LAST SPOTS AVAILABLE: Order your test today to beat the New Year rush and start treatment early.
Testosterone replacement therapy

Feel like you again

Suffering from low energy, decreased libido, or low mood? You may have low testosterone. With our expert medical team, you can get tested, diagnosed, and treated, so you can get back to feeling your best.

90%
of patients reported improvement in symptoms within 3 months
Ali, 34
Improved sex drive
Better sleep
Improvement in symptoms
90%
of patients saw life-changing improvements after 3 months
Improvement in their libido
87%
of patients saw an improvement in their Libido after 6 months
Manual trt
79%
of patients saw an improvement in their enjoyment of life after 6 months
Satisfied with the treatments
Plus
many more benefits to get men back to their best
Caret
Caret
Trustpilot stars
TrustScore 4.6/5 • 675 reviews

The hormone that’s holding men back

Dr. Chris Airey, TRT Expert

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

90% of men in the UK remain undiagnosed³

Too many men are suffering from the life-altering symptoms of this under-diagnosed condition.

Low-T symptoms can take the joy out of life

Low mood/anxiety
Low sex drive
Low muscle mass
Lack of focus
Low energy
Weight gain
Erectile dysfunction
Poor sleep quality
CITATIONS
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
³ Testosterone deficiency in adults and corresponding treatment patterns across the globe.

Do you experience these symptoms?

Answer 10 quick questions to assess if low testosterone could be holding you back.

Trustpilot stars
TrustScore 4.6/5 • 2,458 reviews

3 reasons why 7,000+ men choose MANUAL TRT

World-class medication

Unrivalled access to the gold-standard of TRT services, a variety of options always in stock.

Take the blood test

Ongoing medical care

A dedicated clinician at your fingertips. Access your personal portal to manage your treatment and monitor progress.

Medical care

The leading voice of TRT

Our TRT clinical team is headed up by male hormone expert and men's health author Dr. Jeff Foster, providing tailored treatment plans and a world class service for 7,000+ patients.

The leading voice

As seen in

Metro logoThe Guardian logoIndependentHuffpostThe Sunday Times

The 4 steps to treatment

1. Start with a blood test

Take our quick and easy at-home finger prick test.

£33.95
Confirm your results

2. Confirm your results

Regulation requires a second test to start treatment. It is a comprehensive test analysing additional biomarkers.

£49.95 - £79.95

3. Consultation

Consultation with your dedicated TRT expert who will confirm your suitability and advise on treatment options.

£79.95
Begin your personalised treatment

4. Begin your personalised treatment

Begin your journey with a personalised treatment plan. Choose from gels, injections and creams.

Learn about options
£59.95 - £109.95 p/m

Treatments start from as little as £3/day

Most popular

Injectable treatment

Safe, effective and convenient - our most popular option with different medications for different budgets.

Effectiveness
High
Protocol
Inject 1 to 3 times a week at home
Results
1 to 3 weeks

Topical treatment

Don't like needles? This topical testosterone is applied once daily for fast and effective results.

Effectiveness
Moderate
Protocol
Apply to the shoulders or arms once a day
Results
1 to 6 weeks

Oral treatment

Tablets taken once daily, the most convenient option.

Effectiveness
Individual
Protocol
Take 1 tablet daily
Results
3 to 8 weeks
General Medical Council
Royal College of General Practitioners (RCGP)
British Society of Sexual Medicine (BSSM)
Care Quality Commission

Start to feel like you again

We’ve helped thousands of patients up their T-levels and transform their lives. Our patients and their loved ones really noticed the results.

Caret
Caret
Improvement in symptoms
90%
of patients saw an improvement in their symptoms after 3 months
+239%
average increase in Total Testosterone levels among patients over 3 months
79%
of patients saw an increase in their enjoyment of life after 6 months
Improvement in their libido
87%
of patients saw an improvement in their Libido after 6 months
86%
of patients saw an improvement in their energy levels after 3 months
76%
of patients saw an improvement in their physical ability after 3 months
Satisfied with the treatments
90%
of patients were satisfied with the treatment they received
CITATIONS
Citations

Based on data on MANUAL clinical care data of over 2000 patients over the last 18 months

Dr. Jeff Foster

Dr. Jeff Foster

Medical Director of Men's Health, BSc, MBChB, ISSM, BSSM
Bio
Jeff Foster is one of the U.K.'s leading Men's health and TRT doctors, playing a leading role in the UK's guidance, approach and administering of TRT. Jeff has also written and published the definitive guide to men's health,"Man Alive", released in 2021. He has featured on BBC News and This Morning, while writing 100+ articles on men's health
Educational and Medical experience
Professional memberships
RCGPRoyal college
12+
years of specialising in men's health
20+
years of medical experience
Dr. Jeff Foster

