Dr Xand reports 52% rise in testosterone dispensing
dr xand is reporting a 52% rise in testosterone-related items dispensed in the community between 2020/2021 and 2024/2025. The increase comes as clinicians describe testosterone replacement therapy as controversial, with some men obtaining it outside NHS oversight and testing.
David Edwards, a GP and former chair of the Primary Care Testosterone Advisory Group, said: “There’s more to testosterone than sex,” and added: “I think if testosterone was not involved in sex, it would never have the problems it does.” He also described men as “who have lost their ‘oomph’.”
Edwards on testosterone use
Edwards said testosterone is promoted online for fatigue, loss of muscle mass and concentration that can accompany low testosterone levels. Low testosterone is also called male hypogonadism, and it can point to problems with the testes, hypothalamus or pituitary gland. Testosterone levels can also decline slowly from mid-life onwards, or because of comorbid conditions such as diabetes mellitus and obesity in functional hypogonadism.
Some clinics claim as many as one in four men over the age of 30 years suffers from low testosterone. That figure sits alongside the rise in dispensing, and it shows why the drug is moving through both mainstream care and a wider commercial market at the same time.
Matthew Heppel on illicit TRT
Matthew Heppel, an advanced clinical diabetes and endocrinology pharmacist at Hull University Teaching Hospitals NHS Trust, said social media posts, especially on TikTok, promote testosterone. Heppel added: “The patients who follow these are not coming into primary care or our clinics to get it,” drawing a line between patients seeking medical assessment and those turning elsewhere for treatment.
Several sources suggested that men obtaining TRT illicitly tend to be younger and may be involved in bodybuilding. In 2021, it was reported that a bodybuilder died after injecting TRT and other drugs he had bought on the internet after his GP would not prescribe TRT. Illicit suppliers do not have access to NHS information about a man’s previous health history, are unlikely to carry out the recommended tests, and will not be able to check for contraindications or provide information on side effects.
Channa Jayasena on safety
Channa Jayasena, professor in reproductive endocrinology and andrology at Imperial College London, said in some cases the drug may not be from a pharmaceutical source and may have been “brewed up in someone’s kitchen.” The BNF warns about accidental transferral to children leading to genital enlargement, while other side effects listed include raised haematocrit and prostate-specific antigen levels, as well as increased blood pressure.
For readers weighing TRT, the practical point is simple: the rise in use does not separate safe prescribing from unsafe use. Men being pushed toward treatment by online marketing, and younger men seeking it outside routine care, face different risks, and the safety checks that should come with prescribing are the line between them.
