TRT in the UK

Borderline doesn’t mean an automatic yes or no to TRT. Levels can shift with sleep, illness, alcohol, the time of day, so your doctor will look at the result in context.

Your doctor will review your symptoms and blood tests and consider whether something else could explain how you feel. If further assessment is needed, they may advise speaking to our GP or a specialist.

Under MYTRT’s published criteria, treatment is generally only considered when symptoms are present along with a low free and total testosterone. Your doctor still needs to decide whether TRT is safe and appropriate for you. However, in limited cases a 6 month trial of TRT may be considered in patients who have borderline levels but with significant symptoms.

Further reading

• TRT eligibility criteria: who can have testosterone replacement therapy?
• Testosterone test on the NHS: how to get one and what it covers
• Normal testosterone levels by age: UK reference ranges explained

Yes. We want to understand why your testosterone is low, not just treat the number. Your doctor will ask about your symptoms, medicines, past health, sleep, weight, alcohol and any previous anabolic-steroid use. They may also recommend another morning test or further hormone tests.

Sometimes a low result is linked to something else, such as recent illness, sleep apnoea, a medicine or a change in metabolic health.

If another condition needs attention first, your doctor may suggest further investigation, changes to reversible factors, or assessment by a GP or a specialist instead of TRT.

Further reading

• TRT eligibility criteria: who can have testosterone replacement therapy?
• Low testosterone treatment: every option from lifestyle change to TRT
• Testosterone and sleep apnoea: snoring, low T and treatment safety

There isn’t one form of testosterone that suits everyone. If TRT is right for you, your doctor will talk through the options taking into consideration your fertility plans daily routine and personal preference.

Gel is used daily and avoids needles, but it needs careful application so does not get transferred to someone else. It can also irritate the skin or absorb differently from person to person. Injections are less frequent, depending on the medicine, but involve needles and can cause discomfort, but provide a more controlled stable dose.

We will review how you feel alongside your blood results and safety checks. If a route doesn’t suit you, your doctor can review the dose or timing, discuss another form where appropriate, or reconsider TRT.

Further reading

• Testosterone gel: how TRT gel works, how to apply it and what to expect
• Testosterone injections: types, how they work and what TRT injections involve
• TRT eligibility criteria: who can have testosterone replacement therapy?

We keep an eye on both how you feel and what your tests show. Testosterone can raise haematocrit, the proportion of red blood cells, cause acne, oily skin and hair loss can also occur.

TRT can suppress sperm production. Please mention any plans to have children before starting. We also ask about new or worsening snoring, breathing pauses and daytime sleepiness, which may need assessment for sleep apnoea.

Further reading

• TRT side effects: what to expect and how they are managed
• Testosterone and sleep apnoea: snoring, low T and treatment safety
• TRT eligibility criteria: who can have testosterone replacement therapy?

TRT does reduce sperm production. If you’re trying for a baby soon, TRT is generally not the first approach. However there are medications that can be given alongside to help maintain your fertility.

Tell your doctor if you may want children, even if you’re not sure yet. They may suggest a semen test or specialist advice about fertility-preserving options; sperm freezing may also be worth discussing. These decisions depend on your circumstances, and alternatives or add-ons need individual specialist assessment.

Sperm production may recover after stopping TRT, but it can take months or longer and isn’t guaranteed. Do not stop or change prescribed treatment without medical advice.

Further reading

• TRT eligibility criteria: who can have testosterone replacement therapy?
• Male fertility test: semen analysis, hormone panels and home testing explained
• Low testosterone treatment: every option from lifestyle change to TRT

Your doctor will explain what tests you need before treatment. In general we monitor full blood count (including haematocrit), liver and kidney function, lipids, HbA1c; PSA, Thyroid function and a full hormone panel.

Once treatment starts, UK guidance suggests a review at around three months, again between six and 12 months, and at least yearly when things are stable. That is a guide, not a fixed MYTRT schedule. Your own tests may be timed differently for your medicine, dose changes, results or symptoms.

