A Comprehensive Guide to TRT in the UK
- What is TRT?
- Role in the body
- Who needs TRT?
- TRT treatment
- Low testosterone types
- Blood tests
- Cost of TRT
- TRT from my GP?
- Buying testosterone
- Aromatase inhibitors
- Does TRT build muscle?
- Can TRT help with anti-ageing?
- Prostate issues
- Testicular issues
- Hair loss
- Facial hair
- TRT & ED
- Can TRT help with fatigue?
- Is TRT for life?
- Stopping TRT
- Cycling TRT?
This resource has been medically reviewed for accuracy by Dr Chris Airey.
Dr Chris Airey is a specialist in TRT, with a Masters in Endocrinology and appearances on BBC Radio, UK Health Radio and in the well-known Mr Porter magazine, where he has advised on this treatment.
8 minute read
Introduction to Testosterone Replacement Therapy
Starting your journey on testosterone replacement therapy can be a daunting one. Whilst the benefits of TRT can be huge, there is lots of information to take in before you get started.
We’ve compiled some of the most useful information here for you to read through, it is co-authored by our Medical Director and TRT UK Expert Dr Chris Airey.
If you can’t find what you are looking for here, please make your way over to the TRT MANUAL to read more articles on the topic.
If you have any further questions regarding TRT in the UK then please contact us to talk to one of our advisors.
What is TRT?
TRT stands for Testosterone Replacement Therapy. This is the replacement of a man’s natural testosterone production when it is lower than it should be.
Replacement usually occurs through the use of testosterone medication (exogenous testosterone) that is provided through either injections, pellets, patches, or gel.
In TRT clinics there are usually several different options that you can choose from. Nowadays it is also common to have other medications such as HCG included in TRT to fully optimise the treatment by preserving your fertility and natural testosterone production.
Other hormones such as oestrogen may need to be managed further with the use of other medications. The medications required during treatment vary from individual to individual, and different men respond well to different options.
The use of other medications including HCG to maintain natural testosterone levels, has led some to rename the treatment Testosterone Optimisation Therapy, as natural production remains present and isn’t being replaced.
Low Testosterone Test
The ADAM questionnaire has been shown to have 88% sensitivity in testing for low testosterone.
What does testosterone do in the body?
Testosterone is the male sex hormone responsible for male characteristics and health. It is important for various functions in the human body, in both men and women!
• Testosterone improves sexual function, mainly through changes to sexual drive (libido) which can also impact erectile function.
• Muscle growth is improved by increased testosterone levels, which also improves general strength. This occurs through ramping up of both protein synthesis, tendon strength and neurological changes that affect force production.
• Cognitive function, including memory, mood and mental agility, are all heavily influenced by testosterone. Men with low levels of testosterone often report reduced short term memory and ‘brain fog’ which makes thinking difficult. Men will comment that mental arithmetic is harder than usual.
• Fertility is controlled by various factors including the testosterone level inside the testicles. If testosterone is very low (usually due to genetic or pituitary issues) then men may have reduced sperm count and quality.
• Testosterone is also involved in lesser-known roles such as ensuring normal bone density, producing body hair and increasing the cardiac output of the heart. It occurs naturally to a lesser extent in females.
It is extremely important for good health and general well-being in all men but is often ostracised in the media and by some doctors for its connections to violence, aggression as well as certain health issues.
If used safely, TRT under the supervision of a specialist doctor can be a very effective and safe treatment. For a more in-depth explanation, you can read more on our ‘What is Testosterone’ article.
Why do some men need TRT?
Testosterone levels can become low for many reasons, some of which are still not fully understood. We know that the modern man’s testosterone levels are on average 20% less than they were 20 years ago. This may be due to one, or a combination of several factors:
• Environmental factors – such as plastics and fertilisers leaching chemicals into the water supply/food
• Hormones – the contraceptive pill contains hormones which can disrupt the male hormonal system
• Anabolic steroid use – often a full recovery of the HPTA does not occur after the shutdown of natural production
• Soy consumption – phytoestrogens from some foods such as soy and mint can reduce T levels
• Stress – chronically increased cortisol production may reduce T levels
• Congenital disposition – genetic conditions can lead to low levels
• Age-related decline/andropause – testosterone levels may decrease with age
• Pesticide exposure – pesticides and other chemicals can reduce hormone production
• Obesity – increased body fat can lead to higher conversion of testosterone into oestrogen which reduces levels and suppresses testosterone production
Many of these factors are at play in a lot of men. Although some of the factors above are more controversial than others, it is likely that most of these factors can lead to suppressed hormone function and symptoms of low testosterone which may explain the decade upon decade reduction in male testosterone levels in western societies.
