Do I need blood tests before starting TRT?

Yes. TRT is only started once low testosterone is biochemically confirmed, usually on two separate morning samples, alongside a wider baseline panel covering hormone, blood count, prostate and liver markers. This applies whether you are treated on the NHS or privately.

How often will I need blood tests once I'm on TRT?

Most UK programmes test again around 3 months after starting or after a dose change, again at 6 months, then every 6 to 12 months once things are stable. Testosterone level, haematocrit and, where age-appropriate, PSA are checked at each round.

What happens if my haematocrit is too high on TRT?

TRT can thicken the blood by raising red cell mass. If haematocrit rises above a safe threshold, a clinician will typically reduce the dose, space out injections, or arrange venesection, a blood donation style procedure, to bring it back down, then re-test before continuing.

Are TRT blood tests available on the NHS?

Yes, if you are being investigated or treated for suspected hypogonadism through your GP or an NHS endocrinology service, the relevant baseline and follow-up bloods are funded as part of that pathway. Private testing is generally faster to arrange and interpret, which is the main reason people choose it.

How much do TRT blood tests cost privately?

A baseline workup, covering the consultation and full panel, commonly costs £150 to £400 privately in the UK. Follow-up monitoring rounds are usually £60 to £120 each if billed separately, though some programmes bundle monitoring into the ongoing monthly fee instead.

Men's Health

What happens at your first TRT consultation

Reviewed by the My London Pharmacy clinical team, Yvonne Lim, Pharmacist Independent Prescriber ·2 September 2026 ·8 min read

Quick answer

A first TRT consultation is a detailed conversation, not a quick form: a clinician reviews your symptoms, medical history and current medicines, then arranges baseline blood tests before anything is prescribed. A prescription is only ever issued once your results confirm hypogonadism.

A first TRT consultation is often pictured as a short form and a quick prescription. In a properly run service, it's the opposite: a detailed conversation that comes before any blood test is even booked, let alone before anything is prescribed. Here's exactly what to expect, step by step, so there are no surprises when you actually sit down for it.

Knowing what a good consultation looks like in advance is also a useful way to judge a provider before you commit to anything. If what's described here doesn't match what you're offered, whether that's a rushed conversation, a lack of interest in your medical history, or an offer to prescribe without bloods, that mismatch is worth paying attention to rather than dismissing it as unimportant.

Before you book

It's worth having a few things ready before your consultation: a rough timeline of when your symptoms started and how they've changed, a list of any current medicines or supplements, any past relevant test results you have, and any questions you want answered. None of this needs to be formal; a clinician will ask the right questions, but arriving with a clear picture in your head helps the conversation move efficiently. It also means less back-and-forth later if a detail you'd have otherwise forgotten during the call turns out to be relevant to your case.

It's also worth thinking, even briefly, about your own priorities before the call. Some men are mainly focused on a specific symptom, such as low libido or persistent fatigue; others are more concerned with a general sense that something isn't right. Either is a perfectly valid reason to book a consultation, but knowing which one applies to you helps you get the most out of the conversation.

What's covered in the consultation

A thorough first consultation typically covers:

A detailed history of your symptoms and how long you've had them
Your general medical history, including relevant family history
Lifestyle factors such as sleep quality, alcohol intake and exercise
Any current medicines, including over-the-counter products and supplements
An honest explanation of what TRT involves and what realistic expectations look like

A properly run consultation will also be clear that bloods come before anything is prescribed. If a provider offers to prescribe testosterone based on this conversation alone, without arranging baseline blood tests first, that's a sign to be cautious. This is also the point where a clinician will explain, honestly, what TRT can and can't be expected to do. It treats confirmed low testosterone effectively, but it isn't a general energy or muscle-building shortcut for men with normal levels.

Four-step graphic: medical history, baseline bloods, results reviewed, plan agreed

Blood tests: what happens next

If your history suggests testing is worthwhile, your clinician arranges a baseline blood panel, either as a home finger-prick or venous kit, or a venous draw at a clinic. Our full guide to TRT blood tests covers exactly what's included and why. This step matters because it's what actually confirms a diagnosis, rather than relying on symptoms and a conversation alone, however thorough that conversation has been.

You'll usually be given clear instructions on timing, since accuracy depends on it: the sample needs to be taken early in the morning, when testosterone is at its natural daily peak, and ideally not immediately after an illness, a poor night's sleep, or an unusually stressful few days. If the first sample comes back low, it's standard practice to repeat it on a second morning before anything is confirmed.

Reviewing your results

Once results are in, a clinician reviews them alongside your symptoms and history, rather than simply sending you a set of numbers. They'll explain what each result means for you specifically, including anything that needs a closer look or a repeat test before a decision is made. Don't feel you need to fully understand every marker before the call; that's precisely what the review is for, and asking a clinician to explain something again in plainer terms is a completely normal part of the conversation, not something to feel embarrassed about.

If TRT is appropriate for you

Where a diagnosis of hypogonadism is confirmed and TRT is agreed as the right approach, your clinician will talk through formulation options, set out the ongoing monitoring plan, and be clear about cost before anything is finalised. A prescription and your first supply are arranged from there. This is also the point where practical questions get answered: how often you'll be reviewed, and what happens if a dose adjustment is needed.

If TRT isn't the right answer

Sometimes results don't confirm hypogonadism, or a different, non-hormonal cause becomes clear during the consultation, such as poor sleep, an undiagnosed sleep disorder, a mental health factor, or a lifestyle contributor. A good service doesn't leave you without an answer in this situation; your clinician should discuss what's actually going on and what the more appropriate next step looks like for you. This outcome is more common than many people expect, and it isn't a dead end: symptoms that overlap with low testosterone often have a genuine, treatable cause once properly investigated.

Whatever the outcome, you should leave your first consultation with a clear next step, not an open-ended "we'll be in touch." Whether that's a booked blood test, a referral for a different investigation, or practical advice on a lifestyle factor to address first, a properly run service gives you something concrete to act on rather than leaving you to work out what happens next on your own.

Frequently asked questions

What happens at a first TRT consultation?

A clinician reviews your symptom history, general health, lifestyle and current medicines, explains what TRT involves realistically, and arranges baseline blood tests before anything is prescribed.

Do I need blood tests before the first consultation or after?

After. The consultation comes first so a clinician can decide, based on your history, whether testing is worthwhile and exactly what panel to arrange.

How long does the whole process take?

This varies by route, but a private consultation can often be arranged within a few working days, with blood test results typically back within a few days once the sample reaches the lab.

Will I definitely be prescribed TRT?

No. A prescription is only issued if your blood results confirm hypogonadism alongside your symptoms. Many men who start this process are found to have a different, non-hormonal cause.

What if my results don't show low testosterone?

Your clinician will discuss what else might be contributing to your symptoms, such as sleep, mental health or lifestyle factors, and talk through a more appropriate next step rather than leaving you without an answer.