Testosterone replacement therapy

Is low testosterone silently holding you back?

If you’re experiencing low energy, weight gain, reduced muscle mass, irritability, poor sleep, and difficulty concentrating - there's a good chance low testosterone could be at play.

What TRT is proven to help with
brain
Mood
results
Testosterone levels
male
Muscle mass
willpower
Energy & Motivation
emotional
Erectile dysfunction
TRT benefits
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Medication

Better mood
Studies show that patients feel more energetic and in a better mood after TRT.

Bed

Higher sex drive
It is proven that TRT can enhance sex drive and improve erectile function.

Male

Increased muscle
TRT stimulates muscle protein synthesis and enhances muscle mass.

See more

What TRT is exactly
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Testosterone Replacement Therapy (TRT) is the medical treatment/replacement of the main male-sex hormone testosterone.

TRT treats an increasingly common medical condition known as Testosterone Deficiency; something which already affects nearly a million in the U.K., 40% of diabetic men, and 25% of all men at some point in their lives.

Our process to treatment
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We treat each patient as an individual. Following your blood tests, you will have a discussion with a doctor who is specially trained in TRT.  A joint decision over treatment will be made and you will then be followed up by the same doctor throughout your testosterone journey.

90%
of patients reported improvement in symptoms within 3 months
Ali, 34
Improved sex drive
Better sleep
Improvement
90%
of patients saw an improvement in their symptoms after 3 months
Improvement in their libido
87%
of patients saw an improvement in their Libido after 6 months
+166%
improvement in patients' libido after 6 months
Manual trt
79%
of patients saw an improvement in their enjoyment of life after 6 months
+92%
improvement in patients' enjoyment of life after 6 months
Satisfied with the treatments
Plus
many more benefits to get men back to their best
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Trustpilot stars
TrustScore 4.6/5 • +2,500 reviews

MANUAL TRT: Explained

What is TRT?

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.

How does it work?

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.

Why MANUAL TRT?

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.

Trustpilot stars
TrustScore 4.6/5 • 2,458 reviews

As seen in

Metro logoThe Guardian logoIndependentHuffpostThe Sunday Times

The health issue men don’t talk about

1 in 4 men suffer from low testosterone¹
After the age of 40, testosterone levels start to decline by 1 to 2% on average each year.²
Knowing what your testosterone levels are is really important.”
Dr Jeff Foster, Director of Men’s Health
Before getting tested I thought it was just the way I was.”
Danny, 32 YEARS OLD
Could it be you?
The following symptoms could be a sign of low testosterone.
We recommend you get tested to find out for sure.
Depression
Low sex drive
Low muscle mass
Lack of focus
Low energy
Weight gain
Erectile dysfunction
Fatigue
Citations
¹ The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 11, 1 November 2007, Pages 4241–4247
² Generational decline in testosterone levels observed

Get started with our free 10-question assessment

Take the 2-minute quiz
Dr. Jeff Foster, Director Men's Health
Better mood
Muscle mass
Energy & Motivation
Sex drive
“I took a test and found out I had low testosterone two years ago. The treatment and life habits I put in place literally transformed my life in so many ways.”
ALI, 34 Years Old

Get back to peak performance with TRT

For many men with low testosterone, TRT is a game-changer. Regain your vitality and improve your quality of life, starting now.

Benefits for the body
For the body
Higher testosterone levels
TRT works by mimicking the natural production of your testosterone hormone.¹
Better sleep
Studies show that patients who had TRT reported better sleep quality.³
Better physical ability
Increase your muscle mass, strength and endurance, and cut down your recovery time.¹
Increased libido
Boost your testosterone, the main hormone responsible for your sex drive.⁴
Increased muscle
With TRT, your muscles build new tissue faster and more efficiently after exercise.²
Benefits for the mind
For the mind
Better Mood
Studies show that patients feel more energetic and in a better mood after starting TRT.⁵
Enjoyment of life
79% of patients saw an increase in their enjoyment of life after 6 months.¹
Improved Memory
TRT can significantly improve overall cognitive function in older men with low-T.⁶
Overall satisfaction
90% of patients were satisfied with the treatment they received.¹
Increased energy
86% of patients saw an improvement in their energy levels after 3 months.¹
Citations

The first step towards a stronger you

Take the guesswork out of your health. Get tested and move forward with a treatment plan that works for you.

1

Low testosterone diagnosis

Get your T. levels checked with our at-home blood test kit. We’ll arrange further enhanced testing if necessary.

2

Tailored Treatment

Your doctor will look at your unique data (your goals, symptoms, medical history, etc.) to find the right approach.

3

Ongoing clinical care

We do blood tests every 3-6 months with full doctor report & consultation, to ensure you hit your goals!

Clinically proven treatment

Dr. Jeff Foster, Director of Men's Health

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.

Better Mood

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

Higher Sex Drive

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

Increased Muscle

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

Better Sleep

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

Improved Memory

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

We’ve helped thousands of men with low testosterone

Trustpilot stars
TrustScore 4.6/5
675 reviews
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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.