What is the best type of TRT treatment in the UK?
The most popular (and arguably most effective) form of TRT is via injection. HCG is also important to maintain fertility and natural testosterone production as well as regulating other hormonal pathways.
However, we understand that some men don’t get on with this type of treatment. There are several options for the administration of TRT, some of which have either reduced injection frequency or none at all:
• Testosterone gels – these can have absorption issues.
• Monthly or Quarterly testosterone injections, e.g. Nebido.
• Weekly testosterone injections, typically Testosterone Enanthate or Cypionate. Testosterone Enanthate and Cypionate are the preferred treatment options for most men.
• Pellets which are inserted every 6 months.
You can read more on our article ‘What is the Best TRT protocol?’
What are low testosterone symptoms?
Low sex drive/libido and/or erectile dysfunction
Many men (but not all) with low testosterone suffer from erectile dysfunction. Others will notice that their sex drive has dropped. Sex drive is an important part of feeling healthy and keeping a healthy relationship. It can also improve your confidence and make you feel more energetic.
• Poor cognition/poor arithmetic/brain fog
Often one of the first benefits men who start Testosterone Replacement Therapy realise is improved clarity of thought and reduced brain fog.
TRT has been shown to improve the IQ and cognition of older men and allows many to think straight again. It provides clarity and makes decision-making more assertive and natural. This can lead to really positive changes in a man’s work environment, where men on TRT often find that they suddenly become more productive and competitive.
Many men find that TRT is the catalyst for them to start rising up the ranks at work.
Men with low testosterone often complain of low energy levels and feeling tired all the time. Falling asleep after dinner is another big indicator that you may have testosterone deficiency. TRT has been shown to improve energy levels in men and reduce the tiredness experienced by many after eating.
• Loss of muscle mass/sports performance
Testosterone is a performance-enhancing drug. It is sometimes used illegally by athletes to get a competitive advantage over their peers. TRT is not allowed in most competitions in the UK or internationally. In sport and fitness, testosterone has many useful effects including muscle mass building, strength improvements, improving joint health and reducing body fat levels.
TRT can also improve a man’s energy levels allowing them to work harder and see more improvements. However, TRT is not intended purely for performance improvements. Whilst it is a nice positive side effect of treatment, TRT should only be provided to men with low testosterone symptoms.
Testosterone is always associated with competition, and for good reason. Men and women with more testosterone are more competitive, and tend to win more as a result. Without good testosterone levels, competing and improving in sports or business can be more difficult.
If you have low testosterone, starting Testosterone replacement therapy may increase your performance in sports, in competition and at work.
There are many other symptoms that you might have noticed, which may not be directly associated with low testosterone – you may have increased body fat around your waist, excessive sweating and/or night sweats (often caused by oestrogen levels), reduced or absent body and facial hair, increased breast tissue (gynaecomastia), insulin resistance, and particularly in older men: loss of bone mass (osteoporosis) and reduced circulation (cold hands and feet)
You can learn more about whether you have low testosterone with the ADAM questionnaire.
What are the benefits of TRT?
Testosterone replacement therapy is an effective treatment for men with low testosterone symptoms. The main benefits of taking TRT are that it improves the symptoms seen in men with testosterone deficiency. However, some men notice further improvements that go beyond their natural levels.
Some men notice that their self-confidence and assertiveness improve considerably when on TRT. This can lead to men being more comfortable in social situations and dealing with conflict. In a similar vein, anxiety can be noticeably reduced when on TRT. In some men, if oestrogen levels are raised, anxiety can be made worse when starting TRT. Luckily, this can usually be combated with dose control and medications to reduce the conversion of testosterone to oestrogen.
