TRT Consultation

Testosterone Optimisation Gives you the Foundations Necessary to Achieve Your Full Potential

TRT Consultations

Let us Support You in Achieving

Hormonal Balance and Stability


 

Testosterone Deficiency Syndrome

Testosterone Deficiency Syndrome (TDS) or Male Hypogonadism is a recognised medical condition. There are three types:-

  • Primary Hypogonadism – Where you have an issue with your testes.
  • Secondary Hypogonadism – Where you have an issue with your hypothalamus and/or pituitary.
  • Mixed Hypogonadism – Where there is an issue with both.

It is important to establish a diagnosis so that not only can a possible reversible cause be identified, but also so that your personalised management protocol can be tailored to you.

Testosterone levels decline with age.  This serves a biological function, making way for future generations. Low testosterone however, is bad for your health.  Optimising your testosterone levels decreases your susceptibility to chronic diseases.

In this modern ‘civilised’ world we are living longer, but are we living better? Advances in modern medicine have had an impact on both our quality and quantity of life.  It is a rather peculiar situation to ignore optimising hormonal balance, when it serves as one of the core fundamentals in sustained health.

The impact of this modern life and living environment on testosterone levels is not to be ignored.  Average testosterone levels are dropping at an alarming rate as we become more civilised. Our DNA hasn’t changed, so the decline can only be attributed to our lifestyles.

 

Common Symptoms

In our clinic, the commonest presenting symptoms of low testosterone include:-

  • Loss of libido and/or erectile dysfunction.  The NHS solution?  A little blue pill.
  • Low mood, anxiety, depersonalisation.  The NHS solution?  Antidepressants.

Our patients have often resisted this and sought out the actual diagnosis – LOW TESTOSTERONE.

Other symptoms include:-

  • ‘Brain fog’, loss of motivation and drive.
  • Fatigue, loss of strength, poor recovery after exercise.
  • Weight gain and increased visceral fat distribution.

Symptoms can also include night sweats, increased insulin resistance and loss of bone mineral density (osteoporosis).

Our patients often confess to not feeling like their old selves anymore, and are desperate to feel ‘normal’ again.  Testosterone Replacement Therapy (TRT) isn’t about making you super-human, it’s about restoring you to your former self.  It’s about giving you the ability to take that leap over the invisible barrier that exists when your testosterone level is low.

 

Treatment

Our gold standard treatment is Testosterone Enanthate and Human Chorionic Gonadotropin (HCG).  The single short-acting ester attached to the testosterone makes controlling both testosterone and oestradiol levels easy as there is a linear increase with an increase in dose.  We do not use Sustanon, a blend of four esters, as the inevitable peaks and troughs often mean an aromatase inhibitor is needed to control oestrogen.  Why complicate matters with artificial chemicals that can have a negative impact?  Surely, it’s better to finely titrate your levels according to your genetics and physiology?

HCG is a fundamental component to restoring hormonal balance, it perfectly mimics Lutenising Hormone (LH).  Not only is it important for retaining fertility and testicular size, there are LH receptors in the brain that convey a qualitative improvement compared to testosterone only TRT protocols.  HCG also up-regulates other hormones in the cascade down from Pregnenolone.  Ignore it at your peril, anybody claiming that HCG is not important in TRT displays a fundamental lack of understanding in hormone optimisation and restoring hormonal balance within the body.

 

Our Philosophy

Optimising your testosterone level with TRT isn’t about chasing numbers, its actually about you and how you feel, rather than a quantitive number.  We will work with you to help you find that perfect TRT protocol.  It’s about relinquishing a little control in order to gain it back, it’s about placing your trust in your TRT Doctor.  Let us be the doctor and you be the patient.  We want TRT to be routine, we don’t want it to consume you because it really doesn’t need to.  We want you to get on with living your life!

 

Our Patients

We are very proud of what a positive impact The Men’s Health Clinic has had on our patients’ well-being.  I think our testimonials and the continued growth of the clinic speaks volumes.  It’s about changing the philosophy of optimisation, it’s about increasing understanding and awareness, it’s about applying common sense to attaining and sustaining health.

Let us help you be you again…

 

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New Patient TRT Consultation

(60 Minutes)

Your initial appointment involves a face-to-face consultation with Dr Stevens where he can review your symptoms, conduct a thorough physical examination and assess your overall suitability for Testosterone Replacement Therapy.

This will include a review of what symptoms and signs are of most importance to you, and whether or not these are likely to be attributable to low testosterone, or potentially another cause that may also need to be addressed.  A review of the quantitative and qualitative screening questionnaires issued prior to your appointment act as a good starting point for you to identify what matters most to you.

It is important to look at your past medical history, current/past significant conditions, illnesses and operations that may be influencing your current state of health.  An in-depth look at current and past medication usage may give an indication of what is going on, and whether alterations to these may influence the decisions we make in your care.

