TRT EU Guide

How Do You Get Testosterone Replacement Therapy in the EU?

You can access TRT in the EU through private clinics, such as Androgenix, or public healthcare. Private options offer faster access, personalised care, and more treatment types, including injections, HCG, and creams. Public systems often limit options and involve long delays.

Testosterone Replacement Therapy (TRT) In The EU

Testosterone Replacement Therapy, or TRT, is a powerful solution for men facing the challenges of low testosterone. 

This condition can be something men are born with or might develop with age, stress, or not-so-great lifestyle choices.

Although opinions on the matter vary, the benefits of increasing testosterone levels are garnering increased attention and becoming a popular subject of discussion.

At Androgenix, we're all about giving your testosterone a personal touch-up. We utilise top-notch medications, supplements, and lifestyle tips to help you overcome low-T symptoms and enhance your quality of life. And we're doing it all across the EU!

What Is TRT and Why Is It Prescribed in Europe?

TRT stands for Testosterone Replacement Therapy. It's what we turn to when a guy's natural testosterone isn't hitting the mark, leaving him dealing with those not-so-fun low-T signs.

Testosterone replacement typically involves exogenous testosterone medication delivered through injections, pellets, patches, or gel. Non-medical treatments like lifestyle advice, supplements, and other non-prescription options are also utilised to optimise and replace testosterone levels.

In TRT clinics, various treatment options are typically available. Nowadays, it's common for additional medications like HCG to be included in TRT to fully optimise the therapy, preserving fertility and natural testosterone production.

Managing hormones like estrogen may require additional medications or protocols.

Using medications like HCG alongside TRT to sustain natural testosterone levels has prompted some to call it Testosterone Optimisation Therapy, as it preserves natural production instead of simply replacing it.

This approach is considered the safest and most efficient method of TRT.

How to Access Testosterone Therapy in the EU

You can get Testosterone therapy in the EU using two ways:

1. Getting It From A Private Clinic Like Androgenix:

A top-notch private clinic should offer the latest treatments, provide video consultations for appointments, and deliver reliable services throughout the EU.

At clinics like Androgenix, you can expect a combination of medications, practical lifestyle tips, and the right supplements tailored to your needs. This could mean receiving your treatment through injections, HCG (which is particularly important for men on testosterone replacement therapy), creams, or gels, all tailored specifically for you.

Your treatment should be as unique as you are. No cookie-cutter plans here—what works for one person might not work for another. Whether it's the classic gels or daily shots, it's all about finding a solution that fits into your life and how your body reacts to the treatment.

2. Getting It From A Public Healthcare Clinic

Getting treatment from a public healthcare clinic means you can access care that's often covered or at a reduced cost. They may have longer wait times due to high demand. You may have to wait long to receive the care you need.

The medication options are typically limited to gels, which often lose effectiveness over time for many men. Doctors usually target a low to medium level of testosterone, around 15nmol/l. This is one of the reasons why many doctors believe TRT doesn't deliver the expected results.

Side effects are often poorly managed because off-label medications like HCG and aromatase inhibitors aren't accessible to men who need them. This can lead to ineffective treatment, with many men experiencing high estrogen levels and infertility.

The unavailability of fertility medications such as HCG means younger men often can't start treatment if they plan to have children later in life.

The process is often lengthy, involving additional blood tests with an endocrinologist after a long wait following initial tests with a primary care physician. This process can take nine months to a year in many EU regions, and treatment isn't guaranteed.

TRT Access in the EU: Private vs Public Clinics

Why Choose Endrogenix Testosterone Replacement Therapy

• Androgenix offers virtual clinic services throughout the EU, delivering your medications right to your doorstep for a seamless and secure experience. Regular check-ups are part of the deal, ensuring your TRT works perfectly for you.
  
  
• We're proud to be the leading clinic in the EU, with more top-notch reviews than any other clinic.
  
  
• We provide the finest treatment options, including Cypionate injections, HCG, Versa-base creams, expert advice, and supplements. Our flexible treatment plans are tailored to meet your individual needs.
  
  
• Our medical team aims to boost your testosterone to the upper end of the normal range, minimising the side effects often associated with TRT from other sources like the NHS or different clinics.
  
  
• Our forward-thinking, doctor-led approach, combined with our use of cutting-edge technology, sets us apart, earning us high praise compared to other clinics.

What Are The Advantages Of TRT?