Men who suffer from Crohn’s disease and IBS may notice an improvement in their symptoms. It is not fully understood why this occurs, but one hypothesis is that TRT reduces the anxiety that often makes this condition worse.
Testosterone is a potent libido booster. Men who start TRT usually notice that their libido is substantially improved, even beyond times when they weren’t suffering from low testosterone symptoms. Additionally, testosterone can improve the size and quality of erections.
Testosterone is even more widely associated with muscle growth than with sex drive. This is for good reason, men on TRT will often end up with higher testosterone levels than they did naturally which results in significant muscle growth, especially when coupled with a resistance training program. Similarly, testosterone also improves blood supply and vascularity alongside bone density. Both of these are important for health and wellbeing, especially as men age.
One often overlooked benefit of testosterone replacement therapy is the impact it can have on a man’s sleep quality. Having normal testosterone levels can significantly improve sleep and recovery allowing men to feel more rested and energetic. This is a common benefit that many men didn’t expect when starting on TRT.
For some men, this next one is a benefit, whilst for others, it may be more of a hindrance. Testosterone increases body hair growth in most men that increase their levels with TRT. It may also improve beard growth, particularly in men who previously had poor growth. It is worth noting that this is not always the case as some men cannot grow body and facial hair well. This can be due to certain conditions or genetic proclivity to hair growth in these areas.
The final benefit is one that is not well known or publicised but is probably one of the best reasons to be on testosterone replacement therapy. TRT has been shown to reduce all-cause mortality in a large study looking at deaths over a time period compared to men not on testosterone replacement therapy. This demonstrates how TRT can improve several health outcomes in men if it is well administered and the patient is monitored safely.
Read more about the benefits of TRT and side effects of TRT.
What are the Types of Low Testosterone?
Primary hypogonadism (the testicles don’t produce enough testosterone)
In primary hypogonadism the gonads (testicles in men) don’t respond to the hormones released by the pituitary (in the brain), LH and FSH. In this instance, the testicles can’t produce enough testosterone. Often LH and FSH are raised as the body produces more to try to stimulate the testes to produce testosterone.
• Damage to the testicles / trauma
• Radiation / Chemotherapy used when treating cancer (usually of the testicles)
• Castration (removal of the testicles, often due to cancer or other issues)
• Klinefelter syndrome (a genetic issue that means a man does not have the same chromosomes as other men)
Secondary hypogonadism (also called hypogonadotropic hypogonadism)
In secondary hypogonadism, the gonads (testes) are working but the release of LH and FSH is affected. The brain isn’t telling the testes to produce enough testosterone.
• Pituitary tumours or disease (prolactinomas – this is why your doctor should test prolactin)
• Traumatic brain injury – damage to the pituitary can affect the production of hormones
• Damage or trauma to the testicles
• Radiation / Chemotherapy used when treating cancer
• Other chronic diseases like liver or kidney disease
• Obesity (raises oestrogen which tells the brain to stop producing LH and FSH)
• Nutritional deficiencies
Often there does not appear to be a reason for men having low testosterone. Many people think that it is caused by certain environmental factors in modern-day life, such as hormones in the water and the widespread use of plastic containers for storing food and drinks.
A qualified and experienced Testosterone Replacement Therapy doctor will be able to tell you which type of testosterone deficiency you most likely have and possibly even why.
The blood test values for LH and FSH are important to help with this diagnosis.
Which blood tests do I need before TRT in the UK?
Before starting TRT in the UK you need to have certain blood tests to ensure that you are safe to start this treatment as well as to show that testosterone levels are low on two occasions. These are the guidelines in most countries.
What blood tests do I need for TRT in the UK?
You need to have two results showing low total testosterone and/or free testosterone.
Alongside this, your doctor should make sure that you have the following values tested to ensure your safe treatment:
• Sex Hormone Binding Globulin (SHBG) – This protein binds to your total testosterone making it less available to the body. If you have a raised SHBG level, you could suffer from the symptoms of low testosterone despite good total testosterone levels.
NHS GPs rarely test for this and therefore cannot accurately tell if low testosterone is causing your symptoms. This value is also used to calculate your free testosterone level.
