Asking your GP to test your testosterone can feel unexpectedly difficult. You might expect it to be a simple request — a blood test, a number, an answer. But the reality many men encounter is more complicated. Some GPs are very willing to investigate hormonal concerns. Others are hesitant, dismissive, or simply unfamiliar with the nuances of male testosterone deficiency. Some will test total testosterone but nothing else. Others may attribute your symptoms to depression, ageing, or stress without considering a hormonal cause.
None of this means the system is broken, exactly. But it does mean that going into a GP appointment informed — knowing what to ask for, how to describe your symptoms, what the NHS can and cannot offer, and what your options are if you hit a wall — can make the difference between being taken seriously and being sent away with a leaflet.
This guide is written for men across the UK — England, Scotland, Wales, and Northern Ireland — who suspect they may have low testosterone and want to pursue testing through the NHS. It covers how to approach the conversation, what to expect from the process, common barriers and how to navigate them, and when private testing may be the more practical route.
Do GPs Actually Test Testosterone?
Yes. GPs in the UK can and do order testosterone blood tests. Testosterone testing is well within the scope of primary care, and the blood test itself is straightforward — it is processed by the same NHS laboratories that handle all other blood work.
The question is not whether they can test it, but whether they will in your specific case, and how comprehensive the panel will be if they do.
GPs are more likely to agree to testosterone testing if you present with symptoms that are consistent with testosterone deficiency. The NICE guideline NG161 on hypogonadism and the British Society for Sexual Medicine (BSSM) guidelines both support testing men who present with suggestive symptoms, particularly in the presence of risk factors like obesity, type 2 diabetes, or chronic opioid use.
How to Talk to Your GP About Testosterone
The way you frame your concerns matters. This is not about manipulating the system or exaggerating symptoms — it is about communicating clearly and ensuring your GP has the information they need to make a clinical decision.
Here are some practical suggestions:
Be specific about your symptoms. Rather than saying “I feel tired all the time,” describe the nature and impact of your symptoms. For example:
- “I have had a significant drop in my sex drive over the past six to twelve months, to the point where I have almost no interest in sex.”
- “I am waking up feeling unrefreshed even after seven to eight hours of sleep, and my energy levels crash in the afternoon. This has been going on for several months.”
- “I have noticed difficulty maintaining erections, and morning erections have become much less frequent.”
- “My mood has changed — I feel flat, unmotivated, and sometimes irritable in a way that is not normal for me.”
- “I have been losing muscle mass and gaining body fat despite maintaining my exercise routine and diet.”
- “I am having difficulty concentrating and my memory feels worse than it used to.”
Mention the duration. Symptoms that have persisted for three months or longer are more clinically significant than those lasting a few weeks, which are more likely to be related to acute stress, illness, or lifestyle factors.
Mention relevant risk factors. If any of the following apply to you, bring them up, as they increase the clinical suspicion for testosterone deficiency:
- Obesity (BMI over 30)
- Type 2 diabetes or insulin resistance
- Chronic opioid use (even prescribed)
- Previous testicular injury, surgery, or undescended testes
- History of anabolic steroid use
- Chemotherapy or radiation therapy
- Chronic conditions such as HIV, kidney disease, or liver disease
- Use of corticosteroids
- Sleep apnoea (diagnosed or suspected)
Be direct about what you are asking for. There is nothing wrong with saying: “I would like to have my testosterone levels checked. I have been experiencing [symptoms] for [duration], and I would like to rule out a hormonal cause.” A clear, informed request is more likely to be taken seriously than a vague mention of feeling “off.”
Do not self-diagnose or demand treatment. There is a difference between being informed and being prescriptive. Asking for a test is reasonable. Walking in and announcing that you have low testosterone and need TRT is likely to put your GP on the defensive. Frame it as wanting to investigate, not as having already reached a conclusion.
What Does the NHS Typically Test?
If your GP agrees to test your testosterone, the standard first-line NHS panel usually includes:
- Total testosterone — the main marker
- LH (luteinising hormone) — sometimes included, sometimes not on the first test
- Full blood count — general health screen
- Liver function tests — general health screen
What the NHS first-line panel often does not include:
- Free testosterone — arguably the most clinically meaningful measure of androgen status
- SHBG (sex hormone-binding globulin) — essential for interpreting total testosterone accurately
- Oestradiol — important for understanding hormonal balance
- Prolactin — important for identifying secondary causes of low testosterone
- FSH — sometimes included, sometimes not
- Thyroid function — may be ordered separately if clinically indicated
This limited panel is a practical reality of NHS resource allocation, not an oversight. But it does mean that a significant number of men receive a total testosterone result that looks “normal” while their free testosterone is actually low due to elevated SHBG — a situation that a more comprehensive panel would have identified.
If your total testosterone comes back in the low-normal range (for example, 10–14 nmol/L), it is entirely reasonable to ask your GP: “Would it be possible to also check my SHBG and free testosterone? My total testosterone is on the low side, and I understand that SHBG can affect the amount of testosterone that is actually available.”
Common Barriers — and How to Navigate Them
Many men report encountering resistance when asking their GP to test testosterone. Here are the most common barriers and how to handle them constructively.
