Concierge male endocrinology · London
Male hormone testing, testosterone, LH, FSH, SHBG, prolactin and PSA — the modern male endocrine workup.
A comprehensive male endocrine panel: morning total testosterone (with free / bioavailable), LH, FSH, SHBG, prolactin, oestradiol and PSA — interpreted by a consultant endocrinologist or urologist for hypogonadism, subfertility, prostate health and TRT monitoring.
Why patients choose us
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The right hands
We route you to a consultant endocrinologist or urologist — the person interpreting testosterone, LH and FSH decides the answer.
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Often answers same-week
Fasted morning bloods, interpreted within days — with a clear plan for TRT, fertility or pituitary work-up.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
Six things to know about the male hormone panel.
Everything a well-informed patient should understand before the blood draw — assay timing, the free-T calculation, and the prostate baseline.
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Definition
A male endocrine hormone panel — the core bloods that describe the hypothalamic–pituitary–gonadal axis.
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Fasted morning testosterone
Drawn 7–10am when total testosterone peaks diurnally — the only time the number is reliable.
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Free / bioavailable testosterone
Calculated from total T, SHBG and albumin — the physiologically active fraction.
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LH / FSH distinguish 1° vs 2°
High LH/FSH with low T = primary (testicular). Low or normal LH/FSH with low T = secondary (pituitary).
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SHBG and albumin needed for free T
Without SHBG and albumin, free T cannot be calculated — total T alone can mislead.
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PSA and DRE before TRT
A prostate baseline (PSA plus digital rectal examination) is standard before testosterone replacement.
The problem
A testosterone result is only as good as who orders and interprets it.
Total testosterone alone is not a diagnosis. SHBG, LH/FSH, prolactin and the time of day decide what the number means — and whether TRT, cabergoline, clomiphene or lifestyle is the right next step.
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Low energy, low libido, low mood?
We arrange a properly-timed morning panel and a consultant interpretation — not a self-serve online test.
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Thinking about TRT?
Baseline PSA, haematocrit, lipids and a fertility conversation — before the first prescription.
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Trying to conceive?
A hormone panel folded into an andrology work-up — clomiphene where TRT would harm fertility.
The diagnostic pathway
From consultation to plan — what happens, in order.
One clinician from first consultation to interpretation — usually within a week.
- 01
Consultation
Consultation with endocrinologist / urologist
A focused history: symptoms, libido, mood, energy, fertility plans, prior TRT and pituitary red flags.
- 02
Consultation
Fasted morning blood test (7–10am)
A single venous draw at your local phlebotomy or clinic — fasted, at the diurnal peak.
- 03
Investigations
Confirm low T with a repeat
Guidelines require two low morning testosterone readings before a diagnosis of hypogonadism is made.
- 04
Investigations
SHBG + albumin + LH/FSH
The supporting panel that turns a total T number into a diagnosis — and separates primary from secondary hypogonadism.
- 05
Investigations
Prolactin and TSH
Prolactin excludes a prolactinoma; TSH excludes thyroid disease masquerading as low T.
- 06
Onward
Pituitary MRI if T low + LH low
Secondary hypogonadism warrants pituitary imaging — a small adenoma is a common, treatable finding.
- 07
Onward
Personalised plan
Lifestyle first; TRT, cabergoline or clomiphene where indicated; structured monitoring built in.
Typical end-to-end: 1–2 weeks. Urgent cases (visual field defect, macroadenoma): same week.
What it shows
When a male hormone panel is the right test.
The panel answers specific questions — is testosterone low, why, and what should be done. These are the presentations we see most.
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Primary hypogonadism
Low testosterone with high LH/FSH — the testes are failing to respond.
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Secondary hypogonadism
Low testosterone with low or inappropriately normal LH/FSH — the pituitary signal is missing.
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Hyperprolactinaemia (secondary)
Elevated prolactin suppressing gonadotrophins — usually a pituitary microadenoma.
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Klinefelter syndrome
Very low testosterone with markedly raised LH/FSH and azoospermia — karyotype confirms.
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TRT monitoring
Serial testosterone, PSA and haematocrit on treatment — safety and efficacy in one panel.
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Male infertility investigation
Hormonal component of subfertility work-up — alongside semen analysis and andrology review.
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Age-related low T
Symptomatic low testosterone in older men — treated only when symptoms and biochemistry agree.
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Red flag: markedly elevated prolactin + visual field defect — pituitary MRI urgent
Suspect a macroprolactinoma. Urgent MRI and endocrinology — not a routine outpatient wait.
Treatment options
Not every low testosterone needs testosterone.
The panel points to a treatment — from lifestyle change to TRT, cabergoline, clomiphene or pituitary surgery.
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Lifestyle optimisation
Weight loss, sleep, alcohol reduction — often raises testosterone enough to avoid TRT altogether.
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Testosterone replacement therapy
Gel, injection or long-acting depot — chosen with the patient, with baseline PSA, haematocrit and lipids.
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Cabergoline for prolactinoma
Dopamine agonist that normalises prolactin, restores testosterone and often shrinks the adenoma.
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Clomiphene for secondary hypogonadism
Preserves fertility by driving endogenous LH/FSH — an alternative to TRT when family planning matters.
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Andrology referral for infertility
Semen analysis, testicular ultrasound and specialist andrology input alongside the hormone panel.
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Pituitary surgery (specialist)
Transsphenoidal resection for macroadenomas, mass effect or dopamine-agonist failure.