• Oestradiol (Oestrogen) – Oestradiol is the main active part of oestrogen. It is produced in the male body from testosterone when it is converted by aromatase (an enzyme).
If Oestradiol is too high, or too low, it can affect male libido, erection quality, emotions, fat accumulation and growth of breast tissue (which can lead to gynaecomastia, or ‘man boobs’!) This is extremely important to test before and during treatment for low testosterone!
• Follicle Stimulating Hormone (FSH) – A hormone produced by the pituitary gland that stimulates the testes to produce sperm and testosterone.
• Luteinising Hormone (LH) – A hormone produced by the pituitary gland that stimulates production of testosterone in the testicles. Luteinising Hormone and FSH are important for understanding why you have low testosterone.
• Prolactin – If your levels are high it can affect your mood and sexual health. High levels can reduce testosterone production. If your Prolactin level is very high, it may be associated with a prolactinoma, a tumour in the pituitary gland that can lower your testosterone levels. If over a certain range then the doctor may recommend that you have an MRI scan before starting treatment.
• Prostate-Specific Antigen (PSA) – This can indicate prostate health. The most recent research suggests that TRT does not increase the risk of Prostate Cancer, but it can increase Lower Urinary Tract Symptoms and potentially make prostate cancer worse if you already have it.
If this value comes back high, you may need further tests before starting TRT, including a physical examination by a doctor.
This is required for all men over the age of 45.
• Full Blood Count – TRT increases the production of red blood cells. This can increase the thickness of the blood and the chances of clotting.
If this is high or increases during TRT you may need to have some blood let to reduce your levels.
• Lipids – Certain medications can make your cholesterol, LDLs and HDLs worse. If these are particularly bad before treatment then you may need to talk to your GP before starting.
These are also reviewed whilst on treatment to ensure you are healthy.
Things we may also look at:
• Thyroid hormones – some thyroid problems present with the same symptoms as testosterone deficiency. Your doctor should check these to ensure you are not suffering from thyroid issues before starting TRT.
• Cortisol – this can indicate whether there are other issues with your pituitary gland.
• Liver function tests – Certain medications can make these worse, they can also indicate other issues.
• Renal (kidney) function – Certain medications can make these worse, they can also indicate other issues.
• Iron studies – These can indicate certain issues such as haemochromatosis, which may need further investigation before starting testosterone replacement therapy.
All of these Blood tests serve certain purposes and may be requested before starting treatment, depending on your medical and medication history.
If your doctor or pharmacy is trying to provide treatment based on just one testosterone result, then it may be worth looking for a different clinic with more thorough testing and your health as its priority.
How much does TRT Cost in the UK?
How much does TRT cost per month?
TRT plans in the UK can cost as little as £89.99 per month for medication and support. HCG as an add-on to a TRT plan is £35 per vial which lasts from 4 to 10 weeks depending on dosage. HCG monotherapy (on its own without TRT) is £69.99 per month including support.
You can read more about costs on our Costs of TRT page.
Can I get TRT from the NHS in the UK?
Your local GP may provide you with TRT if you have low enough testosterone levels. However, this process can be long and difficult with the NHS requiring a much lower level of testosterone (usually below 8nmol/l) than the level where men usually get symptoms. Most men report difficulties getting treatment through their GP and if they do the treatment is often low quality.
In most cases, the GP will refer you to an endocrinologist if levels are low. In most cases, the wait for a consultation will be several months. From here the endocrinologist will do further testing. They are taught to look for clear signs of abnormalities that indicate very low testosterone levels or congenital issues. Often, if these aren’t there, and levels aren’t really low, then the endocrinologist will not provide treatment.
The NHS cannot provide important medications for effective treatment, such as HCG. HCG is important for maintaining fertility and natural testosterone production levels in men as well as controlling blood lipids and symptoms and maintaining testicular size.
NHS doctors are also limited to supplying certain medications which all have significant issues. Often, Testogel is offered (which frequently has absorption issues in men). In some cases, Nebido may be offered. Nebido regularly leads to a spike in levels over a few weeks, causing side effects, which then trails off leaving men noticing a return of symptoms as levels get lower.