Testosterone Replacement Therapy (TRT) offers a multifaceted array of benefits that extend beyond physical health, such as:

• Mood enhancement and reduced anxiety
  
  
• Increased muscle mass and physical strength
  
  
• Harder erections and decreased erectile dysfunction
  
  
• Improved libido and sexual satisfaction
  
  
• Enhanced drive, competitiveness, confidence, and assertiveness
  
  
• Better quality of sleep and increased energy levels
  
  
• Improved gut health, potentially reducing IBS and Crohn’s disease symptoms
  
  
• Enhanced mental clarity and cognitive function
  
  
• Deepened and stabilised voice
  
  
• Increased beard hair growth
  
  
• Potential reduction in all-cause mortality

When Do You Need TRT? Symptoms Of TRT

Recognising signs of low testosterone is crucial for understanding when Testosterone Replacement Therapy (TRT) may be necessary. Here are some prevalent symptoms to be aware of:
 

• Decreased sex drive/libido and erectile dysfunction
  
  
• Impaired cognition and brain fog
  
  
• Fatigue and low energy levels
  
  
• Anxiety and depression symptoms
  
  
• Loss of muscle mass and physical performance
  
  
• Reduced drive and competitiveness
  
  
• Poor sleep quality/insomnia
  
  
• Shrunken testicles

These are just a few of the most prominent symptoms. Besides these symptoms, there can be many others.

Why Are More Men in the EU Turning to Testosterone Therapy?

Testosterone levels in men can drop for various reasons, some of which are still a bit of a mystery.

It's interesting to note that the average testosterone in today's men is about 20% lower than it was two decades ago. This could be down to one or more of the following reasons:

• Environmental factors – plastics and fertilisers might release chemicals into our water and food.
  
  
• Hormones – the contraceptive pill has hormones that might mess with men's hormonal balance.
  
  
• Anabolic steroid use – using steroids can sometimes permanently stop natural testosterone production.
  
  
• Soy consumption – eating foods like soy and mint, which have phytoestrogens, could lower testosterone levels.
  
  
• Too much stress can lead to more cortisol, which might lower testosterone.
  
  
• Congenital disposition – some people are just born with conditions that lead to low testosterone.
  
  
• Ageing – as men get older, their testosterone levels naturally drop.
  
  
• Pesticide exposure – pesticides and other chemicals can affect hormone production.
  
  
• Obesity – having more body fat can convert testosterone into oestrogen, lowering overall levels and reducing production.
  
  
• Lack of hormetic stress – not having enough mild stressors like cold, heat, or limited calorie intake.

Many men nowadays are exposed to several of these factors.

While some of these reasons might be more debated than others, they likely contribute to lower hormone levels and symptoms of low testosterone. The gradual decline in testosterone levels among men in Western societies may be attributed to these factors.

Which Blood Tests Are Required Before Starting TRT in the EU?

Have you already undergone your blood tests? Verify below if you have all the requirements.

EU regulations stipulate that you must have two results indicating low total testosterone and/or free testosterone before commencing TRT therapy.

Additionally, your doctor should ensure that the following values are tested to guarantee your safe treatment:

Sex Hormone Binding Globulin (SHBG)

This protein binds to total testosterone, reducing its availability to the body. Elevated SHBG levels may lead to symptoms of low testosterone despite adequate total testosterone levels.

EU healthcare providers often overlook SHBG testing, which can hinder accurate diagnosis of testosterone-related symptoms. This value is crucial for calculating free testosterone levels and determining appropriate treatment.

Oestradiol (Oestrogen) 

Oestradiol is the primary active oestrogen component and is synthesised in the male body from testosterone through aromatase, an enzyme.

Suppose oestradiol levels are either too high or too low. In that case, they can impact male libido, erection quality, emotional well-being, fat distribution, and the development of breast tissue, potentially leading to gynaecomastia, commonly known as 'man boobs.' It is crucial to test oestradiol levels before and during treatment for low testosterone.

Follicle Stimulating Hormone (FSH)

This hormone, produced by the pituitary gland, prompts the testes to generate sperm and testosterone.

Luteinising Hormone (LH)

Another hormone from the pituitary gland, LH, stimulates testosterone production in the testicles. Understanding levels of LH and FSH is crucial in diagnosing low testosterone.

Prolactin

Elevated levels of this hormone can affect mood and sexual health, potentially reducing testosterone production. Very high levels may indicate a prolactinoma, a pituitary gland tumour that can lower testosterone levels. In such cases, a doctor might recommend an MRI scan before initiating treatment.

Prostate-Specific Antigen (PSA)

This test provides insight into prostate health. Recent research indicates that TRT doesn't heighten the risk of Prostate Cancer. However, it may exacerbate Lower Urinary Tract Symptoms and potentially worsen existing prostate cancer.

Elevated PSA levels may necessitate further tests before initiating TRT, including a physical examination by a doctor. This is mandatory for all men over 45, along with a prostate examination or scan.

