TRT on the NHS vs Private

TRT on the NHS vs private

TRT on the NHS vs Private – Getting TRT in the UK

Anyone experiencing the symptoms of low testosterone has two legal options for securing treatment. You can either get TRT on the NHS or via a private health clinic. Unfortunately, the former is not straightforward and deprives many individuals in need of testosterone replacement therapy access to treatment. Therefore, private TRT UK health clinics are a better option for many people. 

Here we look at the differences between getting TRT on the NHS vs private sector in detail. We also discuss the problem with securing testosterone replacement therapy on the NHS, and why getting TRT privately might be the solution you’re looking for

How to Get Testosterone Replacement Therapy in the UK

In the UK, testosterone can only be sold with a prescription from a qualified doctor. Therefore, the most common route for people to get TRT is via the National Health Service and in-person consultation with a qualified doctor. Alternatively, private healthcare providers offer testosterone therapy either in-person or online following a remote online consultation.

How Do I Get TRT on the NHS?

Anyone suffering from the symptoms of low testosterone should visit their local GP and discuss their symptoms. When at the consultation with your doctor, ask for a low testosterone NHS test outright. Even if the signs correlate with low testosterone levels, GPs rarely associate symptoms with this condition. Testosterone insufficiency diagnosis poses challenges within the public healthcare sector and GPs often attribute clinical signs to something other than testosterone deficiency. 

If your doctor agrees to run tests, you will be sent for tests before 9 am when testosterone levels are at their peak. The results from your blood test are assessed to determine whether you qualify for testosterone replacement therapy. This should be based on the current guidelines set by the British Society for Sexual Medicine (BSSM). However, generally, the NHS usually requires testosterone levels to be less than 8nmol/L for men to qualify, which is quite low.

Anyone that qualifies for TRT on the NHS is referred to an endocrinologist to discuss treatment options. Unfortunately, many men report waiting months for a consultation, during which they receive no treatment. The endocrinologist will then perform more testing and look for signs of congenital issues or organic pathology. Where there are no obvious abnormalities, patients are often refused treatment despite qualifying according to BSSM guidelines.

Blood Test

Testosterone test kits

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How Do I Get Private TRT UK?

The major difference between getting TRT on the NHS vs private healthcare sector is simplicity. Private health clinics such as Optimale offer remote consultations across the UK for men with low testosterone symptoms, saving you time taken to visit your GP. You can order a low testosterone blood test online, take it in your own time from home, and return it to the clinic in the post. 

Once received, your samples are sent to the laboratory for analysis. A qualified doctor will call you to discuss your test results, clinical symptoms, and treatment options to find a solution that works for you. Anyone with low testosterone levels in two or more of their blood tests receives access to personalised testosterone treatment. You will be issued an online prescription and can purchase TRT immediately via our pharmacy which will be delivered directly to your door. 

Problems with Getting TRT on the NHS

From the process of obtaining treatment alone, you can already see some of the issues with TRT on the NHS vs private sector. The NHS does provide an excellent standard of care in many situations, but there are obvious flaws in giving men access to the treatment they need. Here is a closer look at some of the current issues with getting testosterone replacement therapy on the NHS.

Considers Blood Testosterone Levels Only

Unless there is a clear organic pathology – in other words, a physical or biochemical abnormality that is responsible for low testosterone – the NHS only offers therapy to people with testosterone levels below 8nmol/L. Many clinical signs are seen at higher levels, with increased reports of diabetes and depression at 10nmol/L, obesity at 12nmol/L, and reduced vigour at 15nmol/L. This means many patients receive no treatment for these symptoms. 

Additionally, the primary low testosterone NHS test looks solely at total testosterone (TT) rather than calculated free testosterone (cFT). Total testosterone is a good first indicator when checking for androgen deficiency. Yet according to research, some older men or those with poor health have been found to have low cFT despite their TT levels falling within the normal range. This could leave some people with low testosterone undiagnosed despite clear clinical signs.

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General Lack of Knowledge of TRT

Anyone seeking TRT on the NHS has to initially see a GP before being referred to a specialist. But according to this study, there is a lack of sufficient knowledge of testosterone replacement therapy among general practitioners in the UK. The results found that guidelines for diagnosis and testing for low testosterone were not being followed uniformly. 

This adds to the challenges of getting testosterone replacement therapy on the NHS and often causes misdiagnosis. For example, depression is a common symptom among men with testosterone levels below 10nmol/L. Rather than attributing this symptom to low testosterone, GPs might diagnose the patient with clinical depression and prescribe antidepressants rather than offering hormonal solutions.

