Testosterone Deficiency
Also known as andropause, or the male menopause, this drop in the male sex hormone affects more than 790,000 men in the UK, and prevalence is increasing year on year. Symptoms include loss of sex drive, feeling tired, lacking motivation or enthusiasm, depression and irritability, erectile problems, decreased muscle mass and increased body fat.
Our doctors assess each patient as an individual, identify any underlying causes for low testosterone, and offer a range of testosterone replacement therapies and treatments. In the right patient, testosterone replacement can be life-changing and is not an inevitable consequence of age.
We assess each patient as an individual at our 30 minute online consultations
What Is testosterone deficiency?
Everyone has heard of testosterone; it is the principle male sex hormone, and is responsible for everything from muscle growth, facial hair, sex drive, and a sense of wellbeing. But testosterone is also so much more. Testosterone affects the way we think, our concentration, mood and drive. It affects our overall energy levels, bone density, blood pressure, cholesterol levels, and has an impact on virtually every organ in the body.
After the age of 30, our testosterone drops by about 1% per year, but this is not the same for every man, there also many external factors that influence how fast we lose our testosterone.
What is a normal level?
Many patients who come to see us are symptomatic of low testosterone, have had their levels checked, and been told their testosterone levels are normal.
But this interpretation of the result may not be correct. Reference ranges for testosterone vary widely throughout the UK, with no apparent reason why some laboratories set their lower limit at a specific level.
Furthermore, even in cases where total testosterone may be within an acceptable range, many men have not had their free testosterone assessed, and are therefore simply dismissed as not having a testosterone problem.
What can I do if I think I have low testosterone?
There are a multitude of companies that offer immediate testosterone tests, both finger-prick and formal blood samples. So if it is so easy to diagnose testosterone deficiency, why not just get a blood test and approach a doctor with the result?
The first problem is that not all tests are accurate, and there are huge variations in results depending on external factors, time of day of test, finger prick vs venous sample etc.
Other problems with diagnosing testosterone deficiency are the variations in determining what is a normal result (as discussed above). Perhaps the biggest problem when looking at testosterone deficiency, however, is the fact that many of the symptoms of testosterone deficiency overlap with other medical conditions such as thyroid disease, anaemia, or even diabetes.
Therefore, we would advise before getting a blood test to look for low testosterone, speak to a specialist doctor first to work out which tests are the right ones for you.
How do I treat Testosterone Deficiency?
If your results show that you might benefit from testosterone replacement therapy, our doctors will decide what type of treatment is best for you. There is no single “best” therapy and the decision on treatment is a joint decision between you and your doctor.
At H3 Health we follow national guidance on treatment, safety, and monitoring, and only use UK approved medications supplied through accredited pharmacies. Safety is essential for our patients.
Would you like to find out more?
If you’re interested in finding out more you can read our blog article on testosterone, read Man Alive (written by our Medical Director, Dr Jeff Foster) or speak to one of our men’s health experts.
Frequently Asked Questions about our Testosterone Deficiency service
When it is safe to do so and you are stable on your medication, we can issue a set quantity, or allow you to order your medication as needed. Some medication requires monitoring, such as blood tests, and you will be reminded of this. Failure to complete these monitoring requirements will mean we will not be able to issue your prescription for safety reasons.
If you are already known to the clinic or if you have had your ID confirmed through other contacts with us, for example during a home visit for bloods and other physical tests, then yes.
We have partnered with a national phlebotomy service, Nationwide Pathology, who offer accredited blood tests all over the U.K. As such, we would request that, where possible, you do not obtain blood tests elsewhere. For those patients that have already had blood tests, we are happy to use them provided they were obtained from a reputable source, such as your NHS GP. However, we ask that you do not expect your NHS surgery to do further testing for you as you have chosen to seek private health care. If you do obtain blood tests from other clinics, they may need to be repeated (especially if via finger prick).
No, a GP letter is not needed. However, you are welcome to send us a letter, or a summary, if you feel it would help.
Unfortunately, we can only see and treat patients who are residing in the UK. We are unable to treat anyone who lives, or is temporarily, overseas.
You can call 03309120769 (national rate) to speak to one of our team or use the online web contact form. You can also email hello@h3health.co.uk
Alternatively, a number of our services can be booked online – you’ll see a Book Now button on the appropriate service pages.
Please see https://www.h3health.co.uk/about-us/making-a-complaint/ – we take all complaints very seriously and will investigate your issues in a customer-centric way.
Your initial consultation will be for approximately 30 minutes.
The cost of the prescription varies depending on what you need. Charging is very different from NHS treatments where the prices are subsidised and you only pay £9.35 per drug regardless of how many packs you need. Some items are more expensive – Female Testosterone, for example, is £80 per tube, but this will last 3-4 months.
The cost of blood tests vary. We will recommend the most appropriate group of tests to suit your requirements. We can test for one thing alone, or a group.
For example, a single testosterone blood test is £35 and a full well man screen is £190.
