Testosterone
Testosterone is a hormone that regulates vital processes in the male body and is responsible for maintenance of secondary male characteristics such as male hair pattern, voice quality, body hair distribution and typical male muscle mass.
TRT
Testosterone Deficiency in Men
95% of Testosterone is produced in the testes but it is also made in the adrenal cortex.
Many men do not realise that they have testosterone deficiency, especially if they don’t have the more common sexual type symptoms that most people have heard about. Testosterone deficiency actually leads to a significant decrease in quality of life. It may be that erection or sexual performance issues encourage some men to think about their testosterone levels but actually, there are so many other symptoms.
Unfortunately, over the years I have seen that men are traditionally poor at visiting the GP regarding health concerns and treatment seeking is typically delayed. Awareness of the symptoms of testosterone deficiency is poor with a complete lack of training in testosterone deficiency for the vast majority of UK General Practitioners.
Low testosterone level is not an inevitable consequence of ageing.
75% of men maintain their testosterone levels throughout their life and so awareness is the key.
Men frequently want to know
- Is my testosterone level low?
- Could my symptoms be caused by a low testosterone?
- What is the cause of my low testosterone level?
- What follow up and monitoring do I need?
- Is Testosterone Replacement Therapy safe?
I want to provide men with a clear answer to their questions and a plan for their symptoms.
Symptoms
Symptoms of testosterone deficiency
Sexual
- Erectile dysfunction
- Loss of sexual desire
- Loss of early morning erections
Cardiometabolic
- Increased BMI
- Obesity
- Metabolic Syndrome
- Type 2 Diabetes
- Visceral Obesity (fat in the organs, leading to an increased risk of cardiovascular disease)
Physical
- Decreased penis size / decreased testicle size
- Delayed ejaculation / small amount of ejaculate
- Reduced body hair
- Listlessness & low energy
- Hot flushes & sweats
- Fat redistribution / stubborn fat in the tummy area
- Loss of muscle mass, reduced strength
- Infertility
- Osteoporosis
- Gynaecomastia (enlarged or swollen breast tissue)
- Sleep disturbance
Psychological
- Tiredness & fatigue
- Irritability
- Depression, mood swings, anxiety
- Cognitive / concentration impairment
Problems
Why does Testosterone Deficiency occur?
Low testosterone levels in men cause adverse physical and psychological effects including a negative effect on general quality of life.
Testosterone Deficiency causes a high level of preventable premature morbidity and mortality in men.
Problems
- Problems with the testes, hypothalamus and pituitary gland
- Problems with the signalling from the brain- hypothalamus and pituitary gland
- Impaired action of or suppression of testosterone, especially with prescribed medications or with drug and alcohol use or abuse.
Low levels of testosterone
- Increased risk of type 2 diabetes
- Worsen outcomes in chronic kidney disease
- Worsen outcomes in COVID 19 infection
- Increase in all-cause mortality (death from all causes)
Problems
Who should have a testosterone blood test?
Men have a shorter life expectancy and must be empowered and enabled to use services and receive targeted prevention to reduce the risk of arriving in old age with a range of diseases.
Who should test
- Men with multiple signs of Testosterone Deficiency
- Men with erectile dysfunction, loss of spontaneous erections or reduced sexual desire (even without a sexual partner)
- Men with Type 2 Diabetes
- Men with Chronic Kidney Disease
- Men with a BMI >30/m2
- Men with a waist circumference >102cm
- Men taking long term opiates, antipsychotics, anticonvulsant medications, and those who use recreation drugs, alcohol & marijuana
Benefits of testosterone replacement
- Improve sexual and erectile function
- Improve bone mineral density
- Correct unexplained anaemia
- Improve skeletal muscle mass & strength
- Improve physical function
- Improve mood
- Improve cognitive function
- Reduce progression of pre diabetes to overt diabetes
- Improve lipid profile / likely benefit in cardiovascular outcomes especially in men with atrial fibrillation, previous heart attack, and chronic kidney disease.
- Improved energy & vitality
- Improved body shape and fat distribution
Patients Journey
Test
Direct to test initial testosterone levels available to book without a previous consultation, pre 11am, fasted.
Full Blood Profile
Proceed to full blood profile if initial testosterone levels are low or borderline, pre 11am, fasted.
Appointment
45mins
Doctor led consultation after completion of medical questionnaire.
This appointment can take place before any blood tests if preferred.
Follow Up
3m, 6m then annually or as required.
FAQs
Frequently asked questions
What type of treatment is used?
Short acting Testosterone gels are commonly used and injections may be prescribed if more appropriate.
Are there any side effects to Testosterone Replacement Therapy?
Yes, but they are not often significant and may include:
- Testicular shrinkage
- Decreased HDL lipid levels
- Increase in red cell count
- Breast enlargement
- Decreased sperm count
- Acne
- Worsened sleep apnoea
Are there any risks from taking testosterone replacement?
Testosterone treatment does not cause prostate cancer or breast cancer but having current prostate cancer is a contraindication (should not proceed with it) to testosterone replacement therapy.
Recent studies suggest that testosterone replacement therapy reduces the risk of prostate and colorectal cancer.
What blood test monitoring is required for men taking testosterone replacement therapy?
– 3 months
– 6 months
– 12 months Testosterone level plus cardiovascular /sexual / general health review
– Annually thereafter – Testosterone level plus cardiovascular / prostate / general health review
Can I book a consultation before having any blood tests taken?
Yes this is fine please use the booking form to make an Initial Male Consultation and Dr Davis will go through any concerns that you may have and take blood tests if appropriate.
If I am on testosterone gel, what is the timing for a blood test?
Blood tests on testosterone should be taken within 2-4 hours of applying gel that day. Make sure that the arms are not used on that day as it is where the sample will be taken from to reduce a false high / contaminated result.
Are there any contraindications to Testosterone Replacement Therapy?
Current prostate cancer – Testosterone Replacement Therapy does not cause Prostate Cancer.
Male breast cancer
Active desire to have children
Severe chronic heart failure
Haematocrit level >54%
Treatment Pricing
Testosterone Replacement Therapy
Pricing
Male Initial Testosterone Blood Profile in clinic (+£60 nurse to your home)
£80
Advanced / second blood profile in clinic (+£60 nurse to your home)
£299
Consultation
£295
Follow-up blood tests, 3, 6 month or after medication change in clinic (+£60 nurse to your home)
£100
Annual monitoring blood profile in clinic (+£60 nurse to your home)
£299
30 minute follow-up consultations
£190
Prescription Charges
£35
Book Now
Appointments
To book an appointment please use the online Booking Form
Booking Form
Or call us on
0800 464 7220
Consultations can be in person in Newcastle upon Tyne or online if you do not live locally or would prefer a video consultation.
If you are unsure whether this service is right for you then a free discovery call can be arranged. Please request this using the Booking Form.
To book a consultation, please use the Booking Form and select which service you would like.
If you live outside the North East we can organise a prescription to be sent to you or it can be requested from your GP. If you require blood tests, they can be taken at or close to home.
