Most men who come to see me have already tried somewhere else. A ten minute appointment that left them with more questions than answers, or an online clinic that ran a blood test and sold them a subscription. A quick fix for a problem nobody had worked out.
Most of what men bring me isn't one clear problem. It's several things that have drifted over years. Energy, weight, sleep, mood, sex, and a sense that something isn't right.
What's usually on offer is narrower. A blood test, a number, a prescription. That helps some men. For most it misses the point.
Fatigue, low libido, weight gain, erection changes, low mood. These almost never have one cause.
They sit across the heart, the hormones, sleep, stress, mental health and the relationship. Treat one and ignore the rest and you get a partial answer at best.
You might be wondering:
Why am I so tired all the time?
Is my testosterone low?
Why has my sex drive changed?
Why can't I get or keep an erection like I used to?
Should I be worried about my heart?
Is this stress, or am I actually depressed?
You don't need to know which one it is before you come.
01Why most men's health misses the point
A lot of clinics with the name over the door do one of two things. Erections and Viagra, or testosterone and little else. Both help some men. Neither is men's health.
The usual consultation
Testosterone
Blood pressure, cholesterol and diabetes risk
Weight, muscle and visceral fat
Sleep, fatigue and sleep apnoea
Mood, anxiety, burnout and ADHD
Alcohol, cocaine and other drugs
Anabolic steroids and body dysmorphia
The medication you are already on
Erections and sexual function
Sexual health: prevention, testing and treatment
Desire, and what sex is actually like
The relationship
Shame, and the thing you haven't said
Cancer risk and screening
What I look at
Testosterone
Blood pressure, cholesterol and diabetes risk
Weight, muscle and visceral fat
Sleep, fatigue and sleep apnoea
Mood, anxiety, burnout and ADHD
Alcohol, cocaine and other drugs
Anabolic steroids and body dysmorphia
The medication you are already on
Erections and sexual function
Sexual health: prevention, testing and treatment
Desire, and what sex is actually like
The relationship
Shame, and the thing you haven't said
Cancer risk and screening
The same man, in two consultations. What is in front of both clinicians is identical.
What gets missed is most of it. The cardiovascular disease the erections were announcing. The depression, or the ADHD nobody has raised. The cocaine at weekends. The relationship that's been hard for years.
Partly that's how medicine is organised. A GP takes the blood pressure, an endocrinologist the hormones, a urologist the prostate, a therapist the anxiety. Nobody sees the whole.
Medication is sometimes the right answer, and I prescribe it when it'll make a real difference. But good medicine starts with understanding, not an algorithm.
How is this different from seeing my GP?
I'm a GP myself, so the problem isn't GPs. It's the ten minutes. Sexual medicine and hormonal health barely feature in general practice training, and there's no room to do them properly in one appointment. What's different here is an hour, and one clinician trained as a GP, a physician, a sexual medicine specialist and a psychosexual therapist. To my knowledge I'm the only clinician in the UK who combines all four. It means the heart, the hormones, the sex and what's going on in your head get thought about together, rather than by four different people.
The blood vessels supplying the penis are smaller than the ones around the heart, so vascular damage tends to show there first.
Erections start to change
3 to 7 years
First cardiac symptoms
Which is why worsening erections in a man in his 50s or 60s are a reason to check the heart.
So I check it as a matter of routine. Blood pressure, the more informative cholesterol markers, HbA1c, weight and waist. Where the risk looks higher, a CT calcium score or CT coronary angiogram tells you what a risk calculator can't.
Finding it early makes an enormous difference. It's why I never treat an erection problem with a prescription alone.
Six that come up constantly, and that men have usually been round several appointments without anyone raising.
Sleep apnoea
The commonest missed cause of the tiredness men come in with. Worth looking at before anyone reaches for a testosterone result.
The medication you're on
SSRIs above all, but finasteride, some blood pressure drugs, opioids and antipsychotics too. Rarely a reason to stop. Usually a change of drug or dose.
Adult ADHD
Often sits underneath what a man came in about. I don't diagnose or treat it, but I think about it and refer to colleagues I trust.