Full Blood Count

TRT stimulates red blood cell production, potentially increasing blood thickness and clotting risk. If levels are high or rise during TRT, bloodletting may be necessary to reduce them.

Lipids

Some medications can adversely affect cholesterol levels (LDLs and HDLs). If these levels are concerning before treatment, consultation with your GP may be necessary before initiating TRT.

These parameters are also monitored during treatment to ensure overall health and well-being.

Additional Parameters for Consideration:

• Thyroid Hormones: Thyroid problems can manifest similar symptoms to testosterone deficiency. Checking thyroid hormones before starting TRT ensures proper diagnosis and treatment.
  
  
• Cortisol: Cortisol levels can indicate pituitary gland issues or other underlying conditions.
  
  
• Liver Function Tests: Certain medications can affect liver function. Monitoring liver enzymes helps assess medication tolerance and identify potential liver issues.
  
  
• Renal (Kidney) Function: Some medications may impact kidney function. Monitoring renal function ensures medication safety and identifies any underlying kidney issues.
  
  
• Iron Studies: These tests assess for conditions like haemochromatosis, which may require further investigation before initiating testosterone replacement therapy.
  
  
• HbA1C: This test screens for signs of prediabetes or diabetes, helping to manage metabolic health.

All these blood tests serve specific purposes and may be requested based on your medical history and current medications. If your doctor or pharmacy only relies on a single testosterone result for treatment, consider seeking care from a clinic that prioritises thorough testing and overall health.

Best Types of TRT Treatment in the EU: What Works Best?

The preferred and most productive form of TRT in the EU is through testosterone injections. 95% of our patients opt for this method, and we specialise in delivering this treatment safely and effectively.

Testosterone is typically administered via injections with an attached ester to slow its release into the body, reducing the frequency of required injections.

HCG is vital in preserving fertility and natural testosterone production while regulating other hormonal pathways.

For individuals who prefer alternatives to injections, several options are available:

• Testosterone gels or creams, though absorption issues may arise for some men. There's also a risk of testosterone transmission to women and children.
  
  
• Monthly or quarterly testosterone injections.
  
  
• Weekly testosterone injections, with Testosterone Enanthate or Cypionate being preferred options for most men, are typically administered twice or three times weekly. Sustanon, available in 1 mL ampules, is the most commonly prescribed injectable in the EU.

Pellets, inserted every 6 months, are another option but may present side effects and challenges with dose adjustment. Additionally, this option is costly and requires minor insertion, adjustments, and replacement surgery.

Frequently Asked Questions About TRT in the EU

Q1: Can I get TRT in the EU without a prescription?

No, testosterone is a controlled substance in the EU and requires a valid prescription based on lab-confirmed low levels.

Q2: Is TRT covered by public healthcare in Europe?

In some EU countries, TRT may be partially covered, but options are limited and wait times are long. Private clinics offer faster, tailored care.

Q3: What are the best types of TRT available in Europe?

Most men in the EU benefit from testosterone enanthate or cypionate injections. Gels and creams are also options, but less effective for some.

Q4: Can TRT affect fertility?

Yes, TRT can suppress sperm production. Using HCG alongside TRT can help preserve fertility in younger men.

Q5: What tests are required before starting TRT in the EU?

Two low testosterone readings (total or free) plus tests for SHBG, oestradiol, LH, FSH, PSA, and blood count are typically required.

Conclusion

Testosterone Replacement Therapy (TRT) is fast becoming a topic of interest for numerous men across the EU. While the EU has historically lagged behind other regions in offering this therapy, it's now catching up, thanks to the advent of modern treatments available through private clinics.

Embarking on TRT is a significant decision that demands thorough contemplation. It's vital to rule out and address other potential causes before considering this therapy. Certain risks are associated with TRT, particularly if it needs to be more closely monitored and managed by a specialised clinic like Androgenix.

For many, TRT has proven to be an incredibly effective way to enhance quality of life. If you suspect low testosterone might be affecting you, getting a testosterone blood test is an excellent initial step towards diagnosis.

References:

• Hackett, Geoffrey. "An Update on the Role of Testosterone Replacement Therapy in the Management of Hypogonadism."
  
  
• Tyagi, Vineet, et al. "Revisiting the Role of Testosterone: Are We Missing Something?"
  
  
• Corona, Giovanni, Luiz Otavio Torres, and Mario Maggi. "Testosterone Therapy: What We Have Learned From Trials."
  
  
• Barone, Biagio, et al. "The Role of Testosterone in the Elderly: What Do We Know?"
  
  
• Bassas, Lluís, and Eugenia Resmini. "Hormone Replacement Therapy with Testosterone."
  
  
• Bhasin, Shalender. "Testosterone Replacement in Aging Men: An Evidence-Based Patient-Centric Perspective."