Everything you need to know about testosterone replacement therapy, from symptoms and testing to treatment protocols and ongoing monitoring. Expert GP-supervised TRT at Lambert Medical Practice, serving Surbiton, Kingston upon Thames, and across Surrey.
January 2025 | 12 min read | Lambert Medical Practice Clinical Team
Testosterone is often called the "male hormone," though it plays crucial roles in both men and women. For men, testosterone is fundamental to physical health, mental wellbeing, sexual function, and overall quality of life. When testosterone levels decline—whether due to ageing, underlying health conditions, or other factors—the effects can be profound and far-reaching.
At Lambert Medical Practice in Surbiton, we provide comprehensive testosterone assessment and replacement therapy for men across Surrey, Kingston upon Thames, and South-West London. Our approach prioritises thorough diagnosis, evidence-based treatment, and careful ongoing monitoring to ensure both safety and effectiveness.
This guide addresses everything you need to know about TRT: who might benefit, how we diagnose testosterone deficiency, what treatment involves, and why proper medical supervision matters more than ever in an era of online TRT clinics making questionable promises.
Testosterone is a steroid hormone produced primarily in the testes, with smaller amounts from the adrenal glands. It belongs to a class of hormones called androgens and is responsible for the development of male characteristics during puberty and the maintenance of male health throughout life.
Sexual Function and Fertility: Testosterone drives libido (sex drive), supports erectile function, and is essential for sperm production. Men with low testosterone often experience reduced sexual desire and may have difficulty achieving or maintaining erections.
Body Composition: Testosterone promotes muscle protein synthesis, helping build and maintain lean muscle mass. It also influences fat distribution, with adequate testosterone associated with less abdominal fat. Men with low testosterone often notice declining muscle mass despite exercise and increasing body fat, particularly around the midsection.
Bone Health: Testosterone is crucial for maintaining bone mineral density. Low testosterone accelerates bone loss, increasing the risk of osteoporosis and fractures—conditions often considered "female problems" but increasingly recognised in men with hormone deficiency.
Energy and Vitality: Adequate testosterone contributes to energy levels, motivation, and overall sense of vitality. Fatigue is one of the most common complaints among men with testosterone deficiency.
Mental Health and Cognitive Function: Testosterone influences mood, with low levels associated with increased risk of depression, irritability, and anxiety. It also affects cognitive functions including concentration, memory, and mental clarity.
Metabolic Health: Testosterone plays a role in insulin sensitivity and glucose metabolism. Low testosterone is associated with increased risk of metabolic syndrome and type 2 diabetes.
Cardiovascular System: The relationship between testosterone and cardiovascular health is complex, but adequate levels appear important for heart health. Testosterone stimulates red blood cell production, which is why monitoring haematocrit (blood thickness) is essential during TRT.
Testosterone levels naturally peak in early adulthood (late teens to early twenties) and gradually decline thereafter. Most studies suggest testosterone decreases by approximately 1-2% per year after age 30. This is a normal physiological process and doesn't necessarily cause symptoms or require treatment.
However, some men experience more significant declines, and when testosterone falls below certain thresholds—particularly when accompanied by symptoms—treatment may be beneficial. The key distinction is between:
Making this distinction requires careful clinical assessment combined with accurate laboratory testing—something that online TRT providers often fail to do adequately.
Recognising low testosterone can be challenging because symptoms develop gradually and often overlap with other conditions. Many men attribute their symptoms to "just getting older" or stress, delaying assessment for years. If you're experiencing several of the following symptoms, testosterone deficiency may be worth investigating:
These symptoms are non-specific—they can be caused by many conditions besides testosterone deficiency. Depression, sleep apnoea, thyroid disorders, chronic illness, obesity, certain medications, and lifestyle factors can all produce similar symptoms. This is why thorough assessment is essential before assuming low testosterone is the cause.
At Lambert Medical Practice in Surrey, we don't simply test testosterone and prescribe if it's low. We conduct comprehensive assessments to identify the true cause of your symptoms and ensure treatment is appropriate and safe.
Accurate diagnosis of testosterone deficiency requires both clinical assessment AND biochemical confirmation. Neither alone is sufficient. Our diagnostic process in Surbiton includes:
Your assessment begins with a detailed 30-minute consultation where we:
We use venous blood testing (not finger-prick) for accuracy. Tests are performed in the morning (7-11am) when testosterone levels peak, after overnight fasting. Our comprehensive male hormone panel includes:
At your follow-up consultation, we review all results and discuss:
We believe in shared decision-making. You'll have all the information needed to make an informed choice about whether to proceed with treatment.
