Conditions & services
Men's health and low testosterone
Low testosterone (hypogonadism) causes low libido, reduced morning erections, tiredness and low mood. It is worth investigating properly, because the cause matters as much as the level. It is also over-diagnosed: testosterone varies through the day and from day to day, and a single low result is often normal when repeated.
What the assessment may involve
- Testosterone, usually measured early in the morning and repeated before a diagnosis is made
- LH and FSH, to tell a problem in the testes from one in the pituitary
- Prolactin, iron studies and, where indicated, a pituitary scan
- Looking for reversible causes: excess weight, type 2 diabetes, sleep apnoea, some medicines including opioids, and previous anabolic steroid use. After anabolic steroids the body's own production can take many months to recover, sometimes longer, and an assessment can follow that recovery
Fertility
Testosterone treatment suppresses sperm production, often severely, and recovery after stopping can take many months. If you want children now or in the future, that changes the choice of treatment, and it needs discussing before anything is started.
Treatment
Where a deficiency is confirmed and treatment is clinically appropriate, it is started with a plan for monitoring. Testosterone is not prescribed on request, or for sport, body-building or anti-ageing.
If you would like a specialist opinion, you are welcome to get in touch. If you are paying for yourself, you can refer yourself; a GP letter isn't needed, though recent results and a list of your medicines help. If you plan to use private medical insurance, check with your insurer first, as it may ask for a GP referral.
Sources:
- British Society for Sexual Medicine guidelines on male adult testosterone deficiency. World J Mens Health 2023
- den Heijer M. Endocrine and fertility implications after anabolic steroids. Endocrine Society, Endocrine Case Management 2026