Even after successful diagnosis and TRT treatment, the monitoring of patients fell below standards. The effectiveness of treatment therefore may not be as successful. This is partially at the fault of the GPs and improved education on TRT is essential. However, this is also an integral problem with the centralised system of the National Health Service. You must go through a GP before you can speak to an endocrinologist with specialised knowledge of hormonal insufficiencies and treatment.

Long-Winded Diagnosis & Referral Process

A lack of testosterone can have serious long-term effects on the body. One study in the Journal of Clinical Endocrinology and Metabolism linked low testosterone with higher mortality rates among older men. The risk of osteoporosis is also increased in men with low testosterone. Sexual dysfunction and low libido impact long-term relationships, while low testosterone levels might be linked with suicidal behavior in older men

Despite these serious health consequences, there is no urgency in treating low testosterone via the NHS. Indeed, regardless of clear BSSM guidelines and symptoms, GPs cannot legally prescribe testosterone replacement therapy. People suffering from symptoms often wait months after their initial appointment to be referred to an endocrinologist. The maximum waiting time for non-urgent referrals in the NHS is an astonishing 18 weeks, but many people are left waiting longer.

This is a huge limitation when getting TRT on the NHS vs private sector, yet there is arguably no need for this wait. Hormone replacement therapy for the treatment of menopause that contains oestrogen and progesterone or oestrogen alone can be prescribed within the primary care setting. Yet testosterone deficiency is not treated at the same primary level. Until guidelines change that enables GPs to prescribe TRT, there is no way to bypass this wait time.

Limited Effectiveness of TRT on the NHS

The testosterone medications available on the NHS are limited. Most clinicians will initially trial the effectiveness of low-cost treatments such as Testogel, Tostran, or Testavan. These are three topical testosterone gel treatments that are applied directly to the skin. They are shown to be effective and are simple to use, but gels frequently have absorption issues in men, especially with long-term use.

Testosterone Undecanoate (brand name Nebido) is an alternative option for TRT on the NHS. This is an injectable given intramuscularly every 12 weeks. However, there are fluctuations in testosterone levels following this commonly prescribed dosage model. Sustanon is another injectable TRT on the NHS that is given every three weeks. The fluctuations in testosterone with this medication are even more significant, thus limiting the effectiveness of the treatment.

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ADAM Questionnaire

Low Testosterone Test

The ADAM questionnaire has been shown to have 88% sensitivity in testing for low testosterone.

Limitations to Availability of TRT medications

Certain treatments are unavailable on the NHS entirely. One example is human chorionic gonadotrophin (hCG). In men, hCG acts as an analogue of luteinising hormone (LH). This hormone naturally stimulates the production of testosterone, therefore hCG has the same effect. It helps men increase their testosterone levels while effectively treating the hypogonadal symptoms and maintaining fertility with no adverse effects.

Aromatase inhibitors (AIs) are also unavailable on the NHS. These drugs lower oestrogen levels by stopping the conversion of other hormones into oestrogen. They are useful in some TRT patients with high oestrogen levels as they correct the hormone imbalance to improve fertility. However, NHS doctors cannot provide AIs – they are only available privately.

The Solution: Private TRT UK

The National Health Service is undeniably a huge asset to our country. Within the public healthcare sector, some exceptional GPs and endocrinologists can help people with low testosterone gain access to the treatment they need. Moreover, the primary benefit of TRT on the NHS vs private healthcare sector is cost. Your initial consultation can be accessed for free and you only pay a small amount to cover the cost of your prescription.

However, getting TRT on the NHS can be a lengthy and often unsuccessful process. Fortunately, private health clinics such as Optimale provide the solution. We offer a convenient and discrete way for you to purchase testosterone online and start therapy quickly. By going with a private healthcare company, you can:

  • Bypass the need to wait months to see an endocrinologist
  • Have a remote consultation from the comfort of your own home
  • Speak to a specialist in low testosterone and male hypogonadism
  • Gain access to a wider range of more effective treatment options
  • Gain access to off-license medications such as hCG and AIs
  • Get personalised medication tailored to your condition and lifestyle
  • Receive your TRT quickly and discreetly direct to your door
  • Get ongoing support to ensure your treatment remains effective

If you want to avoid the wait and gain access to effective TRT fast, your first step is to order your blood test online. Complete the tests and speak with our specialist UK clinicians over the phone. If you qualify, we offer personalised prescriptions and ongoing support throughout your TRT journey.

For any other questions, visit our FAQ section or get in touch with the Optimale team.

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