Testosterone Replacement Therapy (TRT) medication costs vary depending on the type of medication used. But for example:
- Sustanon injected testosterone costs approximately £35 per month
- Testogel , topical testosterone replacement costs £40 per month
- Nebdio long-acting injectable testosterone costs £45
We also prescribe single testosterone injectables, and topical creams. For other specific prices please contact us.
Every patient on testosterone replacement therapy will be monitored as per the British Society of Sexual Medicine guidelines which advise a 3 and 6-month follow-up. These reviews involve a blood test and doctor review to make sure the medicine is working properly, your treatment is optimised, and it is safe.
We send your prescriptions via electronic prescribing to our pharmacy partner, CloudRx. They will prepare them for you, and deliver the medication to your door within 72 hours, and often sooner.
It can take up to 7 days for the processing of your blood tests and for us to receive notification from our partner, Nationwide Pathology. Once we have received them your doctor will be notified, and they will review them. Your doctor will then email them to you with any comments, via a secure link.
Depending on your chosen service, you may have a follow-up consultation to discuss your results.
You can call 03309120769 (national rate) to speak to one of our team or use the online web contact form. You can also email hello@h3health.co.uk
Please note that we do not provide urgent care or assistance, and in these cases, you need to contact NHS 111, or 999 if an emergency. Or contact your own GP for other matters.
H3 Health is regulated by the Care Quality Commission who are the independent regulator of health and social care in England – you can find out more about the CQC at their website.
We do not treat anyone under the age of 18 years.
We do not provide urgent care or treatment of acute conditions.
If you have a medical emergency we request you call 999 or urgent care service via your NHS GP or 111 service.
All our doctors follow national guidance via the National Institute for Health and Care Excellence (NICE) or the British Society of Sexual Medicine (BSSM). Accordingly, a normal testosterone level should be between 15-30nmol/l, irrespective of age. In the NHS, the lower limit of testosterone is usually set at around 6-8nmol/l however, there is no specific reason for this.
We strongly recommend that all men who are told they have normal testosterone levels, but are symptomatic of testosterone deficiency, should book an appointment to determine whether their total testosterone is actually low. Could it be their free testosterone that’s below target, or is there another issue causing similar symptoms that could be treated?
The simple answer is yes. Testosterone is a widely used and abused drug, and many patients who have previously taken TRT from other clinics or used anabolic steroids are surprised to find out how much safety monitoring is involved in prescribing TRT. However, unmonitored testosterone replacement can result in high blood pressure, psychological disturbance, blood clots, strokes, and heart attacks. At H3 Health we are here to make your health and wellbeing our priority, and not just a quick fix.
The consultation costs include the appointment with the GP only. It does not cover prescriptions, follow up appointments, or monitoring blood tests or further investigations.
General health appointments are charged at £175 for up to 30 minutes.
First female health appointments are £250 for up to 1 hour.
All follow up appointments are £175.
If you think you might need a longer appointment, you can book an hour for £250.
After you have seen the doctor, they will send a letter to your normal GP advising of any new diagnosis, treatments and plans.
Unless there are any reversible causes for your low testosterone, (such as obesity, alcohol consumption, some medications etc…), when you stop taking the medication, your testosterone levels will simply go back to what they were before treatment. In a small percentage of patients, we are able to use TRT to help them change their lifestyle enough that they may not need to remain on testosterone replacement, and may be able to produce hormone naturally.
You might need further blood tests or investigations, or a referral to a specialist. We will explain the cost prior to undertaking any work.
You will be charged £30 per email to the clinical team after your consultation if you require further time.
After you have your pre-appointment assessment, if you require a blood test we will arrange a convenient time and location for one of our trained healthcare specialists to visit you to take bloods and carry out any other physical tests that may be required.
If you are seen in person, then this will be at Warwick Nuffield Hospital, The Chase, Old Milverton Lane, Leamington Spa, CV32 6RW.
All of our consultations are doctor-led. You will see a practicing GP, all of whom work within the NHS also, and have a dedicated interest in either Men’s or Women’s Health. For example, for testosterone deficiency you will see a male GP who has a specialist interest and understanding of this condition. For menopause, we have female GPs who have a specialist interest in Women’s Health. Where additional support or treatment is required, we can also refer you to our other specialists such as hospital consultants.
We want to practice as safely as we can and involve your normal GP. We will notify your GP of treatments we provide so that they can update their systems and ensure that there are no concerns highlighted over other treatment you might be receiving from them. For example, some medications cannot be taken alongside others, or you might need more monitoring with some.
For that reason, we ask that you provide your GP’s details before your first appointment using the hello@h3health.co.uk email address.
Wherever possible you will always see the same doctor as you progress through your treatment with us.
Latest Testosterone related advice
Should I consider TRT?
You've heard about Testosterone Replacement Therapy (TRT), but who is it for and what are the benefits? In this article our Medical Director, Dr Jeff Foster, explains more about low testosterone, and how TRT might be able to help.
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By the time we hit forty, being tired is a condition that for many people, seems to be virtually engrained in us. Certainly, the limitless energy my children display is something I now look on in awe and envy. Being tired all the time, or lacking in energy is in fact, so common, that it has filtered down into every aspect of life. But there may be a reason behind your tiredness.
