Can I get TRT on the NHS?

Testosterone replacement therapy (TRT) can be transformative for men with low testosterone, improving energy, mood, and performance.¹ But getting it through the NHS isn’t always easy due to it being a tightly regulated treatment space.

Can you get TRT on the NHS?

Yes, but it’s far from straightforward.

The NHS does prescribe TRT, but only for men who meet strict medical criteria. Current guidance typically limits treatment to those with total testosterone levels below 8 nmol/L (or below 10.4 nmol/L and taking medication for erectile dysfunction).¹

Unlike the NHS, which operates under immense pressure and limited resources, private providers can dedicate more time to each patient. That means clinicians can explore symptoms in depth, consider a man’s full health history, and interpret test results in the wider context.

This doesn’t mean cutting corners or ignoring medical guidelines; it means applying them with clinical nuance. Private clinics can use more detailed diagnostic tools, such as testosterone testing or repeat morning blood draws, to build a clearer picture of hormone health before deciding whether TRT is appropriate.

Because of these differences, many men who feel dismissed by the NHS could find answers - and relief - in a private setting, where the focus is on treating the whole person, not just the blood test result.

How do you get TRT on the NHS?

If you think you might have low testosterone, the first step is to book an appointment with your GP.

Here’s what the process usually looks like:

1. GP consultation: You’ll discuss your symptoms such as tiredness, low sex drive, or mood changes, and your GP will decide whether to arrange a blood test. Because testosterone levels fluctuate throughout the day, this test should ideally be done before 11am.²

2. Blood test results: Once your results are back, your GP will assess whether they meet the NHS criteria for low testosterone.

   • Below 8 nmol/L: You’ll likely be referred to an endocrinologist (a hormone specialist).¹

   • Between 8–12 nmol/L: You may be offered additional tests, but treatment is far less likely.¹

3. Endocrinologist referral: If referred, you’ll usually wait several weeks (or months) to be seen. The endocrinologist may repeat blood tests, check for underlying conditions, and confirm whether TRT is appropriate.²

4. Treatment options: If approved, you’ll typically be prescribed testosterone gels or patches. Injections are used less often within the NHS, partly because they’re more expensive and require close monitoring.

While NHS TRT is cost-effective (you’ll only pay the standard prescription charge), the pathway can be lengthy, and ongoing follow-ups may be infrequent.

Who can get TRT on the NHS?

TRT on the NHS is offered primarily to men with clinically confirmed testosterone deficiency, usually due to primary (testicular) or secondary (pituitary or hypothalamic) causes.³

Women may receive testosterone therapy on the NHS in rare cases, such as to treat low libido linked to menopause, but it’s prescribed far less often and usually at specialist clinics.⁴

Men with borderline levels or non-specific symptoms, like fatigue or low mood, may struggle to qualify for NHS TRT. GPs often attribute these symptoms to lifestyle, stress, or ageing.

How does the NHS test for TRT?

Testing for low testosterone on the NHS involves morning blood tests measuring total testosterone and sometimes free testosterone.

However, because NHS resources are limited, many GPs might only test total testosterone initially. Free testosterone, which can give a more accurate picture of how much hormone is actually active in the body, is often left unmeasured unless you’re referred to a specialist.

The NHS will usually run one or two tests before confirming a diagnosis. But since testosterone levels can fluctuate, a single reading isn’t enough. If your results are borderline or inconsistent, you might be advised to retest, adding more time to an already slow process.

TRT on the NHS: pros and cons

The numan take

You can get TRT on the NHS, but it’s not a quick or straightforward process. Strict criteria, limited resources, and long wait times mean that many are left untreated, even when symptoms clearly point to low testosterone.

If you’re struggling with fatigue, low mood, or loss of motivation, it’s worth taking control of your own health. A Male Hormone Blood Test or Testosterone Blood Test with Numan can give you fast, accurate answers, and if treatment’s right for you, you’ll get expert medical support every step of the way.

References

1. ^{Hackett G, Kirby M, Rees RW, Jones TH, Muneer A, Livingston M, et al. The British society for sexual medicine guidelines on male adult testosterone deficiency, with statements for practice. World J Mens Health. 2023;41(3):508–37.}

2. ^{Website NHS. The ‘male menopause’. nhs.uk. 2025. [accessed 30 Oct 2025] Available from: https://www.nhs.uk/conditions/male-menopause/}

3. ^{Ventimiglia E, Ippolito S, Capogrosso P, Pederzoli F, Cazzaniga W, Boeri L, et al. Primary, secondary and compensated hypogonadism: a novel risk stratification for infertile men. Andrology. 2017;5(3):505–10.}

4. ^{Connelly D. NHS testosterone prescribing in women rises ten-fold in seven years. Pharmaceutical-journal.com. 2023. [accessed 30 Oct 2025] Available from: https://pharmaceutical-journal.com/article/news/nhs-testosterone-prescribing-in-women-rises-ten-fold-in-seven-years}