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Dr. Jeff Foster
Medical Director of Men's Health, BSc, MBChB, ISSM, BSSM
Welcome to Manual, the UK's leading experts in treating low testosterone. With our expert medical team, we can guide you through treatment and get you back to feeling your best.
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¹ The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 11, 1 November 2007, Pages 4241–4247
² Generational decline in testosterone levels observed
³ Testosterone deficiency in adults and corresponding treatment patterns across the globe.
We’ve helped thousands of patients up their T-levels and transform their lives. Our patients and their loved ones really notice the results.
Based on data on MANUAL clinical care data of over 2000 patients over the last 18 months
TRT is used to treat men with low testosterone levels, which can cause a range of life-debilitating symptoms. It works by supplementing the hormone, helping restore you to optimal body functions and overall well-being.
TRT can be administered through various methods, including injections, gels and creams. Our expert, best-in-class TRT clinicians will advise based on your needs and preferences.
Top doctors and world-class treatment at your fingertips - 9/10 patients see life-changing results after just 3 months on treatment. Join the 7000+ men who've transformed their lives with our world-leading treatment.
Take your Randox test or submit your testosterone results to us.
Regulation requires a second test to start treatment. It is a comprehensive test analysing additional biomarkers.
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Consultation with your dedicated TRT doctor who will confirm your suitability and advise on treatment options.
Begin your journey with a personalised treatment plan. Choose from gels, injections or creams, for the cost of a cup of coffee per day.
Learn about options
Once I started on TRT, it was a big change in my life. My energy and physical fitness has improved. I work out 6 days a week and feel good in myself. The team provided support and guidance throughout my journey at an affordable price.
TRT helped me improve my energy, mood, and overall well-being. It has helped me sort out my diet, exercise, better routine and better sleep, resulting in a more positive attitude and better relationships at work and at home.
Low energy and brain fog were the two biggest symptoms I had. Then I found TRT. It’s helped me improve my energy, mental clarity, and overall well-being. I was able to achieve my goals and gain muscle, lose body fat, and improve sports performance.
After starting TRT, I felt more like myself again. I was able to regain interest in things I used to enjoy, and was able to accomplish things that I would never have done before like building a new kitchen at home!
We’ll help you get your testosterone levels back within a normal, healthy range. Our TRT service has research-backed benefits to your health and wellbeing. The results can be life-changing.
Look forward to more good days. Studies show that patients feel more energetic, friendlier, less irritable and generally in a better mood after starting TRT.¹
Testosterone can help you get your mojo back. Numerous studies show that increasing testosterone levels can enhance sex drive, improve erectile function and increase overall sexual satisfaction.²
Testosterone has a bit of a reputation for building muscle and strength. Studies show that increasing testosterone levels stimulates muscle protein synthesis and enhances muscle mass.³
Say goodnight to insomnia and look forward to sleeping soundly. Studies show that patients who had testosterone replacement therapy reported significant improvements in their sleep quality.⁴
Testosterone can help you feel sharper and boost your memory. Studies show that increasing testosterone levels can significantly improve overall cognitive function in older men with low-T.⁵
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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.
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.
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.
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
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.
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!
Yes, you willl 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.
It is legal to purchase TRT online in the UK when buying through a private clinic such as MANUAL.
The World Anti-Doping Agency classifies testosterone as a prohibited substance, so unfortunately athletes who compete in regulated competitions cannot undergo Testosterone Replacement Therapy.
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.
Our blood test kits usually arrive within three working days. It may take longer over public holidays.
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.
