This website has been developed by Besins Healthcare (UK) Ltd.

This website has separate sections for healthcare professionals (containing promotional information), and patients who have been prescribed Testogel® (testosterone) within the UK.

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This website is provided for patients prescribed Testogel® in the UK by Besins Healthcare (UK) Ltd.

Testosterone deficiency (TD)

What is TD?

Your body and mind need various things to stay healthy – good food, exercise, enough sleep. You might be surprised to find out that your body also relies on testosterone to stay healthy.

As you age, your testosterone levels naturally decline. However, in men with TD, testosterone levels drop too low, which can have a negative impact on your overall health.

There are many different causes of TD. Quite often, it is related to another illness or health issue(s) that you might have, such as:1,2

  • Type 2 diabetes
  • Obesity
  • High blood pressure
  • Long-term use of some medications (for example opioids, antipsychotics or anticonvulsants)

It is not fully understood how or why TD is related to these health issues, as the relationship is very complex and research is ongoing.

What is testosterone deficiency (TD)?

The symptoms of TD and how levels of the hormone can be increased naturally.


What are the signs and symptoms?

Testosterone deficiency (TD) can affect you in a lot of different ways. Many of these effects will also change over time as you continue to use Testogel®, so it is a good idea to track your symptoms during your treatment. Be sure to tell your doctor if any of the below symptoms change significantly during your treatment:

Rollover man


  • Compromised bone strength, which may lead to increased fractures
  • Muscle weakness
  • Obesity
  • High body mass index (BMI)

Sexual function1-7

  • Low libido/sex drive
  • Fewer (than usual) or a lack of morning erections
  • Erectile dysfunction
  • Delayed ejaculation

Emotional and mental health1-7

  • Depression or a decreased sense of well-being
  • Fatigue/loss of energy
  • Impaired concentration
  • Irritability
  • Sleep problems


  • Risk of heart disease and stroke


  • Insulin resistance (which can lead to type 2 diabetes if left uncontrolled)
  • Obesity
  • Type 2 diabetes

Stay informed

A clinically approved symptom checker (AMS questionnaire) can help track how you are feeling now and how you feel throughout your treatment with Testogel®. This will help you track how the treatment is working for you and whether your dose needs to be adjusted based on the improvement in your symptoms, which are often gradual.


There are two main types of testosterone deficiency (TD) in men, known as primary and secondary hypogonadism. Sometimes TD can be due to a combination of both primary and secondary hypogonadism.1

TD is sometimes referred to as male hypogonadism by healthcare professionals

This is when TD is caused by a problem with your testicles.1

This is when TD is caused by a signalling problem in your brain (the pituitary gland or hypothalamus).1

This is when men over 50 display symptoms of TD, as testosterone levels can decline as men age.

Risk factors for testosterone deficiency (TD)

Many long-term illnesses are associated with TD. These include:4-6

  • Type 2 diabetes
    • A condition that causes the level of sugar in the blood to become too high. It is caused when the body either does not react to or does not produce enough of a hormone known as insulin, and can cause many other health problems.
  • Metabolic syndrome
    • A medical term for the combination of diabetes, high blood pressure and obesity. Metabolic syndrome can increase your risk of heart disease, stroke and other conditions that affect the blood vessels.
  • Rheumatoid arthritis
    • A condition that causes pain, stiffness and swelling in the joints.
  • COPD
    • Chronic obstructive pulmonary disease (COPD) is a long-term condition that makes breathing increasingly difficult and can also cause a persistent chesty cough, chest infections and wheezing.
  • Anaemia
    • A condition that means your blood cannot carry enough oxygen to all areas of your body. There are many different types of anaemia, with different causes, but it will often cause a feeling of extreme tiredness.
  • Liver and kidney disease
    • A group of conditions that damage your liver and kidneys, and decrease their ability to keep you healthy.

It’s not fully understood whether TD is a cause or consequence of these long-term illnesses.

Treatment for testicular cancer (for example, removal of one or both testicles) and tumours of the pituitary gland (part of the brain responsible for controlling hormone levels) can cause TD.2,4

Radiotherapy and chemotherapy can also affect testosterone production.2,5

As you age, you will naturally experience a decline in testosterone. This is caused by reduced functioning of your testicles and hormonal system. It’s only when testosterone levels fall too low that you will start to experience the symptoms of TD.1,2

Having a lot of weight around your middle is a risk factor for TD. Although it’s not fully understood, changes in your metabolism that are linked to poor health (like obesity, diabetes and metabolic syndrome) are also all related to TD.1,2

Naturally increase your testosterone levels

Just like your overall health and well-being, your testosterone levels are naturally affected by life choices. Testosterone can be boosted naturally by making positive lifestyle changes.1,6 This is a good thing, as generally most of us could benefit from a healthier diet and a little more exercise.

A hectic lifestyle in which you are not getting enough sleep can result in reduced testosterone levels. Aim for 7–8 hours of sleep a night. Making good rest a priority can be more important for your health than you might realise.

Stress can directly affect the way your body releases testosterone. If you work long hours, try to take regular breaks where possible, and make sure you spend time doing activities that help you relax and wind down.

A healthy diet gives your body everything it needs to look after itself. It’s important to eat lots of fruit and vegetables and only have sugar, red or processed meat and alcohol in moderation. Eating a healthy diet is an important part of maintaining a healthy lifestyle and can naturally boost testosterone levels.

Being very overweight or underweight can naturally reduce your testosterone levels. Having too much fat around the waist is also closely related to TD.1,2 Keeping your weight stable and healthy can really help keep testosterone levels up. Use the BMI calculator to see how you are doing.

Exercise is nature’s best testosterone booster. Testosterone levels are higher in physically active men. Regular activity helps your brain to send out signals to your body to boost testosterone production. Find out more about how much exercise you should be doing each week.


  1. NHS. Male Menopause. Available at: Accessed Jan 2023.
  2. Harvard Health Publishing. Treating low testosterone levels. Published August 2019. Available at: Accessed Jan 2023.
  3. Patient. Testosterone Deficiency. Available at: Accessed Jan 2023.
  4. Sexual Advice Association. Testosterone Deficiency. Published February 2016. Available at: Accessed Jan 2023.
  5. Halpern JA, Brannigan RE. Testosterone Deficiency. JAMA. 2019;322(11):1116. doi:10.1001/jama.2019.9290.
  6. Everyday Health. What is Low Testosterone? Symptoms, Causes, Diagnosis, Treatment and Prevention. Published December 2022. Available at: Accessed Jan 2023.
  7. Endocrine Web. Low Testosterone Symptoms, Causes and Treatment. Published November 2021. Available at: Accessed Jan 2023.

BHUK/2022/181. January 2023.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at: or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.