If testosterone deficiency is confirmed and TRT is appropriate, several treatment options are available. At Lambert Medical Practice, we prescribe evidence-based treatments and help you choose the option that best suits your lifestyle and preferences.
How it works: Clear gel applied daily to shoulders, upper arms, or abdomen. Testosterone absorbs through the skin, providing steady hormone levels.
Advantages:
Considerations:
Common brands: Testogel, Tostran
Testosterone Undecanoate (Nebido): Long-acting injection administered every 10-14 weeks in clinic.
Advantages:
Considerations:
Testosterone Enanthate/Cypionate: Shorter-acting injections typically every 2-3 weeks, can be self-administered.
Testosterone patches: Applied daily, similar to gel but with higher rates of skin reactions. Less commonly used.
Testosterone pellets: Implanted under the skin every 3-6 months. Requires minor procedure. Not commonly used in UK.
Nasal testosterone: Newer option with three-times-daily dosing. Limited availability and experience in UK.
There's no single "best" TRT option—it depends on your preferences, lifestyle, and medical factors. During your consultation at our Surbiton clinic, we discuss the options and help you make an informed choice. Many patients start with gel for its flexibility and switch to injections if they prefer less frequent dosing.
TRT isn't instant—different benefits emerge over different timeframes. Understanding this helps set realistic expectations:
| Timeframe | Expected Changes |
|---|---|
| 2-3 weeks | Initial energy improvements, better sense of wellbeing, improved sleep quality |
| 3-6 weeks | Libido improvements, better sexual function, mood stabilisation, increased motivation |
| 6-12 weeks | Continued sexual function improvements, beginning of body composition changes |
| 3-6 months | Noticeable muscle mass increase (with exercise), fat reduction, improved strength |
| 6-12 months | Maximum body composition benefits, bone density improvements, full metabolic effects |
Individual responses vary. Some men notice improvements quickly; others take longer. If you're not seeing expected benefits, we reassess your treatment and may adjust dosing or formulation.
"The key to successful TRT is patience and proper monitoring. We optimise your treatment based on both how you feel and your blood test results."
TRT is generally safe when prescribed appropriately and monitored correctly. However, it does require ongoing medical supervision—something that distinguishes proper medical care from online TRT mills.
3 months after starting: First follow-up blood tests to check testosterone levels, haematocrit, PSA, and assess symptom response. Dose adjustment if needed.
6 months: Repeat blood tests. By now, treatment should be optimised and stable.
Annually thereafter: Ongoing monitoring including comprehensive blood panel, symptom review, and health assessment.
As needed: Additional appointments if concerns arise or adjustments are required.
Common side effects:
Important risks requiring monitoring:
The rise of online TRT providers has made testosterone more accessible, but often at the cost of proper medical care. Common concerns include:
At Lambert Medical Practice, we take the time to do TRT properly. We only prescribe when genuinely indicated, we use accurate testing, we monitor appropriately, and we provide ongoing care from a GP who knows your full health picture.
If you're considering having children in the future, this is a crucial consideration before starting TRT.
Testosterone replacement suppresses the body's own testosterone production and, importantly, suppresses sperm production. Most men on TRT become functionally infertile while on treatment. For some, this can be prolonged even after stopping TRT, and in rare cases, fertility may not fully recover.
We discuss fertility implications thoroughly during your consultation. If you're unsure about future family planning, this should factor into your treatment decision.
We believe in transparent pricing. Here's what TRT typically costs at our Surbiton clinic:
| Service | Cost |
|---|---|
| Initial consultation (30 minutes) | £150 |
| Comprehensive male hormone blood panel | From £250 |
| Follow-up consultation (20 minutes) | £100 |
| Monitoring blood tests (every 3-6 months) | From £150 |
| Testosterone gel (monthly) | £50-80 |
| Nebido injection (every 10-14 weeks, includes administration) | £250-300 |
First year estimated cost: £1,200-1,800 (including all consultations, testing, and medication)
Ongoing annual cost: £800-1,200 (monitoring and medication)
These costs include proper medical supervision, face-to-face consultations, accurate venous blood testing, comprehensive monitoring, and ongoing relationship with your doctor. While online TRT providers may appear cheaper initially, the value of proper medical care cannot be overstated.
If you're experiencing symptoms of low testosterone and would like to explore whether TRT might help, here's how to proceed:
TRT is often part of a broader approach to men's health optimisation. Related services that may complement your treatment include:
Have questions about this topic? Speak to one of our experienced GPs.
Book Appointment 0208 133 5694Book an appointment at Lambert Medical Practice in Surbiton. Same-day appointments available.