TRT UK is a strictly regulated treatment. Knowing how to get TRT in the UK means learning if you qualify, what blood tests you need, and whether the NHS or a private TRT clinic is your best route.
In this TRT UK guide, we explain everything you need to know about getting testosterone in the UK.
Options for getting TRT in the UK
You have two options when trying to get TRT in the UK. You can either go through the NHS or seek out a private TRT clinic.
TRT through the NHS
Here is a step-by-step guide on how to get TRT through the NHS:
1. GP visit
The process of getting TRT through the NHS starts with a visit to your GP. During this visit, you’ll discuss your symptoms, and your GP will decide whether to check your testosterone levels through a blood test.
For a testosterone blood test, your blood sample will be taken in the morning and sent to a lab for analysis.
2. Blood test results
Once your GP receives the blood test results, they will contact you to schedule a consultation to discuss the findings.
The NHS has different criteria for prescribing TRT compared to private clinics. Generally, the NHS requires testosterone levels to be below 8.6 nmol/L, which is considered extremely low by most private clinics.
3. Endocrinologist appointment
If your testosterone levels fall below this threshold, your GP will refer you to an endocrinologist. The endocrinologist will then determine the most suitable low testosterone treatment for you.
4. Treatment options
NHS treatment options can be more limited due to local formulary rules and tighter controls around off-label prescribing. If you are approved for TRT, the NHS usually chooses the most cost-effective licensed options, such as topical gels.
TRT through a private clinic
Here is how to get TRT through a private clinic:
1. Contact the clinic
Most private TRT clinics let you enquire via phone, email, or an online form. They usually also have a patient intake form for you to fill out to help them understand your symptoms and determine the best treatment plan for you.
2. Order blood tests
Next, you will do morning blood tests to assess testosterone and related markers. Some clinics offer at-home kits, but many prefer (or later require) venous blood draws for more accurate and complete results.
3. Doctor consultation
Once results are back, you will usually have a consultation with a GMC-registered doctor. Many private clinics provide online consultation services as well.
During consultation, your doctor will go through your symptoms and bloodwork, check for other possible causes, and discuss whether TRT is appropriate.
4. Treatment plan
If you meet the clinic’s clinical criteria and TRT is approved, you will be prescribed a treatment plan and your medication will be dispensed by a registered pharmacy (often delivered to you).
5. Follow-up and monitoring
You will have follow-ups and regular blood tests to monitor response, side effects, and dose adjustments. They are usually more frequent early on, then less often once testosterone levels become stable. The exact schedule depends on your specific circumstances and the clinic’s standard protocol.
Private TRT vs NHS TRT: Which one should you choose?
Your choice of the TRT treatment route totally depends on you.
Go for the NHS: if you want an easy-on-the-pocket treatment and can wait a long time (sometimes months) to see an endocrinologist or receive a testosterone prescription.
Go for a private TRT clinic: if you want faster access to diagnosis and treatment, patient centred approach, more flexible appointment scheduling, and are willing to pay for consultations, blood tests, and ongoing care out of pocket.
NHS TRT eligibility criteria are also strict comparatively, which is why many men opt for the private TRT option.
The following table highlights NHS TRT vs private TRT:
| Factors | TRT on the NHS | TRT via private clinics |
| Speed | Often slower | Usually faster |
| Eligibility | Diagnosis-led strict process | Diagnosis-led but more flexible |
| Treatment choice | Limited options | Often wider choice of formulations (within legal prescribing) |
| Convenience | Less control over appointments | More convenient scheduling (often remote & quick follow-ups) |
| Cost | Low cost | High cost |
What exactly is TRT?
TRT stands for testosterone replacement therapy and it’s one of the most common hormone replacement therapies for men who are experiencing low testosterone. This treatment is meant to treat specifically men with lower testosterone hormone levels than what is natural for their age.
Bioidentical testosterone is injected into the body as a supplemental way to increase testosterone levels in the blood. There are a variety of ways that this treatment can be administered, such as through injections, gel, pellets, pills, and patches.
More and more men every year begin TRT and it continues to improve the well-being of men across the UK. With ongoing research, testosterone replacement therapy has been refined to better meet the needs of a wider range of people. Nowadays, there are medicines you can take in conjunction with TRT so it doesn’t interfere with fertility and other preexisting conditions.
Benefits of TRT
Testosterone Replacement Therapy (TRT) offers numerous benefits for those with low testosterone levels. It can:
- Improve energy levels
- Enhance mood
- Restore hormone imbalance (testosterone balance)
- Increase muscle mass
- Boost libido, sexual satisfaction and sexual health
- Improve erectile dysfunction (ED)
- Improve cognitive functions, mental clarity and mental health
- Increase bone density
Risks and side effects of TRT
While TRT can be beneficial, it’s important to be aware of potential risks and side effects. These may include:
- Acne or oily skin
- Sleep apnoea
- Increased red blood cell count
- Potential cardiovascular issues
- Increase in prostate-specific antigen (PSA) level
Although rare, it’s important to discuss these risks with your healthcare provider and weigh them against the benefits before starting TRT.
Why was testosterone therapy introduced?
As of 20 years ago, TRT was not nearly as popular as it is today. Some studies report that testosterone levels may be declining among men compared to prior decades due to some unknown causes. The reasons for this decline are not yet fully understood, but it is probably due to a mixture of factors in our change of environment and health habits as a group.
It is thought that the following factors may be some of the driving forces behind the reduction in testosterone levels over the years:
- Plastics and synthetics in food and water
- Increased steroid use
- Increased soy consumption
- Increased stress
- Exposure to pesticides
- Poor diet and obesity
- Smoking and other bad habits
Does TRT contribute to infertility?
