT UK Clinics

New patient – Full assessment (one hour)

London £500, Manchester £300, Blood test £245

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, with one of our specialist doctors in either our London or Manchester clinic, 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 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. 

Please note that full precautions are being taken to ensure the health, safety and wellbeing of our patients, doctors and staff in the current circumstances. Find out more here.

New patient – Initial assessment (30 minutes)

London £275, Manchester £175, Blood test £245

During the initial consultation with the doctor in either our London or Manchester clinic, the specialist will take the patient’s medical history, review his current symptoms and discuss the results of the blood test in detail. A decision will then be reached about the suitability of TRT or other treatments (for example for erectile dysfunction).

New patient – Treatment Planning (30 minutes)

London £275, Manchester £175

If the doctor recommends treatment at the initial assessment consultation, a further appointment is required for the treatment planning process. Treatment options will be discussed and a treatment plan will be agreed, including any other lifestyle or wellbeing recommendations. This appointment in either our London or Manchester clinic involves a physical examination by the doctor. This is essential in order for him to be able to prescribe testosterone or other treatments. Under the current circumstances, this is carried out with full protective equipment and other measures. To find out more, please click here.

Read More About Testosterone Replacement Therapy (TRT) at the Centre for Men’s Health: 

What are the symptoms of Testosterone Deficiency Syndrome/low testosterone?

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. Read more about the symptoms of TDS here

What causes male testosterone deficiency/low T?

Testosterone deficiency results from failure or disruption of the body’s normal process of production or uptake of the hormone. This can be due to any or a combination of:

  • Problems with the testicles: 95% of male testosterone is made in the testicles. If testosterone production is insufficient, testosterone deficiency will result.
  • Problems with the hypothalamus or pituitary gland in the brain: the testicles depend on hormonal signals from these areas of the brain to maintain adequate testosterone production. Testosterone in the blood itself then exerts negative feedback on the brain to ensure that levels remain adequate and balanced. Where this delicate balance is disrupted, testosterone deficiency can result.
  • Poor body tissue response to testosterone or its metabolites (testosterone resistance)
Can you get TRT in the UK?

You can get testosterone replacement therapy (TRT) in the UK. The Centre for Men’s Health has TRT clinics in London and Manchester and has been operating for over 25 years. During that time the Centre has helped thousands of men regain their health, vitality and wellbeing.

Can you get TRT on the NHS?

You can currently (as of 2021) get TRT on the NHS, but only on a restricted basis. Eligibility for TRT is mainly determined using a relatively low and inflexible blood level cut off for testosterone. Men whose blood results fall above this, even if symptomatic, are unlikely to be given treatment. This means that many men in the UK who could benefit from TRT, based on a more detailed review of their testosterone levels and symptoms, are potentially missing out. The Centre for Men’s Health can offer treatment for these men.

How much does TRT treatment cost?

Testosterone replacement treatment (TRT) cost in the UK will vary according to the type of prescription, from around £70 a month for Testogel (testosterone in gel form) to £160 for Nebido (testosterone undecanoate), an injection lasting up to three months, or around £53 a month. In addition you will need to have blood tests and appointments with a doctor to ensure your treatment is effective and safe. The Centre for Men’s Health has provided TRT for more than 25 years and will be happy to find the treatment that is right for you.

How is testosterone deficiency/low testosterone diagnosed?

A team of doctors make use of the full range of information available to them from a review of symptoms, medical history, physical examination and blood test results to reach a conclusion on whether the patient is likely to be suffering from testosterone deficiency syndrome/low testosterone and is likely to benefit from TRT treatment. A physical examination is also carried out, including a check on the prostate. Read more about testosterone deficiency diagnosis here

What are the TRT treatment options?

Testosterone Replacement Therapy (TRT) is usually given by testosterone gel, cream or long acting injections. For the first two to six months it is usually given as a gel or injection. It is often needed long-term and can safely be continued in these forms if good symptom relief is maintained. The type and dosage of medication given can be adjusted to make sure the patient receives the best low T treatment tailored to their own particular needs. Read more about how testosterone deficiency is treated at the centre here

Is TRT safe?

With a track record of over 50 years, Testosterone replacement therapy (TRT) has been shown to be a safe treatment. Before treatment, patients must be screened for pre-existing prostate cancer with both a clinical examination and a blood test to check their levels of PSA (prostate-specific antigen). The Centre for Men’s Health has provided safe and effective TRT in the UK for over 25 years.

Is TRT like using a steroid?

Testosterone replacement therapy (TRT) is totally different from steroid abuse – the illegal and uncontrolled use of various forms of testosterone, mainly by men under 30 with already normal hormone levels, to boost muscle growth and strength, often with serious negative health consequences. TRT is carefully monitored treatment, prescribed by doctors, aimed at men almost exclusively over the age of 40 who show severe symptoms of Testosterone Deficiency Syndrome. The Centre for Men’s health can help men in this situation.

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