The benefit of getting TRT through the NHS is that the treatment is free at the point of access.
Can I buy Testosterone in the UK?
You cannot legally buy testosterone in the UK without a prescription from a registered doctor.
TRT clinics can provide prescriptions to men with low testosterone levels and symptoms of testosterone deficiency.
Buying testosterone from the black market is risky and should be avoided as you do not know if the product is sterile and what concentration it is. It is also very important to have testosterone replacement therapy through a doctor who knows how to manage the treatment and side effects.
Is TRT Available in the UK?
TRT is available in the UK through the NHS and private clinics.
Can I get TRT through the NHS?
NHS treatment can often be hard to get unless you have a very low level of testosterone. The levels at which the NHS will treat men differ from area to area and between doctors. Often they will use the reference ranges provided by laboratories to decide whether you have low testosterone or not.
These ranges are not based on when men get symptoms of low testosterone and are therefore not useful for deciding whether a man has low testosterone and needs TRT. Generally, this range has a bottom level of around 8.6nmol/l, so you will often struggle to get treatment above this level. Read more about normal male testosterone levels.
Even if you do have levels below this, men often struggle to get treatment. Some GPs and endocrinologists think that TRT is not worth the risk, they think that the risks to fertility levels or cardiovascular health outweigh the benefits of the treatment.
If you are offered treatment, the options may be limited. This usually means gels or nebido injections if you are lucky. These both have issues that can prevent men from responding well to treatment. Medications to improve and maintain fertility, such as HCG, are not available from the vast majority of GPs and endocrinologists and leave men with the potential for infertility if starting TRT through the NHS.
Can I get TRT through a pharmacy?
Some pharmacies will provide TRT, but in most cases, this is in the form of gels. Some pharmacies are now being prevented from providing the treatment as they do not have the ability to monitor and manage patients effectively without doctors.
Why get TRT through a Private Clinic?
Private clinics can provide treatment of a higher standard and offer a selection of more effective treatment options including HCG to maintain fertility levels. TRT clinics have a greater selection of treatment options that are usually not available through the NHS, these may include 10ml cypionate vials, 2ml cypionate ampoules, enanthate and HCG as well as creams and gels.
Some clinics are safely able to provide remote consultations. This does still require careful monitoring protocols to ensure you are safe on treatment.
Testosterone test kits
Order an at-home test kit to get started.
What is an Aromatase Inhibitor and do I need one?
An aromatase inhibitor (also known as an AI) is a medication used by men on TRT to reduce the amount of testosterone that is being converted to oestrogen. In men, testosterone is converted into oestrogen by the enzyme aromatase. AIs inhibit this enzyme by binding to it, thus preventing testosterone from binding and being converted into oestrogen.
AIs are best avoided for men if possible as all medications have side effects. However, in some men, they are necessary to maintain a good oestrogen level as reducing the dose and increasing the frequency of injections does not always allow full control of oestrogen levels in some men. This tends to be in men who carry more body fat or who are genetically predisposed to more oestrogen conversion.
Can TRT help build muscles?
Yes, if you have low testosterone levels then your muscle growth will be reduced as testosterone is an important compound for increasing protein synthesis and muscle growth.
When men go through puberty they develop more muscle mass. Testosterone is also used by bodybuilders to increase muscle mass. It is now a widely accepted fact that testosterone helps with muscle mass and therefore strength development.
In one study, men who were on testosterone developed more muscle not training than men who trained but without testosterone.
This is especially important for older men who are more likely to suffer serious injuries or death from frailty. Frailty is one of the biggest indirect killers of men and women. Older men are much more likely to have low testosterone which in turn can reduce their muscle strength.
Muscle strength is indirectly correlated with the chance of falls and fractures in the elderly population.
Testosterone injections have been shown to be more effective at assisting muscle growth than gel forms of TRT.
Many of our patients have seen large increases in muscle mass after starting TRT. Below is one of our patient’s transformations over the first 10 months on TRT.
Further information on this subject is available in our article ‘Does TRT build muscle’.
Can TRT help with anti-ageing?
