Testosterone Replacement Therapy Consultations
Testosterone Optimisation Gives You The Foundations Necessary To Achieve Your Full Potential
Testosterone Optimisation Gives You The Foundations Necessary To Achieve Your Full Potential
Testosterone Deficiency or Male Hypogonadism is a recognised medical condition. There are three types:
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.
In our clinic, the commonest presenting symptoms of low testosterone include:-
Our patients have often resisted this and sought out the actual diagnosis – LOW TESTOSTERONE.
Other symptoms include:-
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.
Our preferred treatment option is a single ester testosterone, such as Testosterone Cypionate or Testosterone Enanthate, alongside Human Chorionic Gonadotropin (HCG). The single short-acting ester attached to the testosterone makes controlling both testosterone and oestradiol levels easier as there is a linear increase with an increase in dose. We do not use Sustanon, a blend of four esters, as the likely 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? The perceived intensive injection frequency necessary to achieve stable male androgen levels using Testosterone Cypionate or Enanthate may not suit everyone, so we do offer alternate testosterone preparations, outlined on the page You TRT Options.
We believe Human Chorionic Gonadotropin to be a fundamental component to restoring hormonal balance, as it 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. We consider TRT to be Hormone Replacement Therapy.
Optimising your testosterone level at our TRT clinic isn’t about chasing numbers, its actually about you and how you feel, rather than a quantitive number. Dr Stevens, our specialist TRT doctor, will work with you to help you find that perfect TRT protocol for your individual needs. 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 Testosterone Replacement Therapy 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!
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 our clinic speaks volumes. It’s about changing the philosophy of testosterone 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.
Your initial appointment involves a face-to-face consultation with your clinician 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 you give us, the more we can potentially assist you. We will also conduct a physical examination as part of this consultation.
Your bloods will then be taken to look at the quantitative blood markers necessary for initiating Testosterone Replacement Therapy. This would be either the ‘TRT Complete’ or ‘TRT Complete Plus’ blood panel (detailed below). Both tests give us a comprehensive analysis of your blood, so that a diagnosis can be made and other possible causes excluded. If this is the first diagnostic blood test you’ve had to assess your hormonal status, you would need a SECOND confirmatory Total Testosterone test, ideally four weeks later, to confirm the diagnosis. 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.
At the end of your consultation (Dorset Clinic Only) you will have the opportunity to use our InBody 770 medical grade bioelectrical impedance scanner. This allows us to record and track data relating to your physical health, as well as providing you with a benchmark to work from. Repeat scanning would also form part of your annual face to face follow up consultations.
At this consultation your clinician will review your blood results with you and commence treatment as agreed. Where appropriate this will include going over safe preparation of your medications and, if you will be self-injecting, gently guiding you through safe and correct injection technique so that you leave the consultation room with confidence, ready to embark on your journey.
We are always happy to support you in approaching your GP to have your ongoing blood tests and medications organised under the NHS where possible. A letter requesting shared-care with your GP can be issued at the end of your consultation if required.
Please allow up to 30 minutes for this appointment.
This is essentially both the 60-minute ‘New Patient’ consultation and 30-minute ‘Commence Treatment’ consultations detailed above, combined into one extended appointment.
This is suitable for patients already on TRT, who are wishing to transfer their care from the NHS or another private clinic or provider. If you are transferring your care over to us, you will need to bring along your original diagnostic blood test results and/or clinical correspondence confirming your deficiency to your appointment. If you do not have up to date blood results, we can organise them for you prior to your appointment, or they can be taken during your consultation. Both the ‘TRT Complete’ or ‘TRT Complete Plus’ blood panels are suitable options (detailed below).
This 90-minute consultation may also be suitable for patients living much further afield, for whom two successive visits to clinic would be impractical. In this instance, you will need to already have confirmed testosterone deficiency, as demonstrated by two separate diagnostic blood tests.
At the end of your consultation (Dorset Clinic Only) you will have the opportunity to use our InBody 770 medical grade bioelectrical impedance scanner. This allows us to record and track data relating to your physical health, as well as providing you with a benchmark to work from. Repeat scanning will also form part of your annual face to face follow up consultations.
We are always happy to support you in approaching your GP to have your ongoing blood tests and medications organised under the NHS where possible. A letter requesting shared-care with your GP can be issued at the end of your consultation if required.