Drink and cocaine
Hits sleep, mood, blood pressure, erections and testosterone at once, usually before anyone connects them. No lecture. I just need to know.
The relationship
Years of difficulty show up in sleep, mood, desire and erections. Men often arrive having had every one of those investigated instead.
The thing you haven't said
The questions that felt too difficult to raise elsewhere are usually the important ones. There's an hour, and there's room.
The male half of it, which is straightforward to assess and is very often the part left until last.
The treatment itself belongs in a fertility clinic with the people who do it every day, and I would refer you rather than hold on to it. What is worth having first is a clear picture of your side, because it changes what the clinic does next.
We've been trying for a year. Should I get checked?
Yes, and early rather than after everything else has been looked at. The male side is quick to assess and it is very often the part left until last, which wastes months. A semen analysis and a look at anything hormonal is not a big undertaking.
How do I get my sperm tested?
A semen analysis, which can be done at home, and is worth repeating over time so we are reading a trend rather than one sample. Results move about between samples more than most men expect, and a single poor one on its own does not tell you much.
Does testosterone affect fertility?
Yes, and it is the thing men are most often not told. Testosterone replacement suppresses your own production, and the same suppression affects sperm production, which for some men persists after stopping. Where fertility matters now or might later, medications that stimulate your own production, such as hCG or clomiphene, can be used instead of replacement or alongside it. Say so before starting anything rather than after.
What are the options for gay and bi men?
Usually donor conception, surrogacy or co-parenting, and that is specialist territory. I would refer you to a fertility clinic rather than try to manage it here. What I can do is the groundwork: a semen analysis, a look at anything hormonal, and an honest conversation about what is involved before you start.
Most serious conditions in men develop quietly, for years, before symptoms appear. The principle I follow is the right test for the right man at the right time, not a package.
What does a men's health check involve?
It starts with a 60 minute consultation rather than a test panel. Full history, examination where it's useful, and the observations that actually predict things, including grip strength, which is a surprisingly good marker of longevity. Then an individual discussion about cancer screening, a written report with a plan, and a follow-up to go through the results properly.
Every screening assessment includes:
Full medical and lifestyle history
Examination as appropriate: cardiovascular, respiratory, abdominal, neurological, skin
Testicular, prostate and breast examination where appropriate and if you feel comfortable
Blood pressure, height, weight, BMI and waist
Grip strength, a validated marker of overall health and longevity
An individual cancer screening discussion covering prostate, bowel and lung
A written report with a plan
A follow-up consultation to go through the results
Do you offer health screening packages?
Yes, though I see a lot of men who've spent thousands on screening and didn't get the most useful or evidence based tests. They were offered what suited a clinic's model. I receive no financial benefit from any investigation I recommend. After a first consultation we decide together what's actually worth doing. Three example screens are set out on the fees and booking page.
Things have usually been quietly accumulating. Blood pressure never checked, a waist that's crept up, energy declining for years.
Men who've tried the quick fix
An online testosterone test, a Viagra prescription, or being told everything's normal when it isn't. What was needed wasn't a different drug.
Men where the physical and mental overlap
Depression and low testosterone can look identical. If one part's been treated and you still don't feel right, the whole picture hasn't been looked at.
High functioning men carrying more than they let on
The career works, the relationship works, and something has shifted anyway. Most of them haven't told anyone.
Gay, bisexual and queer men
As a gay man myself, without needing anything explained. There's a page on this.
Beyond that, men from their 20s to their 90s, across every orientation and relationship structure.
Often the changes that matter most don't come from chasing a number on a blood test. They come from the foundations. Sleep, strength, heart and metabolic health, mood, purpose and connection.
Is it worth coming if nothing's obviously wrong?
Yes, and it's a lot of what I see. Men who are doing fine by any external measure, and something has shifted anyway. Energy, drive, sexual confidence, mood. Most of them haven't told anyone. You don't need an abnormal blood test to justify an appointment, and “I don't feel like myself” is a good enough reason to book one. There's often something specific behind it.
