Testosterone Replacement Therapy (TRT)

Testosterone replacement therapy, commonly known as TRT, is a medical treatment used to restore healthy testosterone levels in men whose bodies do not produce enough of the hormone naturally. This condition is known as testosterone deficiency or hypogonadism. TRT works by supplementing the body's own testosterone production, helping to relieve symptoms such as fatigue, low mood, reduced libido, poor concentration, and loss of muscle mass. It is available in several forms including gels, injections, and tablets. At My London Pharmacy, we currently offer topical testosterone gels as a continuation treatment for established patients.

No. Our current TRT service is a continuation pathway designed exclusively for men who are already established on testosterone replacement therapy. If you have never been prescribed TRT before, this service is not for you. We do not currently offer initial assessment, diagnosis, or new patient pathways for TRT. We recommend speaking to your GP or a specialist men's health clinic who can carry out the appropriate evaluation and get you started on the right treatment. We may expand our service to include new patient pathways in the future.

We currently offer the following MHRA-approved topical testosterone formulations:

• Testogel Pump 16.2mg/g Gel

• Testogel 40.5mg (30 x 2.5g Sachets)

• Testim Gel 50mg (30 x 5g Tubes)

• Testavan Pump 2% Gel

• Tostran Pump 2% Gel

All formulations are applied directly to the skin once daily and are dispensed from our registered UK pharmacy. Your prescriber will review your existing treatment details to ensure the formulation supplied matches your current clinical needs.

Recent blood test results are required before your continuation request can be approved. We ask that results are from the same laboratory we use to ensure consistency and accuracy. Tests required typically include total testosterone, free testosterone, SHBG, full blood count and haematocrit, PSA, LH and FSH, liver function tests, lipid profile, HbA1c, and oestradiol where relevant. Results should ideally be from within the last two weeks. If you do not have recent results, your request may be delayed or declined. Where needed, we can help arrange testing, though two tests taken approximately one week apart may be required to confirm clinical reliability.

Once your request has been reviewed and approved by our UK-licensed prescriber, your treatment will be dispensed from our registered pharmacy and delivered discreetly to your door. Delivery times may vary depending on your location and the time your request is submitted. We aim to process approved requests as quickly as possible.

When prescribed appropriately and used correctly, topical testosterone gel is a safe and well-established treatment for men with confirmed testosterone deficiency. As with all medicines, it carries potential risks and side effects, which is why ongoing monitoring is essential. Our prescribers follow strict clinical guidelines to ensure treatment is only approved where it is safe and suitable for you individually. Regular blood tests and clinical reviews are required throughout your treatment to ensure it remains appropriate.

Yes. Testosterone gel can transfer to others through direct skin contact. To reduce this risk you should always wash your hands thoroughly after applying the gel, allow the application site to dry completely before covering it with clothing, and avoid skin contact with others, especially pregnant women and children, until the gel has fully dried. Accidental exposure in women and children can cause unwanted hormonal effects and should be avoided.

Yes. Testosterone replacement therapy can reduce fertility by suppressing the body's natural hormone signals that stimulate sperm production. This can lead to a significant reduction in sperm count and, in some cases, temporary infertility. If you are planning to have children now or in the future, this is an important consideration and should be discussed with your prescriber before continuing treatment. The effects on fertility may be reversible after stopping TRT, though this can take time and is not guaranteed.

Possible side effects of topical testosterone therapy can include acne and oily skin, fluid retention, mood changes, increased red blood cell levels which may raise the risk of blood clots, reduced fertility, testicular shrinkage, breast tenderness or enlargement, hair loss, and changes in urinary symptoms. TRT may also affect prostate health, cholesterol levels, and liver function, and can worsen obstructive sleep apnoea in some men. You should seek urgent medical attention immediately if you develop sudden leg swelling, shortness of breath, chest pain, or sudden weakness in a limb, as these may indicate a serious condition. All side effects and concerns will be reviewed as part of your ongoing clinical monitoring.

Regular monitoring is essential throughout your TRT treatment, even when you feel well. A typical monitoring schedule includes a blood test review at three months after starting or restarting treatment, followed by six-monthly reviews once stable, and then annual reviews for long-term patients. More frequent monitoring may be required if you are over 50, have higher-risk medical conditions, or if any of your results are borderline or outside the normal range. Monitoring typically includes testosterone levels, full blood count and haematocrit, liver function, blood pressure, and prostate health where appropriate.

If your results fall outside the normal range, your prescriber will need to review this carefully before making a decision on whether treatment can continue. In some cases you may be asked to provide additional information, attend further testing, or be advised to speak to your GP or a specialist. Treatment will only be continued where it is deemed safe and clinically appropriate based on your individual results and overall health profile.