Tiredness, low mood, a fading interest in sex: these are common in men, and they have many causes. Low testosterone is one of them. This service is for men who want that question answered properly. It begins with an assessment and blood tests, and where a deficiency is confirmed and treatment is appropriate, it continues with medical supervision and regular follow-up.
Symptoms that can go with low testosterone
- Reduced sex drive, fewer morning erections, erection problems
- Tiredness and loss of energy that rest does not restore
- Low mood, irritability, poor concentration
- Loss of muscle and strength, more fat around the middle
- Hot flushes, sweats or disturbed sleep
- Less body hair, or thinning of the bones
None of these proves that testosterone is low. Depression, poor sleep and sleep apnoea, thyroid problems, diabetes, excess weight, alcohol, stress and some medicines, strong painkillers among them, produce the same picture, and some of them lower testosterone themselves. The assessment looks for all of them.
How the diagnosis is made
A diagnosis needs two things together: symptoms, and consistently low blood results. Testosterone varies through the day and is lowered by illness and poor sleep, so it is measured on a morning sample, fasting, and a low result is confirmed by a second test on another day. Further blood tests look for the reason and establish a baseline: the pituitary hormones, prolactin, blood count, PSA and others as needed. The doctor also asks about your general health, your heart, your prostate and whether you plan to have children.
If your levels are normal
Then testosterone is not the explanation, and treatment with it would not help and would carry risk for no benefit. The assessment is not wasted: it often finds the real cause, and the doctor will go through what can be done about it. See also men's health screening.
If a deficiency is confirmed
The doctor explains the options, including treating an underlying cause first, since losing weight, sleeping better or changing a medicine can restore levels without anything more. Where replacement therapy is appropriate for you, it is a prescription-only treatment, prescribed after this assessment and reviewed at each follow-up. You are told plainly what it can and cannot be expected to do, and what the risks are.
What you should know before starting
- Fertility. Testosterone treatment reduces sperm production and can stop it. If you want children, now or later, say so before anything is prescribed: there are other approaches.
- Monitoring is part of the treatment. Blood tests and reviews check your levels, your blood count, which can rise, and your prostate. Treatment is not continued without them.
- It is not for everyone. It is not prescribed in prostate or breast cancer, and needs particular care with some heart, blood and sleep conditions.
- It is a long-term commitment. Your own production is suppressed while you are on it.
Common questions
Can I have treatment at my first appointment? No. A diagnosis needs two blood tests on separate mornings and a full assessment.
Is this the same as testosterone for bodybuilding? No. Replacement restores a normal level in men whose own is low. We do not prescribe to raise a normal level.
Where do I start? With a GP appointment, or by asking for the assessment when you book.