Send me anything recent. Old blood tests, letters, a list of what you're taking. Where hormones matter, bloods taken before 11am.
The appointment
Sixty minutes at 23 Devonshire Place in Marylebone, and most of it is talking. Examination is sometimes useful, always optional.
Afterwards
A plan, and any tests or referrals arranged. Nothing is booked without the reasoning, and the cost, explained first.
Beyond blood tests I can arrange overnight erection monitoring, home blood pressure monitoring, sleep apnoea assessment, CT calcium scoring and CT coronary angiography, other scans and body composition.
Where a referral is in your interest I'll say so and arrange it, working with cardiologists, urologists, gastroenterologists, pelvic health physiotherapists, psychiatrists, clinical psychologists, and sex and relationship therapists.
Most men arrive a bit anxious. Almost all of them leave relieved.
Do you prescribe testosterone?
Yes, where it's clinically indicated and properly diagnosed. That needs total testosterone, SHBG, calculated free testosterone, pituitary hormones and metabolic markers, taken before 11am. Many men arrive having been told by an online clinic that their testosterone is low when it's normal. I won't prescribe it unless I think it will genuinely help, and I'll always discuss the alternatives first.
How much does a consultation cost?
A first appointment is 60 minutes at £500, or 30 minutes at £250 if you have one focused question. Follow-ups run from £125 for fifteen minutes up to £500 for an hour. It's the same hourly rate either way, and I only charge for the time we use. Psychosexual therapy is priced separately at £250 for 50 minutes, and EMDR at the same rate over 50 or 90 minutes, and there's a waiting list for therapy at the moment. Blood tests and investigations are quoted before anything is arranged. Full details are on the fees and booking page.
Do I need a referral?
No. Most patients book directly through the website, and there's no requirement for a GP letter or any prior investigation.
Do you see gay, bisexual, queer and trans men?
Yes. As a gay man myself I understand the health concerns, relationship structures and lives that gay, bi and queer men bring, without needing them explained. I see trans men for general medical and sexual difficulties, though I can't start or change gender affirming treatment and would refer you to colleagues for that. There's a dedicated page on gay, bi and queer men's health.
The clinic is at Central Health London, 23 Devonshire Place, Marylebone, a quiet and discreet address a short walk from Regent’s Park. Most men arrive anxious and leave relieved. You will be welcomed by reception, offered tea or coffee, and given time to settle before we start.
A first consultation is usually an hour. We go through your symptoms, your medical and family history, and your sexual experience, relationships and lifestyle: the medical, psychological and relational picture together rather than one at a time.
I will ask you a lot of questions. You do not have to answer any of them: saying "I would rather not answer that" is a complete answer and nothing follows from it. A physical examination is sometimes useful, particularly for erection problems, and it is always optional. You stay in control of the appointment throughout.
If you have had recent blood tests, send them ahead. If not I will arrange them, and I will tell you which ones need taking before 11am.
The waiting room at 23 Devonshire Place.
Who tends to benefit most from seeing me
Men in midlife who have not engaged much with healthcare
If you are in your fifties or sixties, have no GP you know well, do not much like going to the doctor, but recognise it is time to take your health seriously, this is a reasonable place to start. I often find things that matter and have been missed.
Gay, bisexual and queer men
If you want help but are wary of seeing someone who is not comfortable talking about gay or queer sex, you can come to someone who does not need it explained, and who will not judge or shame you.
Men who want a thoughtful, whole-person assessment
Men who have tried quick fixes, or had a purely medical or purely therapeutic approach that did not help. I see a lot of men for second opinions. And men of any age and in any kind of relationship who want to understand what is going on rather than be handed a prescription.
About Dr Ben Davis
I am a GP, a sexual medicine specialist and a COSRT-registered psychosexual therapist, working at 23 Devonshire Place, Marylebone, central London, alongside NHS general practice in Hackney.
Most men reading a page like this arrived from a search rather than my homepage, so this is probably the first you have heard of me. The short version: I hold the medical, the psychological and the relational picture together in one appointment, rather than sending you to three people who each see a third of it.