Four weeks after starting treatment you will have a blood test to see how your body is responding to therapy (these can be organised through clinic if required, further information can be found here). Once you have your results, you will then need to schedule a A 15-minute Telephone Consultation with your clinician to review your results, discuss how therapy is going and for any adjustments to be made to your starting protocol if necessary.
Telephone consultations can also be booked between routine follow-ups if you wish to discuss your treatment plan with your clinician over the phone, rather than via email.
Please allow up to 15 minutes for this appointment.
Your first formal follow up consultation is usually 10-11 weeks after commencing treatment. For this consultation up you have the option of attending clinic and having your 10-week blood test drawn as part of the appointment or, if more convenient, you may have this consultation conducted via Skype after you’ve made the necessary arrangements to have your bloods drawn (further information on how we can help you with this can be found here).
This consultation will be an opportunity to discuss your well-being and any side effects that you may be experiencing. Your clinician will then correlate this information with your blood results to see where your hormone levels are now that you are stable. Your standard three month medications/prescriptions will also be issued following this appointment.
You will then be followed up just once every six months, with up to date blood results. Again, your clinician will review your current protocol, discuss any health concerns that you might have and formulate an on-going action plan so that we can continue to safely and effectively prescribe your TRT.
PLEASE NOTE – All patients MUST have a face to face consultation in clinic at least once every 12 months, so that a physical examination can be carried out as appropriate. This is non-negotiable as it promotes safe and effective practice.
Once every 12 months you would also have another opportunity to use our InBody 770 body composition scannerso that we can continue to track and record data relating to your on-going physical health.
For all video consultations, you have the option of either a 15-minute or 30-minute consultation. If everything is going well with nothing to report, you are welcome to opt for a 15-minute appointment, otherwise please book a 30-minute appointment.
Please allow up to 30 minutes for all appointments conducted in clinic.
This gold standard blood test encompasses all of the necessary blood investigations required to make a formal diagnosis of testosterone deficiency. It also includes additional parameters to help identify any potential reversible causes of low testosterone, including vitamin deficiencies, and gives you a more complete picture of your general health.
Test Includes:
This comprehensive blood test encompasses all of the investigations required to make a preliminary diagnosis of testosterone deficiency. It also looks at other health parameters to help identify any potential reversible causes of low testosterone, and gives you a more complete picture of your general health.
Test Includes:
This blood test includes all of the necessary blood investigations for routine monitoring whilst on testosterone replacement therapy, so that you and your clinician can be confident that your treatment is continuing to be prescribed safely and effectively.
Test Includes:
This test identifies what physiological effect your recent TRT protocol change has had on your most important hormone levels. Dr Stevens will take these into consideration alongside your current symptoms.
Test Includes:
This blood test measures the amount of Prostate Specific Antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It is normal to have a small amount of PSA in your blood, and the amount rises slightly as you get older and your prostate gets bigger. A raised PSA level may suggest you have a problem with your prostate, but this does not necessarily mean cancer. All abnormal results should be discussed with your doctor.
Dihydrotestosterone (DHT) is one of your bioavailable male androgens. Testosterone is converted to DHT by the enzyme 5-alpha reductase which is located in the testes and prostate. DHT has effects on brain function (including libido), muscle growth and repair, and prostate health.
Dehydroepiandrosterone (DHEA) is a hormone produced from cholesterol by the adrenal glands, which your body converts into testosterone and oestrogen. It affects many areas of health and wellbeing. Most of the DHEA in the body exists in the blood in the sulphated form, DHEA-S, which is what this test measures.
Pregnenolone is a chemical substance produced in your body from cholesterol, and is a precursor to all steroid hormones. This test measures the amount of pregnenolone in the blood.
Pregnenolone is considered the father hormone, with Progesterone being one of the important hormones involved in that pathway to testosterone, cortisol and aldosterone. Healthy levels are necessary for sleep and stress reduction.
Cortisol plays a role in metabolism and is the main hormone involved in stress and the fight-or-flight response. Disorders of the adrenal glands can cause the over or underproduction of stress hormones which can cause symptoms such as excessive fatigue, anxiety, insomnia and weight gain. This test measures whether your cortisol production levels are too high or too low, which could be having a negative impact on your sense of well-being.
Thyroid Function Tests include:
Thyroid Function Tests include:
Thyroid Function Tests include:
Speak to our team, book online or email us with any questions that you may have.
