After talking to you and carefully assessing your symptoms, your doctor will have designed a personalised treatment plan that incorporates medication that will work specifically for you.

So that you feel confident and comfortable using your medication, it’s important that you take the time to read through this leaflet, watch the relevant videos, and book yourself in for an Injection Training Consultation (if suitable for your treatment plan).

*It is important to make sure you know your specific medication, dosage, and injection frequency – it’s not the same for everyone! If you are unsure what medication you have been prescribed or how much you should be taking, please contact the team through the support section of your account.

Please note that some of the TRT treatment plans may include off-label or unlicensed use of medication.

Areas included in this treatment plan:

Types of Testosterone available

Topical Testosterone

Common Side Effects

Oestrogen-related Side Effects

Testosterone and Fertility

Testosterone and Cardiovascular Risk Factors

Types of Injectable Testosterone:

Cypionate

Testex

Enanthate

Sustanon

Types of Topical Testosterone:

Testo-gel

Testosterone-cream

You may also be prescribed Human Chorionic Gonadotropin (HCG),

which maintains your natural testosterone production and fertility.

Some customers will also be taking supplementary treatments, such as Tadalafil or an Oestrogen blocker if appropriate.

If you are on Injectable Testosterone/HCG, you will benefit from having a read of the TRT Injection Support Sheet and watching this helpful video.

You can also book in for a one-to-one video Injection Training using the link.

If you are on Topical Testosterone, please follow the instructions below to help with getting started on your plan:

1. Make sure you are aware of your specific dosage plan

If you are unsure about what dose you should be using, please get in touch with the team prior to starting your treatment

Wash your hands before and after applying the testosterone

2. Prime the applicator before using it for the first time

You can do this by holding the product over the sink and pushing the pump until it releases full doses of cream/gel

Wash the extra cream/gel down the drain or prime the pump over a waste bin that pets and children cannot access

3. Measure the correct dose.

For example, you may be prescribed a dose of ‘ONE pump TWICE daily’. In this case, you will need to measure ONE pump per application and repeat this approximately 12 hours apart (morning and evening)

4. Apply the cream/gel to your body.

Apply the testosterone cream/gel to clean dry skin on your shoulders, upper arms, or abdomen (stomach) unless your doctor recommends a different location.

5. Cover the application area with clothes.

After applying the testosterone, allow the testosterone cream/gel at least 10 minutes to absorb into your skin before putting on your clothes.

Wait at least 2 hours to bathe after applying the cream/gel

Extra tips:

Prevent the cream/gel from coming into contact with other people and animals. If testosterone comes into contact with people who have not been prescribed this medication, it can cause a hormonal imbalance and negative health effects. If the gel comes into contact with a pregnant woman, there is a risk of foetal birth defects. It can also trigger masculine secondary sexual characteristics in women and over-stimulate the sexual development of children.

In the event that another person accidentally comes into contact with the testosterone cream/gel, ensure that they wash the area with soap and water as soon as possible

If there is a risk of skin to skin contact with another person (e.g. during sexual intercourse), ensure that you thoroughly wash the area you applied the testosterone to before the contact is made

What are the side effects?

If you feel you are experiencing any side effects from the medication, please reach out to the team as soon as possible.

Common Side Effects:

Excess body hair growth

Increased spots or acne

Changes to prostate size (this may come hand-in-hand with symptoms such as changes to urinary flow or frequency in urination)

Androgenic alopecia/male pattern baldness

Topical testosterone might cause skin irritation in some men, leaving the application site red and sore.

Injectable testosterone might cause injection site reactions, and the carrier oil might cause irritation or allergic reactions. If not injected safely, there is a small risk of infection from injections.

Oestrogen-related Side Effects:

In some individuals, an increase in testosterone can contribute to an increase in oestrogen, which in turn can cause oestrogenic side effects.

Tiredness/fatigue

Changes in breast tissue/nipples (gynecomastia)

Water retention

Changes in mood or increase in anxiety

An increase in oestrogen can be safely managed by our team, however it is important to flag any symptoms to us, to allow us to take the appropriate actions.

Testosterone and Fertility:

When patients are treated with externally administered testosterone (TRT), this can cause a reduction in your body’s natural production of both testosterone and sperm, which in turn could lead to reduced fertility

As part of your individualised treatment package, you may be prescribed HCG with the primary focus to maintain fertility, whilst also maintaining testicular size, normal testosterone production and the production of other hormones which are inhibited by TRT

If you are keen on maintaining your fertility, ensure you highlight this to your TRT doctor. The doctor will assess your individual case and may ask you to undertake a baseline sperm count and monitor this whilst on treatment. Further details on this test will be provided by our team.

Testosterone and Cardiovascular Risk Factors:

Testosterone treatment can increase the thickness of your blood. Therefore as a safety measure, we closely monitor blood thickness using a test called haematocrit throughout your treatment journey.

While being on TRT can increase your risk of clots and thrombotic events, there has been no evidence to suggest that it increases your risk of major cardiovascular events such as heart attacks or strokes.

It is advised that you monitor your blood pressure whilst you are on treatment, and the British Heart Foundation provides helpful information about how to effectively monitor your blood pressure and provides a template for you to use to log your readings. If your blood pressure is greater than 140/90 mmHg, we recommend letting us know and also speaking to your GP. If your blood pressure is greater than 180/110 mmHg, we recommend you seek immediate medical attention.

Your doctor may also advise that you register to become a blood donor and it can be recommended to donate blood every three months. Some TRT users choose to wait until their first 3-month blood test to see how the treatment is affecting them.

If for any reason, you cannot donate blood, you may be advised to undertake a therapeutic venesection (removing blood).

What if my medical status changes?

If you start taking any new medications or if there are any significant changes to your medical history, please inform our clinicians/doctors via your patient account messaging facility. If you experience any significant side-effects or want any further advice on your treatment, please do let us know.

It is important that you inform your GP about the medicines you take to ensure they have an accurate medication history. If you do not share this information with your GP it could result in the healthcare professional not having enough information to make informed clinical decisions about your care, increasing your risk of injuries or side effects. On your account page, you can download a letter to share with your GP that contains all the relevant information about your treatment plan.