Overview
Testosterone deficiency (hypogonadism) can be primary (testicular) or secondary (pituitary or hypothalamic). Symptoms are non-specific, so diagnosis requires consistent symptoms plus two morning fasting total testosterone levels taken on separate days.
Obesity, sleep apnoea, opioid use, chronic illness and some medications lower testosterone and are often reversible, so these are addressed before considering lifelong replacement therapy.
When to seek urgent medical help
- • Visual field loss, severe headaches or milk discharge (possible pituitary problem)
- • Fertility concerns - standard TRT suppresses sperm production
- • Known prostate cancer, very high haematocrit or severe untreated sleep apnoea
Symptoms and signs
- Persistent fatigue and reduced energy
- Low libido and reduced spontaneous erections
- Loss of muscle mass and increased central body fat
- Low mood, irritability or poor concentration
- Reduced body hair, small testes or breast tenderness
- Poor sleep, hot flushes or reduced exercise tolerance
Management and treatment
Diagnosis comes first: morning testosterone, LH, FSH, prolactin, SHBG, full blood count, PSA where appropriate and thyroid and iron studies. Treatment is only started when levels confirm deficiency.
Your ChatDoc doctor reviews your symptoms, advises the exact blood tests required, interprets results and sets out a monitored treatment plan including the safety checks needed on therapy.
Prescription treatment options
Testosterone gel
Daily transdermal treatment with stable levels and easy dose adjustment.
Testosterone injections
Long-acting undecanoate or shorter-acting esters given at defined intervals.
Treating reversible causes
Weight reduction, sleep apnoea treatment and medication review can restore levels without TRT.
Monitoring programme
Repeat testosterone, haematocrit, PSA and symptom review at 3, 6 and 12 months.
Any prescription is issued only after a doctor has reviewed your case and considers the treatment safe and appropriate for you.
Your online Testosterone Replacement Therapy assessment
- 1
Tell us about your concern
Share symptoms, past treatments, medicines and relevant health information.
- 2
Upload clear photos
Upload photos of your concern where applicable.
- 3
Doctor reviews your case
Technology helps organise your answers, but every assessment and prescription decision is made by a doctor, who may message you if they need more information.
- 4
Get your personalised plan
A personalised prescription is issued if treatment is clinically appropriate.
Prognosis and outlook
Libido and mood often improve within 3-6 weeks, energy and body composition over 3-6 months, and bone density over a year or more.
TRT is usually long term. Regular monitoring keeps it safe, and fertility-preserving alternatives exist for men planning to conceive.
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£24.99
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One payment. No subscription. Any prescription depends on clinical suitability.
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This page is general medical information and does not replace a personal consultation. Always seek urgent care for severe or rapidly worsening symptoms. ChatDoc is not an emergency service. Call 999 (UK) or 112 (EU) for life-threatening emergencies or 111 for urgent non-emergency help. Do not wait for an online reply.