Androgen Deficiency in the Ageing Male (ADAM) & Male Hormone Deficiency

The total expected cost of TRT in a private clinic setting can vary widely, typically ranging from S$100 to S$600 per month in the first year, depending on the treatment method, and stabilising after the initial phase. This cost is broken down into three main components:

1. Initial Consultation and Diagnostic Tests (One-Time Cost)

• • Consultation: S$30 to S$120 (per visit).
  • Blood Tests: Comprehensive male hormone panels (including Total T, Free T, SHBG, LH, FSH, etc.) can range from S$200 to S$500 per initial comprehensive test. These tests are essential for diagnosis.

2. Medication/Treatment Cost (Recurring Monthly Cost)

• • Topical Gels/Creams (e.g., Androgel): Approximately S$180 to S$250 per box (lasting about a month), making the monthly cost around this range.
  • Long-Acting Injections (e.g., Nebido): The injection itself costs about S$350 to S$450 per dose. Since this is typically administered every 10-14 weeks, the monthly equivalent is lower, plus a small clinic fee for administration.

3. Ongoing Monitoring (Recurring/Periodic Cost)

• • Follow-up Consultations: S$30 to S$80 (per visit). These are frequent initially (every few weeks) and then become less frequent (every 3–6 months) once stable.
  • Monitoring Blood Tests: Required periodically (e.g., every 3, 6, or 12 months) to check testosterone, haemoglobin, and prostate-specific antigen (PSA) levels for safety. Each follow-up test can cost between S$80 and S$150.

The highest costs are usually in the first 6-12 months due to frequent testing and dosage adjustments, which then drop significantly once a stable maintenance dose is found.

After your blood sample is taken, you can generally expect the test results to be available and reviewed by your doctor within 3 to 5 working days.

• Process: The blood sample is sent to an accredited external laboratory in Singapore for analysis. Once the lab processes the results and transmits them back to the clinic, our doctor will then review the comprehensive hormone panel (including Total Testosterone, Free Testosterone, etc.) and check for any potential red flags or areas of concern.
• Follow-up: We will then arrange a follow-up consultation to discuss the findings, provide a clear diagnosis, and outline the most appropriate next steps for treatment if a deficiency is confirmed.

No, you generally do not need to fast before taking the testosterone blood test at Elyon Clinic.

• Timing is Key, Not Food: For testosterone testing, the crucial factor is the time of day, not food consumption. Eating breakfast will not significantly alter your testosterone level.
• Other Related Tests: If your doctor is also checking for underlying issues related to your testosterone deficiency, such as diabetes (glucose levels) or cholesterol, those specific tests may require you to fast. If fasting is required for any part of your blood panel, the clinic staff will clearly inform you of this requirement when scheduling your appointment. When in doubt, it is always best to clarify with the clinic beforehand.

While TRT is generally safe when medically supervised, our doctors ensure patients are aware of the common side effects, which can often be managed through dosage adjustment and regular monitoring:

• Common, Generally Mild Side Effects:

• • Skin Reactions: Acne or oily skin, particularly in the early stages of treatment.
  • Fluid Retention: Mild swelling in the ankles or feet.
  • Sleep Issues: Development or worsening of sleep apnoea (a sleep disorder where breathing stops and starts).
  • Injection Site Reactions: Pain, bruising, or irritation at the injection site (for patients using intramuscular injections).
• Less Common, Monitored Side Effects:

• • Erythrocytosis: An increase in the red blood cell count, which can thicken the blood and increase cardiovascular risk. This is why regular monitoring is essential, and blood donation may sometimes be recommended.
  • Prostate Changes: TRT can cause a small increase in the size of the prostate (benign prostatic hyperplasia, or BPH) or raise the Prostate-Specific Antigen (PSA) level. TRT does not cause prostate cancer, but it can accelerate the growth of existing, undiagnosed cancer. Therefore, prostate monitoring (PSA testing) is mandatory.
  • Shrinking Testicles: Since the body stops producing its own testosterone, the testes may shrink in size (testicular atrophy), which is why TRT affects fertility.

If a diagnosed, clinically significant low testosterone level is left untreated, the patient risks the worsening of physical, sexual, and mental health symptoms, potentially leading to long-term health complications.

At Elyon Clinic, we find that untreated low testosterone can lead to:

• Worsening Sexual Health: Persistent and worsening erectile dysfunction (ED), complete loss of libido (sex drive), and a reduction in spontaneous erections.
• Mental Health Decline: Increased risk and severity of depression, anxiety, irritability, and chronic fatigue, alongside difficulties with memory and concentration (“brain fog”).
• Physical Deterioration: Progressive loss of muscle mass and strength, increased accumulation of body fat (especially abdominal fat), and a significant decrease in bone density, leading to an increased risk of osteoporosis and fractures.
• Metabolic Issues: Low testosterone is closely linked to metabolic syndromes, and untreated deficiency can contribute to the worsening of conditions like Type 2 diabetes and cardiovascular risks.

Treatment with TRT can reverse or halt the progression of these symptoms, significantly improving the patient’s quality of life and overall health profile.

Whether a male hormone deficiency can be fixed by itself depends entirely on the underlying cause of the low testosterone, which is categorised as either primary or secondary hypogonadism.

• Secondary Hypogonadism (Often Reversible): This is the more common type, where the low testosterone is caused by factors outside the testes (e.g., issues in the pituitary gland or hypothalamus). This type is often reversible if the underlying cause is addressed.
  • Examples: Low T caused by severe obesity, poorly managed diabetes, excessive stress, or the use of certain drugs/medications can often be improved or corrected through aggressive lifestyle changes (weight loss, diet, exercise) and addressing the root medical problem.
• Primary Hypogonadism (Not Self-Fixing): This type is caused by a problem in the testes themselves (e.g., due to injury, infection, or a genetic condition like Klinefelter syndrome). Since the testes are physically damaged or impaired, they are unable to produce adequate testosterone. This condition is not self-correcting and requires lifelong TRT to manage.

At Elyon Clinic, a thorough diagnostic process helps us determine the cause, guiding us to either recommend reversible lifestyle treatments or permanent replacement therapy.