“Your symptoms sound like depression.”
There is genuine overlap between the symptoms of low testosterone and depression: fatigue, low mood, poor concentration, reduced motivation, and loss of interest in activities. It is not unreasonable for a GP to consider depression as a possibility. The problem arises when depression is assumed without considering a hormonal cause, particularly when other symptoms such as reduced libido, erectile dysfunction, and loss of morning erections are also present.
A reasonable response: “I understand that these symptoms can overlap with depression, and I am happy to discuss that possibility. But I am also experiencing reduced libido and fewer morning erections, which I understand can be associated with low testosterone. Would it be possible to check my levels to rule that out as a contributing factor?”
If your GP prescribes an antidepressant without investigating testosterone, be aware that some SSRIs can actually worsen sexual symptoms and may further suppress testosterone. This is not to say antidepressants are wrong in every case — but a blood test to check hormonal status before starting treatment is reasonable due diligence.
“You are too young to have low testosterone.”
While testosterone deficiency is more common in older men, it is by no means exclusive to them. Testosterone deficiency in men under 40 is well documented and can result from genetic factors, previous anabolic steroid use, obesity, medications, chronic illness, or testicular issues. Age alone should not be used to dismiss the possibility.
A reasonable response: “I understand it is more common in older men, but I have read that it can affect younger men too, particularly with [your relevant risk factor]. Given that my symptoms have been persistent, I would really value having it checked.”
“Your levels are normal.”
This is perhaps the most frustrating response — receiving a total testosterone result of, say, 11 nmol/L and being told it is “within range.” Technically, it is within the laboratory reference range. Clinically, it is in the grey zone where symptoms are common, and without free testosterone and SHBG, the result is incomplete.
If this happens, you have several options:
- Ask for SHBG and free testosterone to be tested, explaining that your total testosterone is at the lower end and you understand that SHBG levels can affect the clinical picture.
- Request a referral to endocrinology for a specialist opinion. You are entitled to a second opinion, and a specialist may take a different view.
- Seek a private comprehensive panel that includes free testosterone, SHBG, LH, FSH, oestradiol, and prolactin. This can either confirm that your hormone levels are genuinely adequate, or provide evidence to support a clinical case for treatment.
“We do not prescribe testosterone / that is a specialist decision.”
This is actually a fair point. Most GPs are not trained or experienced in initiating testosterone replacement therapy, and current guidelines recommend that TRT be started by a specialist (endocrinologist or urologist) or by a clinician with specific expertise in testosterone deficiency. Your GP’s role is typically to test, identify a potential problem, and refer appropriately.
If your GP confirms low testosterone but says they cannot prescribe treatment, the next step is a referral to endocrinology or a men’s health clinic.
The NHS Referral Pathway
If your GP identifies low testosterone on blood testing (usually confirmed on two separate morning samples), the standard NHS pathway involves referral to an endocrinologist. Here is what to expect:
Referral criteria: Two confirmed low morning testosterone results (generally below 12 nmol/L, and certainly below 8 nmol/L) along with clinical symptoms. Some GP practices may also refer based on borderline results with significant symptoms.
Waiting times: This is where the NHS pathway can become difficult. Endocrinology is a specialist service, and waiting times vary enormously across the UK:
- England: Waiting times for a first endocrinology appointment range from 4 to 26 weeks depending on the NHS trust. Some areas, particularly in rural regions and areas with workforce shortages, can have waits exceeding six months.
- Scotland: NHS Scotland health boards report variable waits, typically 8 to 20 weeks for non-urgent endocrinology referrals.
- Wales: NHS Wales waiting times for endocrinology consultations have been among the longest in the UK in recent years, with some health boards reporting waits of 20 weeks or more.
- Northern Ireland: Health and Social Care (HSC) trust waiting lists for endocrinology in Northern Ireland have historically been lengthy, with some patients waiting over six months for a first appointment.
What happens at the endocrinology appointment: The specialist will typically review your blood results, take a detailed medical and symptom history, examine you (including testicular examination), and may order additional investigations such as a pituitary MRI (if secondary hypogonadism is suspected), bone density scan (if deficiency has been long-standing), or semen analysis (if fertility is a concern). They will then discuss treatment options if a diagnosis of testosterone deficiency is confirmed.
Ongoing management: If TRT is initiated by the specialist, ongoing prescribing and monitoring may be transferred back to your GP under a shared care agreement. However, some GP practices are reluctant to accept shared care for TRT, which can create complications with ongoing prescriptions.
Your Rights as a Patient
It is worth knowing your rights within the NHS system:
- You have the right to request a blood test. While your GP can decline if they feel it is not clinically indicated, you can explain your reasoning and ask that the refusal be documented in your medical records.
- You have the right to a second opinion. If your GP dismisses your concerns, you can see a different GP within the same practice or request a referral for a specialist opinion.
- You have the right to access your test results. You can request a printed copy of your blood test results from your GP practice. Many practices now offer online access via the NHS App, where you can view your results and reference ranges directly.
- You can refer to NICE guidelines. If you feel your GP is not following best practice, you can politely reference the relevant NICE or BSSM guidelines. These are not mandatory, but they represent the clinical standard of care that GPs are expected to follow.