Yes, it can. New research from an Australian study of 2913 men shows that men with higher levels of oestradiol (which is produced from testosterone in men) had longer telomeres which can lead to an increased life span.
They also found that higher SHBG (sex hormone-binding globulin) levels reduced telomere length. Testosterone reduces SHBG levels so it may also increase telomere length indirectly.
Anti-ageing is now big business with new compounds and treatments becoming available by the day. TRT is often used by Longevity or Anti-ageing companies in the US.
Testosterone is used alongside Human Growth Hormone (HGH) to improve general health and energy levels.
Many of our patients see improved energy, less stress, less anxiety and more vitality on TRT which can lead to better lifestyle choices and healthier living through exercise and improved mood.
Is TRT linked to prostate cancer or prostate issues?
Recent research suggests there is no link between TRT and an increased risk of prostate cancer. However, if you have prostate cancer then extra testosterone may make it worse.
A recent study observing 1,500 patients concluded that higher testosterone levels may even reduce the risk of prostate cancer, and that low testosterone may increase your risk of prostate cancer.
You can read more about this on the Prostate Cancer UK website. However, if you already have prostate cancer then starting TRT is not advised.
Men over 45 require a clear prostate exam and PSA blood test reviewed by our doctors before starting TRT in the UK as there is some evidence that higher testosterone levels can increase the growth of prostate cancers which are already there.
When men start TRT there is a phenomenon that may result in a raised PSA (prostate specific antigen) – this usually reduces within a few months of starting.
If the dose is too high and too much testosterone is converted into DHT, then some men may get Benign Prostatic Hypertrophy – growth of the prostate which isn’t linked to cancer. This can cause some issues with urination. It is usually treatable and improves with a reduced dose.
Will TRT make my testicles shrink/atrophy?
Increasing the amount of testosterone in the body from outside sources, for example through Testosterone Replacement Therapy, can cause the testicles to shrink in size by up to 75%.
Luckily, medications like HCG (Human Chorionic Gonadotropin) can be used to effectively improve testicle size back to normal whilst stimulating further production of your natural testosterone levels.
Many men also notice improvements in mood when starting HCG as it maintains a downstream of other hormones such as pregnenolone and progesterone which are important for wellbeing, anxiety and libido.
Will TRT make me infertile?
The addition of exogenous (not from the body’s natural production) testosterone can reduce sperm production in men.
Can I maintain fertility on TRT?
Traditionally this meant that TRT could only be used by men who weren’t interested in fertility, or who were suffering so much that they had no choice but to be infertile for life. Luckily some privates clinics have access to TRT programs which include medications to stimulate the natural production of sperm by the testes.
The medication which some doctors recommend to maintain the fertility of TRT patients is called HCG, and has been shown to improve fertility in men. HCG is used in women to improve their fertility when undergoing IVF to increase their chances of pregnancy.
It is used in smaller, more frequent doses in men to improve their testicular function. The byproduct of this is that the testicles remain a normal size and continue to produce testosterone in most men.
This can add to the testosterone levels from TRT and also allows the production of other hormones which are usually ‘knocked out’ by exogenous testosterone use.
HCG should be used by almost all men on TRT.
Our medical director Dr Chris Airey encourages all men to use this medication alongside TRT as it improves fertility, maintains testicular function and stimulates other hormonal pathways important for well-being in men.
If you are concerned about your fertility levels then a sperm count test is recommended before starting TRT.
You can read more on TRT and fertility and look at fertility testing options.
Does TRT cause hair loss?
TRT can increase levels of DHT in the body. DHT is known to bind to hair follicles in certain areas of the scalp and cause them to miniaturise. This can lead to hair loss known as androgenic allopecia.
Luckily, there are treatment options to reduce and reverse this type of hair loss by the use of DHT blockers. Whilst some DHT blockers (finasteride) have been linked to negative side effects, we can offer a topical solution that reduces the likelihood of side effects by limiting the DHT blocking effects to the scalp only.
To apply for this treatment you can complete this form.
To read more about hair loss on TRT see our article on side effects.
Can TRT help grow my facial hair/beard?
