If you have been diagnosed with low testosterone — or suspect you might have it — one of the first practical questions is how much testosterone replacement therapy (TRT) actually costs. The answer depends on whether you access treatment through the NHS or a private clinic, which medication you use, and how comprehensive the monitoring programme is.
This guide breaks down the real costs of TRT in the UK, covering everything from initial consultations and blood tests through to ongoing medication and monitoring. We will be straightforward about pricing, including where hidden costs can catch you out and what to look for when comparing providers.
TRT Through the NHS: Is It Free?
In theory, testosterone replacement therapy is available through the NHS for men with a confirmed diagnosis of testosterone deficiency (hypogonadism). If your GP or endocrinologist prescribes TRT, you will pay the standard NHS prescription charge for the medication and nothing for consultations or blood tests.
What the NHS route costs
| Component | Cost |
|---|---|
| GP and endocrinologist consultations | Free |
| Diagnostic blood tests | Free |
| Ongoing monitoring blood tests | Free |
| Medication (per prescription) | £9.90 in England (free in Scotland, Wales, and Northern Ireland) |
| Prepayment certificate (if applicable) | £31.25 for 3 months or £111.60 for 12 months |
An NHS Prescription Prepayment Certificate (PPC) caps your annual prescription costs if you need regular medications. If you are on TRT and have other prescriptions, a PPC can reduce your overall medication costs considerably.
The reality of NHS TRT access
While NHS TRT is technically low-cost, accessing it can be challenging for several reasons:
- Referral waits: Many GPs are reluctant to initiate TRT themselves and will refer to endocrinology. NHS endocrinology waiting times vary significantly across the UK, but waits of three to six months (or longer) are common in many areas
- Diagnostic thresholds: Some NHS practitioners apply conservative diagnostic criteria, requiring testosterone levels to be very low before considering treatment. Men with symptomatic testosterone deficiency but levels near the lower boundary of the reference range may be told their levels are “normal”
- Limited medication options: NHS prescribing tends to favour the most cost-effective options, primarily Sustanon 250 and testosterone gel (Testogel or Tostran). Other formulations like testosterone enanthate or Nebido may be harder to obtain on the NHS, though they are available
- Monitoring frequency: NHS follow-up can be less frequent than recommended by specialist guidelines. Some men report going 12 months or more between blood tests, which is below the monitoring standards recommended by the British Society for Sexual Medicine (BSSM)
- Limited specialist expertise: Not all endocrinologists have a specific interest in male hypogonadism, and GPs receive minimal training in TRT management. This can result in suboptimal protocols and a lack of proactive dose adjustment
None of this is to discourage you from pursuing NHS treatment if it is available to you. The NHS remains an excellent option for men who have straightforward testosterone deficiency and are able to access a knowledgeable prescriber. For a more detailed comparison, see our guide to NHS vs private TRT in the UK.
Private TRT Costs: What You Can Expect to Pay
Private TRT clinics offer faster access, a wider range of treatment options, and typically more comprehensive monitoring. However, this comes at a cost. Understanding the different components of private TRT pricing will help you compare providers accurately and avoid unexpected expenses.
Initial consultation
Most private TRT providers charge for an initial consultation where your symptoms, medical history, and blood test results are reviewed by a clinician. Costs vary widely:
| Provider type | Initial consultation cost |
|---|---|
| Private endocrinologist (face-to-face) | £200–£350 |
| Specialist TRT clinic (face-to-face or video) | £100–£250 |
| Online TRT clinic (video or asynchronous) | £50–£150 |
| Evernu | Included in treatment programme |
Some providers include the initial consultation in their overall programme fee, while others charge it separately. Be sure to ask whether the consultation fee is a one-off or whether follow-up consultations incur additional charges.
Blood tests
Blood testing is a non-negotiable part of responsible TRT. You will need baseline blood tests before starting treatment, and regular monitoring blood tests throughout. The cost of blood testing is one of the most significant variables between providers.
| Blood test type | Typical cost |
|---|---|
| Basic testosterone panel (total T, free T, SHBG) | £50–£80 |
| Comprehensive male hormone panel (full TRT panel) | £80–£150 |
| Full baseline panel (hormones + FBC + metabolic markers) | £120–£250 |
| Follow-up monitoring panel | £80–£150 |
A comprehensive baseline panel should include: total testosterone, free testosterone, SHBG, LH, FSH, oestradiol, prolactin, full blood count (including haematocrit), PSA, liver function, renal function, lipid profile, HbA1c, and thyroid function. Any provider who starts you on TRT without at least this level of baseline investigation is cutting corners.
At Evernu, blood tests are included as part of our TRT programme, so you do not face separate charges for each panel. You can also order a standalone testosterone blood test if you want to check your levels before committing to a full programme.