More energy
Improved physical fitness
Before treatment
3 months after treatment
220%
increase in Free Testosterone

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.

More energy
Improved mood
Before treatment
3 months after treatment
220%
increase in Free Testosterone

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.

More energy
More muscle mass
Before treatment
3 months after treatment
220%
increase in Free Testosterone

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!

More energy
Improved physical fitness
Before treatment
3 months after treatment
417%
increase in Free Testosterone
1
Today
At-home Testosterone test
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Start with a simple at-home finger-prick blood test which measures your total and free testosterone levels.

Testosterone & Free Testosterone checked

Easy at-home finger-prick collection

Expert validated report

Analysed at UKAS certified laboratories
Get started for £33.95
2 weeks
Enhanced Testosterone test
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A comprehensive venous blood test is needed to confirm the initial result, learn more about your health, and assess whether it’s safe to start treatment.

Venous collection by a nurse

Checks liver, kidney & PSA levels to make sure you’re suitable for treatment

Analysed at UKAS certified laboratories
2
Within 4 weeks
Speak to a specialist Doctor
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Discuss your blood test results, symptoms, medical history, treatment options (including costs), and monitoring process with an expert TRT doctor.

Video consultation

Private and confidential

Qualified TRT experts

Analysed at UKAS certified laboratories
3
4 weeks
Start your treatment
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Your doctor will design a personalised treatment plan that’s tailored to your lifestyle. It may include medication, lifestyle advice or supplements.

Analysed at UKAS certified laboratories
4
On going
Testosterone monitoring and plan adjustments
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We’ll test your blood at 6 weeks, 3 months, 6 months, and 12 months after to allow your doctor to effectively monitor your progress and make any adjustments.

Analysed at UKAS certified laboratories
5
Our pricing
Take a closer look at our pricing structure to understand the cost of your customised treatment plan.
Learn about pricing
THE PROCESS

Got low T? Here's what to do

We’ve helped thousands of men with low testosterone

Trustpilot stars
TrustScore 4.6/5
675 reviews
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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.

More energy
Improved physical fitness
Before treatment
3 months after treatment
220%
increase in Free Testosterone

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.

More energy
Improved mood
Before treatment
3 months after treatment
220%
increase in Free Testosterone

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.

More energy
More muscle mass
Before treatment
3 months after treatment
220%
increase in Free Testosterone

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!

More energy
Improved physical fitness
Before treatment
3 months after treatment
417%
increase in Free Testosterone

A treatment plan tailored
for you

As part of our TRT service, you’ll receive a comprehensive diagnosis and a bespoke treatment plan that may include medication, lifestyle advice or supplements.

Injectable
Effectiveness

High

Format

Injections two or three times weekly for most patients

Results in

1-3 weeks

Oral
Effectiveness

Moderate

Format

Tablet taken once daily

Results in

3-8 weeks

Topical
Effectiveness

Individual

Format

Apply to the shoulders or arms once a day

Results in

1-6 weeks

Led by TRT experts

“We offer the most effective protocols in formats to suit your preference”

Specialist care on your terms

What you get
Manual
NHS
Convenient & online
YesNo
Quick diagnosis & treatment
YesNo
Doctors who specialise in TRT
YesNo
Gold-standard treatment plans
YesNo
Monitoring & treatment adjustment
YesNo
Jeff Foster

Meet our TRT experts

We have the UK’s leading TRT experts on board, so you know you’re in good hands.

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Dr. Jeff Foster

Dr. Jeff Foster

Medical Director of Men's Health
Read Bio

Dr Kapil Savania

TRT Medical Expert
Read Bio

Dr. Imad Mekhail

TRT Medical Expert
Read Bio

Dr. Mandeep Sandhu

TRT Medical Expert
Read Bio

Your questions answered

Our team has a lifetime’s worth of expertise and experience between them. They’re on hand to answer all of your questions at every stage of your journey.

View all
About TRT
Symptoms
How it works
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Play button
5 common symptoms of low testosterone
Dr David Huang, Deputy Medical Director
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What are the potential benefits of TRT?
Dr Sheliza Darvesh, GP Clinical Lead
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What type of people are on TRT?
Dr. Mandeep Sandhu, TRT Specialist Doctor
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Is there a discount?
Dr Kapil Savania, TRT Specialist Doctor
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Can I speak to someone about TRT?
Dr. Vivek Ramamoorthy, TRT Specialist Doctor
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Is it legal to purchase TRT online?
Dr Sheliza Darvesh, GP Clinical Lead

Testosterone Replacement Therapy

Curated by Dr. Chris Airey, TRT Expert
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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.

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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.

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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.

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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

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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.

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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!

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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.

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It is legal to purchase TRT online in the UK when buying through a private clinic such as MANUAL.

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The World Anti-Doping Agency classifies testosterone as a prohibited substance, so unfortunately athletes who compete in regulated competitions cannot undergo Testosterone Replacement Therapy.

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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.

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Our blood test kits usually arrive within three working days. It may take longer over public holidays.

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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.

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Start with a testosterone blood test
Start with a test
£33.95