Dr. Jeff Foster

Medical Director of Men's Health, BSc, MBChB, ISSM, BSSM
Bio
Jeff Foster is one of the U.K.'s leading men's health and TRT doctors, playing a leading role in the UK's guidance, approach and administering of TRT. Jeff has also written and published the definitive guide to men's health,"Man Alive", released in 2021. He has featured on BBC News and This Morning, while writing 100+ articles on men's health
Educational and Medical experience
Professional memberships
RCGPRoyal college
12+
years of specialising in men's health
20+
years of medical experience
Idea
Author
"Man Alive: The Health Problems Men Face and How to Fix Them" (2021)
Idea
Joint Author
The National BSSM Guidance on Testosterone Replacement Therapy (2023)

Join thousands of men getting back to their best

Tom, 34
Improved energy
Better mood
Antony, 64
Improved fitness
Better mood
Ali, 34
Improved sex drive
Better sleep
Mark, 36
Improved energy
Better focus

Thousands of patients have seen life-changing results

Trustpilot stars
TrustScore 4.6/5
675 reviews
Caret
Caret
trustpilot 5 stars
Life changed

2 months in, I'm very happy with results so far - life changed. I cannot recommend them highly enough

James
trustpilot 5 stars
TRT has genuinely changed my life

You don't know what you are missing until you get it back. TRT has genuinely changed my life.

Lionel
trustpilot 5 stars
Got my life back

I’m happier in general, less irritable, I’m more present especially around the kids and my wife, plenty of energy and have no problems getting a full working week in.

James
trustpilot 5 stars
Doctors are incredibly helpful

Consultants and doctors are incredibly helpful and knowledgeable, making the experience extremely easy to go through and treatment plans easy to follow. Couldn't recommend more.

Sean
trustpilot 5 stars
Amazing experience so far

Amazing experience so far. Treatment has changed my life and I’ve been supported all the way.

Terry
trustpilot 5 stars
Service has not dipped or faltered once

This is my second review, a year later, and the service has not dipped or faltered once. My wellbeing is at the centre of their actions.

Leigh

With treatment you feel like yourself again

We’ve helped thousands of patients up their T-levels and transform their lives. Our patients and their loved ones really noticed the results.

Caret
Caret
Satisfied with the treatments
90%
of patients were satisfied with the treatment they received
+239%
average increase in Total Testosterone levels among patients over 3 months
86%
of patients saw an improvement in their energy levels after 3 months
76%
of patients saw an improvement in their physical ability after 3 months
CITATIONS
Citations

Based on data on MANUAL clinical care data of over 2000 patients over the last 18 months

Clinically proven treatment

Dr. Chris Airey, TRT Expert

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

1
Today
At-home Testosterone test
Caret

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
Caret

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
Caret

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
Caret

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
Caret

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

How to start treatment

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.

Caret
Caret
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
Caret
Caret
TRT doctorPlay button
How long to see results?
Dr. Mandeep Sandhu, TRT Specialist Doctor
TRT doctorPlay button
How many blood tests to get started?
Dr. Mandeep Sandhu, TRT Specialist Doctor
TRT doctorPlay button
What are the costs of TRT?
Dr. Mandeep Sandhu, TRT Specialist Doctor
TRT doctorPlay button
Are there side effects?
Dr. Mandeep Sandhu, TRT Specialist Doctor
Play button
5 common symptoms of low testosterone
Dr David Huang, Deputy Medical Director
Play button
What are the potential benefits of TRT?
Dr Sheliza Darvesh, GP Clinical Lead
Play button
What type of people are on TRT?
Dr. Mandeep Sandhu, TRT Specialist Doctor
Play button
Is there a discount?
Dr Kapil Savania, TRT Specialist Doctor
Play button
Can I speak to someone about TRT?
Dr. Vivek Ramamoorthy, TRT Specialist Doctor
Play button
Is it legal to purchase TRT online?
Dr Sheliza Darvesh, GP Clinical Lead

Testosterone Replacement Therapy

Curated by Dr. Chris Airey, TRT Expert
Caret

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.

Caret

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.

Caret

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.

Caret

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

Caret

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.

Caret

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!

Caret

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.

Caret

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

Caret

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

Caret

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.

Caret

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

Caret

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.

ARTICLES

Learn more about testosterone

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