Many people believe TRT causes infertility. While this was more common with older treatment approaches, current medical practice allows fertility to be preserved by combining TRT with specific medications. If you plan to have children while on TRT, your doctor may recommend using hCG alongside testosterone to help maintain sperm production.
When hCG is used with TRT, common side effects such as testicular shrinkage and reduced sperm count are far less likely. hCG stimulates the testes to continue producing testosterone, helping keep intratesticular and blood testosterone levels closer to normal. TRT alone can reduce intratesticular testosterone by up to 94%, but when combined with hCG, the reduction may be as low as around 7%.
Is injection the only option?
One common misconception among those who are looking to have TRT is that injections are the only option. However, this is not true. There are several ways to have TRT treatments, such as:
- Topical testosterone gel or cream
- Testosterone patches
- Testosterone pills
With these options, you’ll be able to find the TRT treatment method that works for you and how you prefer to seek treatment.
| Method | Advantages | Disadvantages |
| Gel | Easy to apply | Risk of transferring testosterone to others |
| Convenient, can be applied at home | Potentially messy and inconvenient to wear under clothing | |
| Provides steady, daily dosage | Daily application required | |
| Risk of inconsistent absorption | ||
| Injection | Effective, delivers a strong dose quickly | Requires injections, which may be uncomfortable for some |
| Can be administered less frequently (weekly or bi-weekly) | May cause fluctuations in testosterone levels (peaks and troughs) | |
| Convenient, can be self-administered | Potential for injection site pain or irritation | |
| Patches | Convenient, easy to apply | May cause skin irritation |
| Provides a steady, continuous dose | Visible on the skin, which may be undesirable for some | |
| Can be worn discreetly under clothing | May not adhere well with sweating or water exposure | |
| Less frequent application (every 24 hours) | Generally provides a lower dose of testosterone compared to injections or gels |
Necessary tests before TRT
There are some tests that you will need to have before starting TRT. These tests are conducted to ensure you are a suitable TRT candidate. Some are also done during the treatment to ensure your safety and evaluate testosterone’s effect on your body.
Some of these tests include:
- Total testosterone levels test
- SHBG Level Test
- Oestrogen Test
- Follicle Stimulating Hormone Test
- Lutenising Hormone Test
- Prolactin Test
- Prostate-Specific Antigen Test
- Full Blood Count
- Thyroid Hormones Test
Can you buy testosterone online?
Yes, you can purchase testosterone online. However, it’s important to choose the seller carefully, as many online sellers operate without proper medical oversight.
Testosterone is a prescription-only medication. So, obtain it through a licensed pharmacy after getting a prescription from a qualified doctor.
How to choose a TRT clinic?
Selecting the right TRT clinic is important for effective treatment. Look for clinics with qualified medical professionals who specialise in hormone therapy. Read reviews and testimonials from other patients to gauge the clinic’s reputation.
Additionally, ensure the clinic offers comprehensive diagnostic testing and personalised treatment plans tailored to your needs.
Preparing for your first TRT appointment
Preparation is key to getting the most out of your first TRT appointment. Bring a list of your symptoms, medical history, and any questions you have about the treatment. Be prepared to discuss your lifestyle, diet, and exercise habits.
This information will help the healthcare provider develop a tailored treatment plan that suits your needs.
Monitoring and adjusting your TRT plan
Once you start TRT, regular monitoring is essential to ensure the treatment is effective and to adjust dosages as needed. This typically involves periodic blood tests to check testosterone levels and assess overall health.
Open communication with your healthcare provider is crucial to address any side effects or concerns promptly.
FAQs about TRT in the UK
How much is TRT UK?
TRT cost in the UK can vary from clinic to clinic, depending on which services you need (such as consultations and blood tests). On average, TRT costs between £70 and £150 per month. Contact our team for a personalised assessment and a clear breakdown of your expected treatment costs.
How to get on TRT at 30?
You can get TRT at 30 after a doctor confirms that you have low testosterone levels and clinical symptoms of low testosterone.
Will being on TRT bring my libido back?
Yes, testosterone treatment can help bring your sex drive back, especially if you are facing this problem due to low testosterone levels.
Does TRT shrink the testicles?
Yes, testosterone therapy can reduce your testicle size. However, if you are concerned about this TRT effect, discuss it with your doctor. They may prescribe HCG or other medications that can prevent testicular shrinkage while you are on TRT.
Does TRT cause prostate cancer?
Several studies show that TRT does not cause prostate cancer in low testosterone men.
However, testosterone can stimulate the growth of an existing, undiagnosed prostate cancer, which is why screening and monitoring are required before and during TRT.
Does TRT cause heart attacks or strokes?
Current evidence shows that TRT does not directly cause heart attacks or strokes in men who are properly assessed and monitored.
However, TRT can increase red blood cell levels and may raise cardiovascular risk in some men. To prevent this problem, proper medical screening and ongoing monitoring are essential.
Does TRT help build muscle?
Yes, TRT can help men with hypogonadism improve their muscle health by restoring blood testosterone levels. Testosterone is an essential hormone required for muscle mass and muscle strength. Its optimal levels can contribute to building muscle.
What happens if I miss a week of TRT?
If you miss a week of TRT, your serum testosterone levels may decline, and some of your low T signs may also return.
Final thought
Choosing the right route for TRT in the UK depends on your symptoms, testosterone levels, and how quickly you want access to treatment. While the NHS can be an appropriate option for men who meet strict clinical thresholds, many are not eligible due to their levels falling outside NHS criteria.
For those seeking faster access, more personalised care, and structured monitoring, a reputable private TRT clinic can be a practical alternative. If you’re looking for reliable in-person TRT treatment, a specialist private clinic such as Balance My Hormones may offer the ongoing support and care you need to manage your low T well.