Testosterone

Testosterone is the most important androgen in men and testosterone deficiency is increasingly common.

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.

1

Blood Test

A Testosterone blood test will be taken in clinic (not a finger prick sample as they can be unreliable).

The sample must be a fasted one and taken before 11am.

2

Results

Initial Testosterone level normal › No further action is needed. Re-check testosterone levels in 12 months.

Initial Testosterone level low or borderline › Additional early morning, fasted blood test 2-4 weeks later.

Additional blood sample includes tests for;
– Male Hormone(including repeat testosterone level)
– Lipids, Kidney, Prostate if over 50y, Liver, Full blood count, Hba1c plus vitamins, urate and inflammatory markers.

3

Consultation

A 45 minute face to face consultation (in person or virtual) takes place at this point. A general medical history will be taken after completing a medical questionnaire PLUS an additional validated questionnaire is used to evaluate baseline symptoms and response to treatment. All of this information helps us to determine the cause of your testosterone deficiency and the correct treatment path for you.

This includes
– Cardiovascular / Metabolic health assessment
– Lifestyle assessment
– Prostate health discussion.

4

Follow Up

Follow up consultation after 3 months, 6 months then annually or as required.
FAQs

What type of treatment is used?

Are there any side effects to Testosterone Replacement Therapy?

Are there any risks from taking testosterone replacement?

What blood test monitoring is required for men taking testosterone replacement therapy?

Can I book a consultation before having any blood tests taken?

If I am on testosterone gel, what is the timing for a blood test?

Are there any contraindications to Testosterone Replacement Therapy?

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

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.