Further reading

• TRT eligibility criteria: who can have testosterone replacement therapy?
• Testosterone online: how to get TRT legally from a UK online clinic

The goal isn’t the highest possible reading. Your doctor will look for a level that helps your symptoms while keeping treatment within a safe, physiological range.

For injectable TRT, MYTRT’s published guide describes a target trough of 15–25 nmol/L. A trough is the low point just before the next injection; it isn’t a target for everyone or for every type of treatment. Patents using gels have their blood tests timed differently.

Your doctor will interpret the level alongside how you feel, when the sample was taken, your dose and safety results such as haematocrit. More testosterone isn’t automatically better.

Further reading

• Is 1 ml of testosterone a week enough? Dosing, concentrations and blood levels
• TRT eligibility criteria: who can have testosterone replacement therapy?

Please tell your MYTRT doctor if you’re not feeling better. The answer isn’t always a higher dose. They’ll check how you’re taking treatment, when your blood sample was taken, your testosterone levels and other blood results. Sleep, medicines, stress and other health conditions may also be part of the picture.

Some effects take time. UK guidance considers about six months a reasonable trial for benefits such as libido and sexual function once effective levels have been reached. If there’s still no meaningful improvement, your doctor should reconsider TRT and look for other causes, even if your testosterone level is in range.

They may discuss an adjustment, stopping treatment or further assessment. Don’t change your dose or stop prescribed treatment without advice; seek urgent care for severe or urgent symptoms.

Further reading

• TRT eligibility criteria: who can have testosterone replacement therapy?
• How to get TRT in the UK
• TRT and erectile dysfunction: what testosterone does and does not treat

MYTRT is doctor-led. A GMC-registered doctor assesses whether TRT is appropriate, makes prescribing decisions and oversees your treatment and monitoring. They consider your symptoms and medical history as well as your blood results.

MYTRT works in partnership with CQC-registered messageGP. Prescribed medicines are dispensed by a GPhC-registered pharmacy.

In general, we aim to have a single doctor manage each patient but there may be times when one of our other doctors oversees your treatment in the absence of your regular doctor.

MYTRT isn’t an emergency service; use NHS urgent or emergency care when needed.

Further reading

• The doctors behind MYTRT
• TRT eligibility criteria: who can have testosterone replacement therapy?
• Testosterone online: how to get TRT legally from a UK online clinic

A MYTRT TRT subscription is £129.95 a month, or £1,559.40 for 12 continuous payments, with a three-month minimum. Please check the latest price and what’s included before committing. Treatment is offered only where clinically appropriate.

The published plan includes prescribed testosterone, routine follow-ups and monitoring blood tests, relevant injection supplies, delivery or postage, and routine letters or correspondence where appropriate.

Pre-treatment tests are separate unless suitable recent results are accepted. Curren prices are £33.49 for the initial screen and £53.49 for the Advanced Test if you arrange qualified collection yourself (an addental £45 with a clinic draw or £55 with a home-nurse visit). The £53.49 price excludes the external collection cost.

Further reading

• Testosterone replacement therapy (TRT) cost
• TRT eligibility criteria: who can have testosterone replacement therapy?
• Advanced testosterone blood test

We can help you have that conversation. With your consent, MYTRT can provide records or a letter for your NHS GP, including relevant test results, the clinician’s diagnosis, your treatment plan and monitoring results. Your GP will still make their own assessment.

Your GP or local NHS service decides whether to take over follow-up or prescribing. They may repeat tests, refer you to a specialist or follow a local shared-care pathway. MYTRT cannot require an NHS GP to prescribe or accept shared care.

If NHS continuation isn’t agreed, speak to your MYTRT clinician about safe options within your existing arrangement before changing treatment. Ongoing testosterone treatment needs appropriate monitoring.

Further reading

• TRT on the NHS: eligibility and referral routes
• Testosterone test on the NHS: how to get one and what it covers
• TRT eligibility criteria: who can have testosterone replacement therapy?