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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes. Assessment and blood-test direction everywhere; prescribing, whether initiation or renewal, only where two confirmed low results and national rules allow.
- Diagnosing testosterone deficiency requires consistent symptoms plus low testosterone on two separate morning blood tests; testosterone is never prescribed for bodybuilding or sport.
- TRT suppresses sperm production in most men, and recovery after stopping can take months and is not certain.
- On testosterone, chest pain, sudden breathlessness, or sudden swelling or pain in one leg can signal a blood clot: call 112.
- Libido and mood often shift within about 3–6 weeks; strength, body composition and bone changes build over 3–12 months.
If you use testosterone and develop chest pain, sudden breathlessness, or sudden swelling or pain in one leg, call 112 now: these can be signs of a blood clot. And be aware before booking: we do not prescribe testosterone for muscle gain, sport or appearance, and no reputable doctor anywhere does. Requests without a medical diagnosis are declined, with an honest explanation of why.
How an online consultation helps with TRT
- Honest symptom triage first: low libido, erection changes, fatigue and low mood have many causes besides testosterone. The doctor works out whether your picture actually points at testosterone deficiency before any needle goes near a vial.
- The right blood tests, done right: you are told exactly what to have tested (morning total testosterone twice, plus LH, SHBG and prolactin where indicated), why the timing matters, and how to arrange it at a laboratory near you.
- Treatment with monitoring, or not at all: where TRT is lawful and clinically right for you, it comes with a schedule of testosterone, haematocrit and PSA checks. Where it is not, you are told plainly instead of strung along.
- Referral without the runaround: very low results, abnormal prolactin, fertility plans or prostate concerns need endocrinology or urology; the doctor says so and directs you there.
Can you get TRT online?
Sometimes, and only properly. Testosterone deficiency is diagnosed by consistent symptoms plus low testosterone on at least two morning blood samples taken on separate days.[1] Testosterone is prescription-only everywhere in Europe and a controlled substance in some countries, so what an online doctor may do varies: assessment and blood-test direction everywhere, prescribing and monitoring only where law and clinical findings both allow, and specialist referral otherwise.
What are the symptoms of low testosterone?
The most specific symptoms are sexual: reduced sexual desire, fewer morning erections and erectile difficulties. Physical and mood changes (persistent fatigue, loss of muscle and strength, increased belly fat, low mood, poor concentration, reduced body hair, low bone density) also occur, but they overlap heavily with sleep problems, depression, thyroid disease and ordinary overload, which is why symptoms alone never make the diagnosis.[1]
Why symptoms alone are not enough
Every symptom on that list is common in men with completely normal testosterone. Erectile difficulties in particular are more often vascular, neurological or psychological than hormonal, and deserve their own assessment; our erectile dysfunction page covers that pathway. Likewise, persistent exhaustion has a long differential worth working through on our fatigue page before anyone blames a hormone. Treating a number without a genuine deficiency exposes you to risks with no prospect of benefit.
What lowers testosterone in the first place
Obesity, type 2 diabetes, obstructive sleep apnoea, heavy alcohol use, opioid painkillers, anabolic steroid use and significant illness all suppress testosterone, and several of these are reversible.[1] Weight loss in particular can raise testosterone meaningfully in men with obesity, which is why the doctor may talk about weight loss treatment as a genuine testosterone strategy rather than a brush-off. Testosterone also declines gradually with age; a slow drift in later life is normal ageing, not automatically a disease needing treatment.
How is testosterone deficiency diagnosed?
Blood is taken in the morning, ideally between 7 and 11am and fasting, because testosterone peaks early and falls through the day; an afternoon result can look falsely low. A low result is always repeated on a separate morning before any diagnosis, because levels fluctuate and up to a third of borderline results normalise on repeat.[1] If both are low, the work-up extends: LH to tell testicular from pituitary causes, SHBG where binding may distort the total, prolactin and iron studies where indicated. European urology guidance places clear deficiency below roughly 8 nmol/L, with a grey zone up to about 12 nmol/L where symptoms, repeat testing and calculated free testosterone decide the call.[1] One number from one afternoon, or a finger-prick kit result, is not a diagnosis, whatever an advert told you.
