Testosterone Replacement Therapy for Men

Low mood? Low energy? Low libido? Low testosterone levels could be to blame. Our experts can provide a comprehensive diagnosis and life-changing treatment.
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Men's testosterone levels are declining
of men
Scientific studies show that 1 in 4 men over the age of 30 may have abnormally low testosterone levels. This could be caused by genetics, age, lifestyle or environmental factors.
Source: The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 11, 1 November 2007, Pages 4241–4247
Signs your testosterone is too low
Testosterone deficiency is often misdiagnosed as depression or other disorders. If you're experiencing any of the symptoms below, your testosterone levels may be in decline.
Poor erections or sex drive
Poor erections or sex drive
Low mood or motivation
Low mood or motivation
Lack of focus
Lack of focus
Depression or irritability
Depression or irritability
Difficulty losing weight
Difficulty losing weight
Reduced muscle mass
Reduced muscle mass
Dr. Chris Airey, Testosterone Medical Expert
Testosterone levels start to drop 1 to 2% each year from age 35. Testosterone replacement therapy (TRT) maintains healthy testosterone levels.
How can testosterone replacement therapy change your life?
TRT isn’t the fountain of youth, but it can restore your energy, drive, focus, and lust for life - helping you feel happier, stronger, and more normal again.

Real customers, real results

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How it works
Take two blood tests
Take an at-home finger-prick blood test, and if eligible another venous test
Get your results
See your testosterone levels on your online portal with expert medical advice
Speak to a doctor
Discuss your results with a specalist doctor who will go over your treatment options
Start treatment
If you are approved for treatment, receive your prescription directly to your door.
Meet our team of experts
We have the UK's leading doctors and experts in testosterone replacement therapy. Meet our team.
Chris Airey
TRT Medical Expert
Alastair Kennett
TRT Expert
Rana Mirzai
Clinician, TRT
Testosterone replacement therapy, everything you need to know
Curated by Dr. Chris Airey, TRT Medical Expert
What is Testosterone Deficiency (TD)??
Low testosterone is a common condition that men can be born with or develop due to age, stress, disease, physical trauma, an unhealthy lifestyle or environmental factors.
What are the key symptoms of TD?
Men with low testosterone often report low mood, irritability, fatigue, anxiety, reduced libido or difficulty achieving an erection. Other common symptoms include brain fog, lack of motivation, low confidence, difficulty losing weight and difficulty gaining muscle.
How do you test for TD?
Blood testing is the only way to know for sure if you have a testosterone deficiency. Our Initial Testosterone Blood Test (a simple finger-prick test) can be taken at home. If the results show that you have low testosterone and you’d like to start testosterone replacement therapy, UK regulations require you to take a second, more comprehensive blood test first to ensure that you can safely start treatment. This one is a venous test which has to be administered by a nurse or phlebotomist.
How common is TD?
Research has confirmed that testosterone counts in men are significantly lower than they were just a few decades ago. One in four men over the age of 30 may have abnormally low testosterone levels according to scientific studies.*

Around the age of 30 testosterone levels naturally begin to decline, but it’s usually a very gradual process. For most men, testosterone levels drop between one to two percent each year from the age of 35. Free testosterone levels also drop considerably as men age, making TD even more common. An increase in obesity, hormone-disrupting environmental chemicals, and anabolic steroid use is also making testosterone deficiency in younger men more prevalent than ever.

*The Journal of Clinical Endocrinology & Metabolism
How do TD medications work?
Everyone’s medical history is different so our doctor will prescribe a medication that works specifically for you. Successful hormone therapy involves getting just the right dose by the right delivery method for your individual needs. Testosterone replacement therapy involves taking prescribed testosterone medication in the form of injections, pills, patches, creams, and testosterone pellets (placed under the skin).

Testosterone injections are the most common form of medication as they are convenient and most effective for the majority of men.
Is TRT safe and are there any side effects?
Undergoing testosterone replacement therapy is completely safe if you’re treated by a specialist doctor who regularly monitors your testosterone levels along with any side effects.

As with all medications, some people may experience side effects - however, they’re easily controlled and generally avoided with sensible doses and regular monitoring. Some possible minor side effects include fluid retention, acne, and increased urination. More severe potential side effects include gynecomastia (the growth of male breasts), worsening of existing sleep apnea, increased cholesterol levels, decreased sperm count, infertility, and an increased number of red blood cells.

Testosterone injections may also increase your risk of certain health problems, such as heart attack, stroke, blood clots or a worsening of pre-existing prostate tumours or benign prostatic hyperplasia (enlarged prostate). However, these side effects can be mostly avoided or controlled through regular monitoring and other medications.

In order to keep side effects to a minimum you’ll check in to monitor your testosterone levels and any potential side effects. If you have any concerns or questions, get in touch with our clinicians - it’s free!
Will I be able to talk to a licensed doctor?
Yes, you’ll have a consultation with one of our doctors to discuss your test results and they can provide a personalised treatment plan tailored to your needs. Our doctors specialise in TRT for men and are all registered with the General Medical Council.
Is it legal to purchase testosterone therapy online?
It is legal to purchase TRT online in the UK when buying through a private clinic such as MANUAL.
Is TRT appropriate for professional athletes?
The World Anti-Doping Agency classifies testosterone as a prohibited substance, so unfortunately athletes who compete in regulated competitions cannot undergo Testosterone Replacement Therapy.
How do these blood tests lead to treatment?
Our initial blood test will establish whether you have a testosterone deficiency. If the first test shows that you have low testosterone you’ll need to take our second, more comprehensive blood test if you’d like to start TRT - this is due to UK regulations. If both tests show that you have low T levels, you’ll discuss suitable treatment options with one of our doctors and during an in-depth consultation before starting treatment.
How soon will the test arrive?
Our blood test kits usually arrive within three working days. It may take longer over public holidays.
When will I get my results?
We’ll get in touch to give you your results within two to three business days. One of our TRT specialists will then walk you through the results, provide advice, and answer all of your questions.
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