Your social history is also taken into consideration, including any past drug usage, as this can often provide a useful insight into your current testosterone level. The information you give is in complete confidence so the more information Dr Stevens has, the more he can potentially assist you.

Your bloods will then be taken to look at the quantitative blood markers necessary for initiating Testosterone Replacement Therapy.  The ‘VIP Male Health Package’ blood test (as detailed below) is the preferred option for this as it gives us a comprehensive analysis of your blood, so that a diagnosis can be made and other possible causes excluded.  If you have had previous blood tests and/or investigations carried out, please bring hard copies of these with you so that they can be taken into consideration.

 

Consultation Price:  £220 + Blood Tests

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New Patient TRT Consultation

(90 Minutes)

This is effectively the 60-minute ‘New Patient’ consultation, plus FIRST 30-minute ‘Follow Up’ consultation (usually one week later) combined.

Suitable for patients already on TRT, wishing to transfer their care from another provider.  If you are transferring your care over to us, you will need up to date blood results which include testosterone, oestradiol, prolactin and SHBG, before booking your consultation.

This 90-minute consultation may also be suitable for patients living much further afield, for whom frequent visits to our clinic are impractical.  In this instance, you will need to already have confirmed Testosterone Deficiency Syndrome (TDS), as demonstrated by recent blood tests.  For a diagnosis of TDS, you will need the following blood results at a bare minimum – FSH, LH, Prolactin, Testosterone, Oestradiol, SHBG, FBC and PSA.

 

Consultation Price:  £340

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Follow Up TRT Consultation

(30 Minutes)

Your first follow up consultation is usually one week after your initial 60-minute ‘New Patient’ consultation, where we will review your blood test results and commence treatment as appropriate.

You will be reviewed again four weeks after commencing treatment (with additional blood investigations as appropriate) to see how you are responding to TRT.

You are then reviewed just once every six months to monitor your continued response to treatment and to discuss any symptoms.  This process ensures that both you and Dr Stevens are happy with your on-going management plan, making any adjustments as necessary for continued safe and effective prescribing of Testosterone Replacement Therapy.

You should allow up to 30 minutes for this consultation.

 

Consultation Price:  £120 + Blood Tests

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Skype Follow Up TRT Consultation

(30 Minutes)

Dr Stevens will always prefer a more personalised approach to your care, but he does appreciate that the logistics of travelling long distances may sometimes be impractical.

We therefore offer Skype follow-up consultations to all EXISTING patients, however, we do still insist on a once yearly face-to-face consultation back in clinic.

Please note that all NEW PATIENT Consultations are carried out face-to-face in clinic, this is non-negotiable.

 

Consultation Price:  £120

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Blood Tests

 

VIP Male Health Package

A thorough complement of blood investigations specifically chosen to cover men’s health issues and metabolic markers important in general health.  These blood tests are suitable for men wanting a general health screen, or diagnosing & monitoring conditions such as Testosterone Deficiency Syndrome, libido issues, erectile dysfunction and premature ejaculation.

This comprehensive hormonal profile looks at the hypothalamic pituitary gonadal (HPG) axis including Lutenising Hormone (LH) and Follicle Stimulating Hormone (FSH), however it also calculates the amount of usable testosterone there is within the body, measured as the Free Androgen Index.  It calculates other hormonal markers important in men’s health, such as Sex Hormone Binding Globulin (SHBG) which binds to Testosterone making it unusable. Prolactin is also important in the diagnostic work up of Testosterone Deficiency Syndrome as well as its role in sexual function.

It is important to measure your Prostate Specific Antigen (PSA), Full Blood Count (FBC) to ensure they are within normal limits. The VIP Male Health Package also looks at other metabolic markers such as your HbA1C, a measure of your glycolated haemoglobin, useful in diagnosing diabetes; your lipid & cholesterol profile which is an important marker of cardiovascular health, your liver (LFT) and kidney health (U+E) and your thyroid function (TFT), another important hormone needed for overall health.

Package includes:- Total Testosterone / Free Androgen Index / Follicle Stimulating Hormone / Lutenising Hormone / Sex Hormone Binding Globulin / Prolactin / Oestradiol / Full Blood Count / Prostate Specific Antigen / Urea & Electrolytes / Liver Function Tests / HbA1C / Lipids incl. Cholesterol / Thyroid Function Tests.

Price:  £140

 

Sensitive Oestradiol Test

The Men’s Health Clinic also has access to the sensitive oestradiol test. The Liquid Chromatography / Mass Spectometry (LC-MS) test is a more sensitive measure of your oestradiol level.  The standard test tends to over read because the test cannot differentiate between oestradiol and CRP.  This is especially important in men who are having oestrogenic side effects such as water retention, breast swelling, nipple tenderness and loss of libido, alongside their TRT treatment.

Package includes:- Senstive Oestradiol (LC/MS)

Price:  £40

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