Medication costs
The cost of the testosterone medication itself varies significantly depending on the formulation:
| Medication | Typical dose/frequency | Cost per dose | Approximate monthly cost | Approximate annual cost |
|---|---|---|---|---|
| Sustanon 250 | 250 mg every 2–3 weeks | £3–£15 | £5–£30 | £60–£360 |
| Testosterone enanthate | 125–250 mg every 1–2 weeks | £20–£40 | £40–£80 | £480–£960 |
| Nebido (testosterone undecanoate) | 1000 mg every 10–14 weeks | £80–£120 | £25–£50 | £320–£600 |
| Testogel / Tostran (gel) | Daily application | N/A | £30–£80 | £360–£960 |
| Testosterone cream | Daily application | N/A | £40–£100 | £480–£1,200 |
These figures represent the medication cost alone. With some private providers, medication is included in the overall programme fee; with others, it is charged separately (often via a private prescription that you fill at a pharmacy).
Ongoing monitoring and follow-up consultations
Beyond the initial setup, ongoing TRT costs include regular blood tests and clinical reviews. The frequency and cost of these vary between providers:
- Blood tests: Recommended every 3 to 6 months in the first year, then every 6 to 12 months once stable. Cost: £80–£150 per panel if charged separately
- Follow-up consultations: Typically every 3 to 6 months initially, then annually. Cost: £50–£150 per consultation if charged separately
- Dose adjustments: Some providers charge for protocol changes; others include this in the consultation fee
Total annual cost of private TRT
Putting it all together, here is what a typical year of private TRT costs, depending on the medication and provider model:
| Component | Budget option (Sustanon, basic provider) | Mid-range (enanthate, comprehensive provider) | Premium (Nebido with full service) |
|---|---|---|---|
| Medication | £60–£180 | £480–£960 | £320–£600 |
| Blood tests (3–4 per year) | £240–£400 | £240–£600 | £240–£600 |
| Consultations (2–4 per year) | £100–£300 | £100–£400 | £200–£500 |
| Injection administration (if needed) | £0 (self-inject) | £0 (self-inject) | £100–£250 |
| Total annual cost | £400–£880 | £820–£1,960 | £860–£1,950 |
These are broad estimates. Actual costs depend on the specific provider, your dosing requirements, and how frequently blood tests and consultations are needed.
Online TRT Clinic Costs
The growth of regulated online TRT clinics has introduced more competition and, in many cases, more transparent pricing. Online clinics typically offer all-inclusive monthly or quarterly subscription packages that bundle consultations, blood tests, medication, and ongoing monitoring into a single fee.
Typical online TRT subscription costs in the UK range from £60 to £150 per month, depending on the medication and level of service. This can represent good value compared to paying for each component separately, though it is important to verify exactly what is included.
What to look for in an online TRT provider
- Regulatory registration: The provider should be registered with a recognised healthcare regulator (such as the CQC in England, or the RQIA in Northern Ireland)
- Prescriber qualifications: Your TRT should be prescribed by a qualified doctor, not a non-medical practitioner
- Comprehensive blood testing: Baseline and monitoring blood panels should be thorough, not limited to just testosterone levels
- Transparent pricing: All costs should be clearly stated upfront, with no hidden fees for consultations, dose adjustments, or additional prescriptions
- Clinician access: You should have access to your prescribing clinician for questions and concerns, not just automated messaging
Hidden Costs to Watch For
When comparing TRT providers, look out for costs that may not be immediately obvious:
- Setup or registration fees: Some clinics charge a one-off joining fee of £50–£200 on top of the initial consultation
- Ancillary medications: If your clinician prescribes additional medications alongside testosterone (such as anastrozole to manage oestrogen, or hCG to maintain testicular function and fertility), these may be charged separately. Costs for ancillary medications can add £20–£60 per month
- Sharps disposal: Some providers include sharps bins and needle supplies; others expect you to source these yourself
- Cancellation fees: Check the terms for cancelling your subscription or treatment programme
- Additional blood tests: If your clinician orders extra blood tests outside the standard monitoring schedule (for example, to investigate a specific side effect), these may incur additional charges
- Delivery charges: Medication delivery costs are sometimes included, sometimes charged separately
- Prescription fees: If medication is provided via private prescription rather than dispensed directly, you will pay a dispensing fee at the pharmacy
Cost by TRT Medication Type: A Closer Look
Testosterone gel (£30–£80 per month)
Testosterone gels such as Testogel and Tostran are applied daily to the skin. They offer needle-free delivery but require consistent daily application and carry a risk of transferring testosterone to others through skin contact. Gel tends to sit in the mid-range for cost, though absorption can be variable — some men require higher doses (and therefore higher costs) to achieve therapeutic levels.