In puberty, the increase in testosterone levels initiates facial and body hair growth. Many men notice an increase in body and facial hair when they start TRT, especially if they had poor growth before they started.
Can TRT help with ED (Erectile dysfunction)?
However, some men will also need help from a PDE-5 inhibitor such as sildenafil (Viagra) or tadalafil (Cialis).
TRT is especially effective for ED if the ED is caused primarily by low sex drive (libido).
Can TRT help with fatigue?
Many men with low testosterone experience fatigue that is improved drastically when they start TRT (testosterone replacement therapy). Normal testosterone levels improve sleep quality and general energy levels. TRT also helps men to deal with stress more effectively and reduces the impact of raised cortisol levels.
Can I take TRT with other medications?
In most cases, TRT will not impact any other medications you are taking. However, it is always important to tell your doctor about all medications and conditions before starting TRT as you may not be aware of some contraindications or interactions that could occur between them.
Can TRT help with Anxiety?
Testosterone is known to improve symptoms of anxiety and depression. Having low testosterone is often a cause of anxiety, this can be exacerbated further if high oestrogen levels are involved.
Balancing testosterone and oestrogen levels in our patients often results in dramatic improvements to anxiety symptoms, with many patients noticing huge improvements and coming off anti-depressant medications.
Is TRT for life?
In most cases, men will take TRT for life. This is because it has great benefits to symptom relief, longevity, vitality and health.
Occasionally men may develop another condition which means that TRT should be stopped either temporarily or permanently. Others may not be able to get rid of certain side effects and decide not to continue treatment. Often these same men will return as they realise the low testosterone symptoms were worse than the side effect they had.
By taking TRT with HCG alongside it, men are more able to stop TRT if they have health or other issues which force it.
This means that natural testosterone production remains and men aren’t left with no ability to produce testosterone after stopping treatment.
What happens if I stop TRT? What happens if I need to come off TRT?
If you need to stop TRT, for whatever reason, then our doctors can support you to make the process as easy as possible. It is worth noting that your previous symptoms from low testosterone will return, as TRT needs to be continued to maintain its benefits.
However, by using a combination of medications, our doctors can increase the likelihood of allowing you to return to your pre-treatment testosterone levels. This is done by stimulating your natural testosterone production to reduce the period of time where your natural testosterone levels are suppressed. Additionally, the use of HCG on treatment maintains your natural production so that the testicles remain active and able to produce testosterone.
Can I 'Cycle' on and off TRT?
Can I cycle TRT?
No, it isn’t advisable.
Testosterone replacement therapy is meant to replace your low natural production so that you have high normal levels to relieve your symptoms.
It isn’t effective if you stop and start TRT. If you ‘cycle off’ (a term used by AAS users to describe the way they take steroids on and off for short ‘cycles’ of a few weeks) TRT then your levels will drop down to below what they were whilst they recover back to pre-TRT levels. This causes a see-saw in symptoms.
This leaves men with low testosterone and a return of symptoms. Levels do not stay at the same point whilst off TRT and you do not keep the symptomatic relief.
Unlike ‘cycles’ of AAS which are used to increase muscle mass with large doses, TRT is meant to be used long-term to reduce symptoms by bringing testosterone levels to the top of the normal range and avoid side effects.
Testosterone replacement therapy in the UK is a growing area of interest for many men. Whilst the UK has been behind other countries in providing this treatment, it is now starting to bring more modern treatment approaches to the UK through private clinics.
TRT is a long term treatment that requires careful consideration before starting. Other potential causes should be identified and treated before treatment is considered. There are some risks to testosterone replacement therapy, especially if the treatment is not carefully monitored and managed by a specialist doctor.
TRT is an extremely effective treatment for many men and can improve a man’s quality of life exponentially, if you think that low testosterone is an issue for you then a testosterone blood test is the best first step to diagnosing this condition.
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8 minute read
Published: September 27th, 2020
Last updated: January 17th, 2022
This resource has been medically reviewed for accuracy by Dr Chris Airey.
Dr Chris Airey is a specialist in TRT, with a Masters in Endocrinology and appearances on BBC Radio, UK Health Radio and in the well-known Mr Porter magazine, where he has advised on this treatment.
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