- You can make a formal complaint. If you believe your concerns have been unreasonably dismissed, the NHS complaints process is available through your GP practice’s patient liaison service (PALS in England) or equivalent in the devolved nations.
When Private Testing Makes More Sense
For some men, private testing is not about bypassing the NHS — it is about getting a more complete picture, more quickly. There are several situations where private testing may be the practical choice:
- Your GP will not test you. If your GP declines to test your testosterone despite persistent symptoms, a private blood test can either confirm that your levels are fine (providing reassurance) or demonstrate a clear abnormality that you can bring back to your GP to support a referral.
- You want a comprehensive panel. If you want total testosterone, free testosterone, SHBG, LH, FSH, prolactin, oestradiol, thyroid function, and a full blood count tested simultaneously, private testing provides this in a single panel rather than requiring multiple GP visits.
- You cannot wait. If your symptoms are significantly affecting your quality of life, waiting weeks for a GP appointment followed by weeks for results followed by months for an endocrinology referral may not be acceptable. Private testing delivers results within days.
- You want continuity of care. Some private clinics, including regulated providers like Evernu, offer not just testing but an integrated pathway from diagnosis through to treatment and ongoing monitoring, with consistent clinical oversight.
What to Do With Your Results
Whether you test through the NHS or privately, the next step depends on what the results show:
If your results are clearly normal (total testosterone above 15 nmol/L with adequate free testosterone), your symptoms likely have another cause. This is actually useful information — it directs investigation toward other possibilities such as thyroid dysfunction, iron deficiency, sleep disorders, or mental health conditions.
If your results are in the grey zone (total testosterone 8–12 nmol/L), free testosterone and SHBG become the deciding factors. If these were not tested, they should be. If free testosterone is low alongside symptoms, further investigation and potentially treatment are warranted.
If your results are clearly low (total testosterone below 8 nmol/L on two occasions), the priority is determining the cause (primary vs secondary hypogonadism, reversible vs non-reversible) and discussing treatment options.
Regardless of where you test, the results belong to you. If you have private results showing low testosterone, you can and should share these with your GP. While some GPs may want to repeat the test through an NHS lab, private results from an accredited laboratory are valid clinical evidence and should be taken into account.
Frequently Asked Questions
Will my GP test my testosterone if I just ask?
Most GPs will agree to test testosterone if you present with relevant symptoms such as reduced libido, erectile dysfunction, persistent fatigue, low mood, or loss of muscle mass. However, if your GP feels there is no clinical indication, they may decline. Presenting clearly, mentioning specific symptoms and their duration, and referencing relevant risk factors significantly increases the likelihood of your request being approved. If your GP declines, you are entitled to see another GP for a second opinion or pursue private testing.
How long does it take to get testosterone test results on the NHS?
NHS blood test results typically take between three and seven working days to be processed, though this varies by laboratory and region. Some GP practices will contact you only if results are abnormal; others will ask you to book a follow-up appointment to discuss results regardless. You can also access many blood test results through the NHS App, which provides direct online access to your medical records, including lab results.
Can I take my private testosterone results to my GP?
Yes. Private blood test results from an accredited laboratory are valid medical evidence. Your GP may want to repeat the test through an NHS lab to confirm the findings, but they should take your private results into account when making clinical decisions. Bringing comprehensive private results can actually help your case, particularly if your private panel shows low free testosterone or elevated SHBG that a standard NHS panel would not have detected.
What if my GP says my testosterone is normal but I still have symptoms?
First, request a copy of your actual result and the reference range used. A total testosterone of 9 nmol/L and 22 nmol/L are both “within range” but represent very different clinical situations. If your result is at the lower end of the reference range, ask whether SHBG and free testosterone can be tested. If your GP is not willing to investigate further, you can request a referral to endocrinology for a specialist assessment, seek a second opinion from another GP, or obtain a comprehensive private panel to get a fuller picture.
How often should testosterone be retested?
For diagnostic purposes, a low testosterone result should be confirmed with a repeat test two to four weeks later, taken in the morning under fasting conditions. If you are already on TRT, monitoring blood tests are typically performed every three to six months in the first year and then every six to twelve months once stable, as recommended by the BSSM guidelines. These monitoring tests should include not just testosterone but also haematocrit, PSA (for men over 40), and liver function.
Moving Forward
Getting your testosterone tested on the NHS is achievable, and for many men it works well. The key is approaching the conversation with your GP clearly and informedly, knowing what to expect from the process, and understanding the limitations of standard NHS testing so you can advocate for a more complete picture when needed.
If you are finding the NHS pathway slow, limited, or frustrating, and your symptoms are affecting your daily life, a private consultation with a regulated provider can bridge the gap. Evernu’s testosterone assessment service offers comprehensive hormone panels, clinical evaluation, and treatment pathways for men across the UK, with the clinical governance and regulatory oversight (RQIA-regulated) that you should expect from any healthcare provider managing hormone therapy.
Whatever route you take, getting tested is the right first step. The numbers do not lie, and they provide the foundation for every decision that follows.
