Why Your GP Might Refuse a Testosterone Test in the UK

Meet James

James is 44 and works in IT. Over the past year he has noticed his energy dropping, his motivation fading and his gym progress stalling. He also admits his sex drive is not what it used to be. Thinking it might be his testosterone, he went to see his GP.

After listening to his symptoms, the GP explained that they did not meet the specific criteria used in the NHS for testosterone testing. These criteria focus on a combination of symptoms and examination findings that point strongly toward a hormone deficiency. Without these clear indicators, NHS doctors are advised not to arrange tests, as many mild symptoms can be caused by stress, poor sleep, changes in lifestyle or other medical conditions. James left feeling frustrated but understood his GP was following clinical protocols.

Why GPs might say no

Testosterone testing on the NHS is not offered as a routine health check. GPs work within structured care pathways designed to make sure each test ordered is clinically justified and likely to influence what happens next. If there is little chance that a result will lead to a change in treatment, the NHS prefers not to carry out the test.

Here are some common reasons a GP may decline:

• Symptoms are vague or non-specific – fatigue, low mood and reduced energy are common in midlife and often have multiple possible causes. NHS practice is to first rule out more common issues such as thyroid imbalance, anaemia, vitamin deficiency, poor sleep, stress, and depression.

• No clear signs on examination – if there are no physical changes that suggest low testosterone, such as loss of body hair, reduced muscle mass or testicular changes, testing is less likely to be approved.

• Timing and accuracy concerns – testosterone varies through the day and should be tested in the early morning when levels peak. If a reliable sample cannot be arranged, GPs may prefer to wait.

• Transient causes are possible – illness, injury, significant weight change, and stress can temporarily lower testosterone. GPs may want these factors resolved first to avoid misleading results.

• NHS resources – while the test itself is not expensive, unnecessary testing at scale can put pressure on NHS budgets and lab capacity, so criteria are used to keep it targeted.

In practice, this means that even if a patient feels strongly about testing, a GP may still recommend addressing lifestyle factors or investigating other possible causes before arranging a hormone panel.

When private testing can help

Private testosterone testing is available without a GP referral, which means you can arrange it even if you do not meet NHS criteria. This can be helpful if:

• You have ongoing symptoms and want quicker access to testing

• You want to check a broader range of hormones alongside testosterone

• You wish to track levels over time for personal monitoring

Types of private testosterone tests

Finger-prick home kits

• Posted to you and involve taking a small sample of blood from your finger

• Convenient and can be done at home, but may be less accurate for certain markers than a vein sample

• Best for initial screening or repeat monitoring

Clinic-based blood tests

• Taken by a nurse or phlebotomist from a vein in your arm

• More reliable for full hormone analysis

• Can be combined with other health checks in one visit

Comprehensive hormone panels

• Measure total testosterone, free testosterone, SHBG (sex hormone binding globulin), and often other related hormones such as LH, FSH, and prolactin

• May also include thyroid function, vitamin D, cholesterol, and glucose to give a broader view of health

Disclaimer

This is for information only and not a substitute for medical advice. Always speak to a qualified healthcare professional about your symptoms or before starting treatment.