Which situation is yours? What happens next
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Suggestive symptoms, no blood tests yet | Structured assessment, then two morning testosterone tests arranged at a local laboratory | Yes, this is the standard starting point | Not yet; testing comes first |
| One low result from an afternoon sample or a home kit | Repeat properly: morning, fasting, on two separate days before any conclusion | Yes | Only if repeat testing confirms deficiency |
| Symptoms plus two confirmed low morning results | Discuss TRT, risks and alternatives; treat reversible causes alongside | Where national rules allow remote prescribing; the doctor confirms what applies | In some countries initiation is specialist-only or in-person-only; you are told plainly |
| Planning children now or soon | TRT suppresses sperm production; fertility-preserving alternatives via a specialist | Assessment and honest advice online | Urology or endocrinology referral is the right path |
| Very low testosterone, raised prolactin, or an abnormal prostate history | Specialist work-up before any treatment decision | Initial assessment and test direction only | Endocrinology or urology, arranged promptly |
Availability of individual medicines and who may prescribe them vary by country; your doctor confirms what applies where you are.
Not sure which row is you? A doctor can tell you in one consultation. €49.
See available times →What the doctor checks in an online TRT consultation
The assessment mirrors European urology guidance rather than a marketing funnel. The doctor will typically check:
- Symptom pattern and timeline: sexual symptoms carry the most diagnostic weight; fatigue and mood are noted but never diagnostic alone.
- Your blood results, critically read: time of day, fasting state, laboratory reference ranges, and whether the mandatory second morning sample exists yet.
- Reversible suppressors: weight, alcohol, opioids, past anabolic steroid use, sleep apnoea symptoms and significant recent illness.
- Contraindications: prostate or breast cancer history, a raised haematocrit, severe untreated sleep apnoea, severe heart failure, and plans to conceive, any of which changes or blocks the plan.[3]
- Cardiovascular picture: existing heart disease and risk factors are weighed openly; European regulators found no confirmed increase in heart risk with properly diagnosed and monitored treatment, which is precisely an argument for doing it properly.[2]
- Medicines and expectations: what you take, what you expect TRT to do, and a frank correction of the gap between advertising and evidence.
What monitoring does TRT require?
Any legitimate TRT programme is built around monitoring, not just supply. Before treatment: baseline testosterone confirmed twice, haematocrit and PSA. After starting: testosterone level, haematocrit and PSA are rechecked at around 3, 6 and 12 months, then at least yearly.[1][3] The haematocrit matters because testosterone stimulates red cell production, and blood that grows too thick raises clot risk: a rising haematocrit means a dose reduction or a pause, not perseverance. PSA and prostate monitoring exist because testosterone can accelerate an existing prostate cancer, even though it has not been shown to cause one. Other effects the doctor watches for include acne, worsened sleep apnoea and mood changes. TRT also switches off the body's own signal to the testicles, suppressing sperm production, sometimes for a long time after stopping; for men who may want children, that is a central conversation, not a footnote.[3][5] A provider that offers vials without this schedule is not offering medicine.
What treatment actually looks like
Where TRT is genuinely indicated and lawful, the practical options are transdermal gels applied daily and longer-acting intramuscular injections given every few weeks to months.[4] Gels are often the sensible start: the dose adjusts easily and the effect fades quickly if treatment needs to stop, while injections suit men who are settled on a stable dose and want fewer steps. Gels come with one household caution worth knowing: skin-to-skin transfer to partners or children is real, so hands are washed and the site covered or washed before contact. Levels are rechecked on treatment to keep testosterone in the mid-normal range, not pushed to the top of it; more is not better, it is just more risk.[1]
When we treat low testosterone online, and when we refer you
We treat online: the full diagnostic assessment; direction of correct morning blood testing at a laboratory near you; treatment of reversible causes such as weight; and, where your country's rules allow remote prescribing and two confirmed low morning results plus symptoms support it, initiation or continuation of TRT with the monitoring schedule above. Where you already have a legitimate diagnosis and have moved countries, the doctor can review your records and keep monitoring on track.
We refer or redirect you: countries where testosterone initiation is specialist-only, in-person-only or otherwise restricted, stated plainly rather than worked around; men planning children, to urology or endocrinology for fertility-preserving options; very low levels, raised prolactin or other pituitary signals; prostate concerns or a rising PSA; and every request for performance or appearance use, which is refused with an honest explanation of the harms of anabolic misuse. Women's testosterone questions, which usually arise in the context of menopause care, belong with a proper hormonal assessment; our menopause page covers that pathway.