Sustanon 250 (£5–£15 per injection)
The most affordable injectable option, Sustanon 250 is widely available on both the NHS and through private providers. The medication itself costs very little, though the overall cost of TRT is driven more by blood tests and consultations than by the medication. If cost is your primary concern, Sustanon offers the lowest medication expense.
Testosterone enanthate (£20–£40 per month)
Increasingly popular in private TRT clinics due to its stable pharmacokinetics when injected weekly, testosterone enanthate sits in the moderate price range. It is not as widely available on the NHS as Sustanon but can be obtained through most private providers.
Nebido (£80–£120 per injection)
The most expensive per-injection option, but the infrequent dosing (four to five injections per year) means the annual medication cost is comparable to testosterone enanthate. The additional cost of clinic-administered injections can push the total higher.
What Is Included in Evernu’s TRT Pricing?
At Evernu, we believe that TRT pricing should be transparent and comprehensive. Our treatment programmes are designed to include everything you need for safe, effective testosterone replacement therapy:
- Initial clinical assessment and consultation
- Comprehensive baseline blood testing
- Personalised treatment protocol developed by a qualified prescriber
- Testosterone medication
- Injection supplies (needles, syringes, sharps bin) for self-injecting patients
- Regular monitoring blood tests
- Follow-up consultations and protocol adjustments
- Ongoing clinician access for questions and support
We do not charge hidden setup fees, and our pricing is clearly stated before you commit to treatment. If you are interested in exploring TRT with Evernu, our free online testosterone assessment is a good starting point.
Making TRT Affordable
Here are some practical strategies for managing the cost of TRT:
- NHS route: If you have not yet explored NHS TRT, it is worth asking your GP for a testosterone blood test and referral. Even if wait times are long, the ongoing cost savings are significant
- Prepayment certificates: If you are on NHS TRT in England, a Prescription Prepayment Certificate can reduce your medication costs, especially if you take other regular medications
- Choose medication wisely: If you are paying privately and cost is a concern, discuss more affordable medication options (like Sustanon) with your clinician. The most expensive option is not necessarily the best for your situation
- Bundle packages: Providers that offer all-inclusive monthly packages can be more cost-effective than paying for each component individually
- Self-injection: Learning to self-inject (where appropriate for your medication) eliminates the cost of nursing visits for injection administration
- Annual blood test packages: Some providers offer discounted rates if you prepay for a year of monitoring
Insurance Considerations
Private medical insurance in the UK may cover some aspects of TRT, but coverage varies significantly between insurers and policies:
- Diagnostic investigations: Most comprehensive policies will cover the endocrinology consultation and diagnostic blood tests if you are referred for investigation of symptoms
- Ongoing medication and monitoring: This is where coverage becomes less certain. Some policies classify TRT as a chronic condition requiring long-term medication, which may be excluded or subject to benefit limits
- Private prescriptions: Even if the consultation is covered, the ongoing medication and monitoring may not be
If you have private medical insurance, contact your insurer before starting treatment to understand what is and is not covered. Ask specifically about coverage for “endocrine conditions” and “testosterone replacement therapy” to get a clear answer.
Is TRT Worth the Cost?
This is ultimately a personal question, but it is worth framing the cost of TRT in context. Men with confirmed testosterone deficiency often experience significant improvements in energy, mood, cognitive function, body composition, sexual health, and overall quality of life when treated appropriately. For many, these improvements have a measurable impact on their productivity, relationships, and wellbeing.
The cost of not treating testosterone deficiency — in terms of lost productivity, reduced quality of life, and potential long-term health consequences (including increased cardiovascular risk, metabolic syndrome, and reduced bone density) — is harder to quantify but can be substantial.
That said, TRT is a long-term commitment, and it is important to go in with clear expectations about both the costs and the benefits. If cost is a barrier, explore the NHS route or discuss affordable medication options with your provider.
Next Steps
If you are ready to explore whether TRT is right for you:
- Check your symptoms: Take our free online testosterone assessment to evaluate whether your symptoms are consistent with low testosterone
- Test your levels: Order a testosterone blood test to get an objective measure of your hormone levels
- Explore treatment options: Visit our TRT treatment page to learn about our approach and pricing
- Speak to a clinician: If your results suggest testosterone deficiency, our clinical team can discuss your options and develop a personalised treatment plan
Whatever route you choose — NHS, private clinic, or online provider — make sure your TRT includes comprehensive blood monitoring, qualified clinical oversight, and transparent pricing. Cutting corners on any of these to save money is a false economy that can compromise your health.
This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting or changing any medication. Evernu is regulated by the Regulation and Quality Improvement Authority (RQIA).
