“Are your male hormones getting the better of you? It could be low testosterone.” That’s a message from a health company called Voy, prominently featured throughout London’s Underground. This provocative advertising campaign has not only gained popularity but also raised eyebrows, especially among women who’ve often been labeled “hormonal.” The insinuation here seems to be that men’s poor behavior might not be entirely personal responsibility; another poster in the series bluntly states, “Feeling irritable? It might be low testosterone.”
The ads shed light on companies like Voy that are promoting at-home blood test kits designed to help men check for testosterone deficiencies, with offerings that also include treatments for menopause and GLP-1s.
The process generally involves a test to assess testosterone levels (costing £33.95 with Voy), a follow-up test for confirmation, and then consultations leading to potential testosterone replacement therapy (TRT). Similar services are also provided by other firms such as Numan, Optimale, Balance My Hormones, Alphagenix, and Urban TRT.
Dr. Rob Stevens, who has managed The Men’s Health Clinic in Dorset for a decade and specializes in testosterone deficiencies, notes that men of a certain age are being inundated by these ads. He points out that the frequency of testosterone blood tests has surged due to this aggressive marketing strategy. According to the research firm Future Market Insights, the global testosterone market was estimated at $114.3 million in 2025, with blood testing being the largest segment.
So, who really needs testing, and what should they know about TRT?
Testosterone plays a vital role in many physiological processes in men, including growth of hair and muscles, bone density, mood regulation, and sexual development. Women produce it as well, but in much smaller amounts. Typically, testosterone levels decline with age. By the time men hit 40, about 10 to 30 percent have already seen some decrease, as noted by Professor Suks Minhas, a consultant urologist and andrologist at Imperial College London.
However, hitting rock bottom isn’t guaranteed. Stevens mentions that while he sees many patients—ranging from 18 to 90—who report feeling quite low, he also encounters men in their fifties and sixties with perfectly healthy testosterone levels.
He cites four primary symptoms of testosterone deficiency: low mood, brain fog, fatigue, and decreased libido. He encourages men experiencing these symptoms to get tested. Other signs can include increased abdominal fat, erectile dysfunction, and muscle loss. But he acknowledges, “symptoms can be pretty vague; there are countless reasons for fatigue, like poor sleep or even something as serious as cancer.”
This vague symptomatology sparks concerns with online-testing firms. Many only provide basic blood tests that may not accurately reflect a person’s overall health since low testosterone is often linked to conditions like type 2 diabetes and metabolic syndrome, increasing the risk of cardiovascular diseases.
“Isolated testosterone testing often yields little useful information aside from pushing TRT if levels are low,” Stevens states. “Plus, it can exacerbate health anxieties without offering clarity, boosting confirmation bias.”
His suggestion? Find a licensed healthcare provider for a thorough blood screening that covers various factors—from kidney function to vitamins that influence testosterone production—and collaborate on lifestyle changes that could improve testosterone levels before considering TRT.
Stevens adds, “I often tell my patients they don’t need TRT; they need to focus on managing stress, improving sleep, and enhancing nutrition and exercise.” The goal is to help them avoid TRT entirely.
Another issue, according to Minhas, is the timing of testosterone tests. They should be done in the morning, ideally before 10 AM, when levels peak. He recounts experiences where patients tested at inappropriate times were wrongly diagnosed with low testosterone.
“It’s crucial testing follows evidence-based guidelines. We must avoid over-prescribing since TRT also has its drawbacks. It’s not intrinsically bad, but it needs careful management. Not every man with low testosterone requires TRT,” he points out.
TRT involves injections that halt natural testosterone production, typically necessitating lifelong commitment with continued health risks requiring regular check-ups, like elevated blood pressure and cholesterol levels.
“It’s a controlled substance for a reason,” Stevens notes. “Inappropriate prescriptions without proper supervision can lead to serious long-term side effects.”
This includes effects on fertility. Stevens often prescribes daily microdoses of TRT to mimic natural production and adds hCG, which helps stimulate sperm production in men.
TRT is costly too, usually starting at over £100 per month. So why not turn to NHS support? “The NHS struggles to provide this treatment due to the need for ongoing monitoring and competing priorities,” Minhas explains. “It’s complicated when low testosterone is involved—doctors for different specialties may divert you, but we lack specialists focusing solely on men’s health.”
Stevens feels there’s a lingering misunderstanding surrounding this condition, in part because testosterone deficiencies are often overlooked in medical education. Meanwhile, TRT still grapples with a reputation problem, often tied to bodybuilders, causing some physicians to dismiss it, while many men feel ashamed of such a diagnosis. He believes many of his patients have been prescribed antidepressants instead, a scenario reminiscent of the experiences faced by many menopausal women denied hormone replacement therapy.
Luckily, companies like Voy are raising awareness regarding testosterone’s significance in men’s health, Stevens concludes, emphasizing, “There shouldn’t be any stigma around it. After all, it’s simply a hormone.”
