Sliced Bread Testosterone Replacement Therapy
Jan 29, 2026
Jeff Foster, NHS GP and Director of Men's Health at Manual, explains testing pathways and treatment options. Mike Kirby, President of the British Society for Sexual Medicine, outlines clinical guidance on testosterone deficiency. They discuss what testosterone does, how testing and diagnostics work, treatment types and safety, fertility and sporting risks, and when long-term therapy might be appropriate.
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Listener's Home Test Led To Low T Result
- Clive ordered a home finger‑prick testosterone test after feeling low on energy in his 50s.
- He received a low total T (10.7 nmol/L) and a borderline free T (0.225), prompting further tests.
Male Testosterone Decline Is Gradual
- Testosterone falls about 1% per year with age, but most healthy men keep normal levels into later life.
- Male hormone decline is gradual and unlike the abrupt female menopause.
Investigate Before Prescribing TRT
- Don't rely on a single blood result; low readings require repeat testing and investigation.
- Look for causes like obesity, past testicular issues, thyroid disease or anemia before prescribing TRT.