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Structured TRT monitoring
Testosterone, PSA and haematocrit at 3, 6 and 12 months — then annually — to catch polycythaemia and prostate change early.
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Multi-disciplinary team review
Endocrinology, urology and andrology together — for infertility, pituitary disease and complex TRT cases.
Our vetted London network
A small panel of clinicians, we picked them.
Consultant endocrinologists and urologists across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinician in our network.
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Consultant endocrinologists or urologists with a special interest in male hormonal health
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UKAS-accredited laboratories with validated assays for testosterone, SHBG, LH/FSH and prolactin
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Same-week interpretation and a written plan, with images available for onward review
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Onward andrology, fertility or pituitary pathway where the biochemistry demands it
Safety and eligibility
A safe test — when it is done properly.
A hormone panel is a blood test. The safety story is really about who orders it, when it is drawn, and how TRT — if it follows — is monitored.
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Fasted morning draw
Blood taken between 7 and 10am, fasted — the only window in which total testosterone is reliably interpretable.
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Two readings before diagnosis
Hypogonadism is a diagnosis of two low morning testosterone readings, not one.
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SHBG and albumin included
Without them, free testosterone cannot be calculated and a total-T number can mislead in either direction.
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Prolactin and TSH always
A prolactinoma or unrecognised thyroid disease will masquerade as simple low T — the panel excludes both.
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PSA and DRE before TRT
Baseline prostate assessment is standard before starting testosterone replacement.
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Haematocrit on TRT
TRT can drive erythrocytosis — monitored at 3, 6 and 12 months, then annually.
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Fertility conversation up front
TRT suppresses spermatogenesis. If fertility matters, clomiphene or gonadotrophin therapy is discussed before the first injection.
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Not a screening test
The panel is for men with symptoms or a clinical reason to test — not routine well-man screening.
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Bring prior bloods and medication list
Opioids, steroids and some antipsychotics suppress the axis — the medication list changes interpretation.
Red flags we specifically look for
- Pituitary macroadenoma
- Prolactinoma with visual field loss
- Klinefelter syndrome
- TRT-induced polycythaemia
- TRT-induced prostate cancer progression
- TRT-induced sleep apnoea worsening
- Testosterone abuse (very high T + low LH)
- Male osteoporosis
- Male-factor infertility (azoospermia)
Reading your report
A hormone panel report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and symptoms
Your details, the clinical question, and the symptom pattern that shapes interpretation.
- 02 Technique
Assays and sampling conditions
Which laboratory, which assay platform, and whether the sample was fasted morning as required.
- 03 Findings
Testosterone, LH, FSH, SHBG, prolactin, PSA
Value-by-value results with reference ranges, calculated free and bioavailable testosterone, and PSA.
- 04 Impression
The conclusion: read this first
Normal, primary or secondary hypogonadism, hyperprolactinaemia — and the concrete next step.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about male hormone testing.
Quick answers on morning timing, primary vs secondary hypogonadism, TRT, prostate safety and fertility.
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What is included in a male hormone panel?
The core panel is total testosterone, SHBG, albumin (for calculated free and bioavailable T), LH, FSH, prolactin, oestradiol and PSA — with TSH added to exclude thyroid disease masquerading as low T.
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Why does the blood test have to be in the morning?
Total testosterone follows a diurnal rhythm and peaks between 7 and 10am. A number taken in the afternoon can look falsely low and lead to a wrong diagnosis, so the draw must be fasted, morning and — if low — repeated.
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What is the difference between primary and secondary hypogonadism?
Primary hypogonadism is testicular failure: testosterone is low and LH/FSH are high because the pituitary is trying to drive the testes harder. Secondary hypogonadism is a pituitary or hypothalamic problem: testosterone is low and LH/FSH are low or inappropriately normal.
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Do I need testosterone replacement therapy?
Only if you have symptoms and confirmed low morning testosterone on two occasions, with a reversible cause excluded. Weight loss, sleep and alcohol reduction come first — many men rise back into range without medication.
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Is TRT safe for the prostate?
Current evidence does not show that TRT causes prostate cancer, but it can accelerate an existing cancer. A baseline PSA and digital rectal examination are standard before starting, with PSA rechecked at 3, 6 and 12 months.
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Will TRT affect my fertility?
Yes — TRT suppresses LH and FSH and therefore spermatogenesis, often severely. If you want children now or in future, clomiphene or gonadotrophin therapy is the right route, not testosterone injections.
Sources
Guidelines this guide follows.
- British Society for Sexual Medicine. Guidelines on the management of testosterone deficiency.
- Society for Endocrinology. Position statement on adult testosterone deficiency.
- European Association of Urology. Guidelines on male hypogonadism.
- Endocrine Society. Testosterone therapy in men with hypogonadism — clinical practice guideline.
Reviewed by Pulse Atlas Editorial Board (). Last reviewed 2026-07-30. Next review 2027-07-30. Reading time approximately 6 minutes.
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In practice, in London
Booking male hormone testing privately in London — what actually happens
With male hormone testing, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. On the NHS, male hormone testing typically sits behind a triage step and a wait that can stretch from a few weeks into months. In London’s private sector, the same appointment often lands within days. That speed matters when symptoms are disrupting work, sleep, or a plan you’d already committed to — and it’s the single most common reason people call us in the first place.
A private male hormone testing pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For male hormone testing specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see male hormone testing — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.