When to get in-person care
Call 112 immediately if you develop chest pain, sudden breathlessness, coughing up blood, sudden swelling or pain in one leg, or stroke-like signs such as face drooping, arm weakness or slurred speech while using testosterone: these can be signs of a blood clot. Seek prompt in-person care for a painful, swollen or hard testicle, new urinary difficulty, or symptoms of very thick blood such as persistent headaches with visual disturbance.
TRT across the EU
Testosterone is a prescription-only medicine in every EU country, and any legitimate route to treatment runs through blood tests, a diagnosis and ongoing monitoring, wherever you live. Sellers offering it without those steps are operating outside the law of every member state, and their products are a genuine safety risk.
The consultation is the honest starting point: the doctor explains what your levels and symptoms actually show, what proper treatment and monitoring involve, and whether TRT is medically justified in your case at all.
How Mobi Doctor works
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Book a time that suits you:
Open daily 7am–11pm. Most patients speak to a doctor within about 15 minutes of their booked time. €49 flat, no subscription.
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Speak to a licensed doctor about testosterone replacement therapy (TRT):
a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
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Get your assessment, blood-test plan and next steps:
treatment follows only where results and local rules support it. If we can’t help you online, you get a full refund.
No sign-up needed
Tick what you feel to see every condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Frequently asked questions about testosterone replacement therapy (TRT)
Can an online doctor prescribe TRT in Europe?
Only where three things line up: consistent symptoms, low testosterone confirmed on two separate morning blood tests, and national rules that allow remote prescribing of testosterone, which is a controlled substance in some countries. A prescription is never issued without a consultation, and where online prescribing is not permitted, the doctor tells you plainly and refers you to the right local specialist.
How much does a TRT consultation cost?
A video consultation costs €49. The exact price is shown before payment, and there is no subscription. The first consultation is an assessment: nobody receives testosterone at it, because a proper diagnosis needs two morning blood tests first.
How do blood tests work with an online service?
The doctor tells you exactly what to have tested and directs you to a laboratory or clinic near you; results are reviewed together at a follow-up video consultation. Testosterone must be sampled in the morning, ideally fasting, and a low result is always repeated on a separate day before any diagnosis is made.
Can I get TRT for bodybuilding or performance?
No. Testosterone is prescribed only for diagnosed testosterone deficiency, never for muscle gain, sport or appearance, and this is standard medical practice across Europe, not our house rule. Using anabolic steroids without a diagnosis carries real risks: infertility, blood clots, heart and liver damage, and dependence. If that conversation is relevant to you, the doctor will have it honestly.
Will TRT make me infertile?
It suppresses sperm production in most men, because external testosterone switches off the body’s own signal to the testicles, and recovery after stopping can take months and is not certain. If you may want children, say so at the assessment: fertility-preserving alternatives exist and are a specialist conversation.
Is TRT safe long term?
For men with genuinely confirmed deficiency who are properly monitored, European regulators found no consistent evidence of increased heart risk, and the known issues (thickened blood, prostate monitoring, suppressed fertility, acne, worsened sleep apnoea) are exactly what the scheduled blood checks exist to catch. Unmonitored use, and use without deficiency, is a different and genuinely risky thing.
How quickly does TRT work if I start it?
Gradually. Libido and mood often shift within about 3–6 weeks; strength, body composition and bone changes build over 3–12 months. The first-year reviews at 3, 6 and 12 months track both benefit and safety, and if symptoms have not meaningfully improved on adequate treatment, stopping is the honest move rather than escalating.
Sources & further reading
- Guidelines on Sexual and Reproductive Health, EAU, European Association of Urology, 2025.
- Testosterone-containing medicines: Article 31 referral review, EMA, European Medicines Agency, 2014.
- Testosterone Therapy in Men with Hypogonadism: clinical practice guideline, Endocrine Society, 2018.
- Male menopause: symptoms, causes, diagnosis and treatments, HSE, Health Service Executive Ireland, accessed August 2026.
- Male hypogonadism: patient information, EAU, European Association of Urology, accessed August 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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