There are two ways to get Testosterone Replacement Therapy (TRT) in the UK. One way is through the NHS and the other is through a Private Health Clinic. Many opt for the latter due to the over-complicated TRT NHS route. Unfortunately, due to a lack of funding, the NHS have sidelined conditions like low testosterone, making it difficult to get diagnosed, let alone receive treatment.
Read on to find out more about what to expect from TRT on the NHS.
What is TRT?
TRT stands for Testosterone Replacement Therapy and is a medical treatment that aims to restore testosterone levels to the optimal physiological range. Being prescribed TRT in the UK involves providing the body with bioidentical testosterone to help relieve low testosterone symptoms.
The most common way for testosterone to be administered is through injection or topical methods such as creams and gels but it can also be administered by patch, pill, or implant.
Some men are born with low testosterone, but you can also develop insufficient testosterone levels through poor lifestyle choices or natural ageing (also called late onset hypogonadism). The most common underlying cause of low T in many men is male hypogonadism.
Low testosterone symptoms NHS
Some of the most common symptoms of low testosterone according to NHS include:
- Low sex drive/libido
- Erectile dysfunction (reduced ability to gain or maintain an erection)
- Decreased muscle mass
- Increased weight gain (especially around breasts, leading to development of man boobs)
- Increased tiredness, poor concentration
- Frequent urination at night
- Body and facial hair loss
- Pelvic floor pain
- Depression or mood changes
- Poor memory
If you are experiencing one or more of the symptoms listed above, you should get in touch with your GP for a low T check-up.
The NHS route to TRT: How to get TRT on NHS?
Follow these steps to get TRT on the NHS:
1. GP Consultation
TRT through the NHS typically begins with a visit to your General Practitioner (GP). During this consultation, you’ll discuss your symptoms, prompting your GP to determine whether a blood test to assess testosterone levels is needed. Once your blood sample has been collected, it will be sent to a lab for free testosterone and total testosterone level analysis.
2. Blood Test Analysis
Once you have your GP has your blood test results, your GP will arrange a consultation to review your results. It’s important to note that NHS criteria for TRT eligibility differ from those of private clinics.
The NHS requires a lower testosterone level than private clinics for you to receive treatment. This threshold is typically below 8.6 nmol/L, which is considered extremely low to most private clinics.
3. Referral to Endocrinologist
Should your testosterone levels fall below 8.6 nmol/L, your GP will refer you to an endocrinologist. The endocrinologist will then evaluate your case and recommend the most appropriate treatment option.
4. NHS TRT Treatment Options
NHS TRT treatment options are limited compared to private clinics as their access to off-licence medications is restricted. The NHS also generally leans toward less expensive methods of administration such as testosterone patches and gels despite them being less effective.
Additionally, follow-up consultations to monitor treatment progress may be less frequent once treatment commences.
Advantages of NHS route
Less expensive
The NHS operates on a government-funded model, which means that services, including TRT, are subsidised by taxpayers’ contributions. This means that your consultations will most likely be free and the most you’ll have to pay for would be your NHS prescription.
Disadvantages of NHS route
Long wait times
The NHS is known for long wait times. This is due to a high demand for services coupled with limited resources and staff. This means the NHS has to prioritise urgent cases so less urgent medical conditions (like low testosterone) get sidelined.
You can be left waiting months for one endocrinology appointment, let alone follow-up appointments.
Lack of TRT knowledge among NHS GPs
GPs generally lack sufficient knowledge of TRT. This is because it’s a specialised field within endocrinology and urology, and GPs may not receive extensive training in this area during medical school or postgraduate training.
Additionally, guidelines and best practices for TRT are continually evolving, making it challenging for GPs to stay updated on the latest research and recommendations. These are a few of the reasons why low testosterone symptoms are often mistaken for other conditions, such as depression or anxiety.
Low ‘normal’ testosterone ranges
The NHS guidelines for normal testosterone levels are very low (compared to private clinics), making it difficult to be diagnosed with a testosterone deficiency and nearly impossible to receive treatment to relieve your symptoms.
This is because the NHS prioritises the most severe cases. Therefore, the threshold for diagnosing low testosterone levels is set relatively low to ensure that individuals with significant symptoms are the ones to receive treatment.
Non-bespoke treatment
Unlike many private clinics, the NHS is restricted in the range of treatments it can offer. Consequently, if approved for treatment, patients often have limited input into the type of TRT they receive. As mentioned above, it is usually topical treatments that are prescribed as they are less costly.
The NHS are also unable to offer supplementary medications such as HCG, which preserves fertility while on TRT.
The solution: Private health clinic
It’s no secret that the NHS stands as a vital asset to the UK, with dedicated GPs and endocrinologists within the public healthcare sector offering invaluable support to individuals requiring treatment for low testosterone. However, funding cuts have meant that wait times have increased, staff numbers have decreased, and overall patient satisfaction has taken a huge hit.
Thankfully, private health clinics offer a solution. Many private clinics provide a convenient and discreet online platform for purchasing testosterone blood tests and starting TRT promptly.
By going private, you can:
- Talk to specialist doctors who are experienced in hormone therapy.
- Order discrete blood tests right to your home.
- Experience prompt consultations and quick bloodwork results.
- Have access to specialist equipment and a wider range of medications.
- Have a bespoke treatment plan tailored to your specific needs.
- Regular bloodwork monitoring and follow-up consultations
Who can get TRT on the NHS?
Men with low testosterone levels and associated symptoms may get TRT on the NHS. Similarly, menopausal women with problems like low sex drive may also be able to receive testosterone as a potential treatment.
How long to get TRT on NHS?
Due to limited resources and long waiting times for specialist referrals, it could take several months to see an endocrinologist for testosterone replacement therapy (TRT) on the NHS.
Can you get testosterone on the NHS for menopause?
Yes, you can get testosterone on the NHS for menopause. However, it is only prescribed by a specialist when other menopause treatments, such as hormone replacement therapy, have failed and a specific symptom, such as very low libido, is affecting quality of life.
It is important to note that testosterone therapy is not a licensed menopause treatment in the UK. And the NHS doctors can prescribe it off-label only under certain circumstances.
Is TRT free on the NHS?
NHS TRT is almost free or very low-cost, as you just have to pay standard prescription charges.
Will my doctor prescribe TRT?
Your doctor may prescribe TRT if you meet their standard criteria. They will check your testosterone levels via a blood test and evaluate your low T signs. After this, they will decide whether testosterone treatment is appropriate based on your symptoms and medical history, potentially referring you to a specialist if needed.
A final thought
Navigating the realm of Testosterone Replacement Therapy (TRT) in the UK presents two distinct paths: the NHS and Private Health Clinics.
While the NHS offers the advantage of affordability, with consultations often being free and prescription costs nominal, it comes with drawbacks such as long wait times and limited treatment options.
On the other hand, Private Health Clinics offer bespoke treatment plans, quick consultations, access to specialist doctors, and a wider range of medications, providing a viable alternative for those seeking efficient and personalised TRT.
Ultimately, the decision between the NHS and Private Health Clinics hinges on individual preferences, healthcare needs, and financial considerations.
Contact us to learn more about TRT on the NHS and start testosterone replacement therapy journey with expert help.