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Testosterone & NICE Guidance

(15 Posts)
Oxfordblue Mon 04-Dec-17 17:42:02

I’ve been taking HRT for 4 weeks now & whilst there is a significant improvement for my hot flushes, I still have NO libido.
Have done some research & it seems testosterone could be the answer.
Just been to my GP & despite quoting Nick Panay & the NiCE guidelines, she says she can’t prescribe it as not currently licensed sadhmm
I told her I’m feeling like an empty vessel & that hubby saying he doesn’t want a loveless marriage (not that he wants to split up or demanding rampant sex but would like to be intimate maybe 1 x a mth & I would like to have the urge).
GP has suggested I contact Marie Stopes.
Any other options or words that I’m missing?
I thought testosterone could be prescribed even though it isn’t licensed?

PollyPerky Mon 04-Dec-17 20:53:23

Two things...
4 weeks is nothing smile It's taken years for your hormones to fall away and it will take months for them to rise again. You have to give it all at least 3 months and even increase the estrogen before anything else. Testosterone for women is also for muscle strength, not just libido and can have side effects, so don't rush for it.

Testo for women is not licensed on the NHS. some GPs will prescribe the brand available for men and women use a tiny bit each day.

It's up to your GP but if she adamantly refuses you will have to ask her to refer you for a private appt with a gynae who can prescribe then GP may be willing to do repeats on their advice.

Oxfordblue Mon 04-Dec-17 23:46:25

Thanks PollyPerky. I’m on femoston 2/10, have another 5mths supply.
Do you think if I don’t notice any difference in libido I should try something else?

PollyPerky Tue 05-Dec-17 08:36:02

I think you should
1 Give it a lot longer because HRT is not a quick overnight fix for some symptoms. That's why all drs say 3 months at least.
2 Think about patches or gel for the estrogen because pill form is poorly absorbed (so you might be losing a lot in digestion.)
3 Maybe- and this is controversial I know- consider which is chicken and which is egg- some women find if they have sex, their libido comes back. (It's well known that the more sex we have, the more we want it) without of course, being 'forced' in any way.

I don't know enough about your relationship to comment further but you could think about whether the sex thing has fallen off a cliff, if it's declined very slowly and if the quality of your relationship has any bearing on it. You do sound under pressure from your partner, which won't help.

If you still feel it's an issue then maybe an appt with a consultant is the way to go.

Oxfordblue Tue 05-Dec-17 13:12:30

I’ve got another 5mths of the tablets so though best to continue with this & then ask for the gel. Would you know the like for like in a gel? I was looking at Tibolone but not sure that’s appropriate for me?
Ref the sex, there is just no urge or fire. I’m also feeling quite lacklustre in other things like cooking confused I’ve lost a bit of zing but not depressed, just physical effort. I did think earlier that we should just ‘do it’ & then the urge etc may come back.

PollyPerky Tue 05-Dec-17 14:17:06

Ref the sex, there is just no urge or fire. Any chance you have just gone off him ? smile

Gel- 2 pumps is the starting dose and equiv to 1.5mgs estrogen.
Tibolone is something else- it's not 'normal' HRt it's a special steroid compound.

Oxfordblue Tue 05-Dec-17 14:32:38

I just don’t feel sexy 😰 like a rose with no smell. I’ve lost my glow really. I posted a few weeks back about my mum who said I looked gaunt & haggard. I’m actually not bad for my age, but the grey hairs, lines, varifocals, dry vagina & then the literally volcanic hot flushes have just taken their toll. I (try) to think positively but the truth is I don’t really like what’s reflected in the mirror blush I’m not depressed or anxious, just missing my zing.

Crispmonster1 Tue 05-Dec-17 14:35:31

Watching but unable to help at all!

alligator77 Wed 06-Dec-17 18:16:15

I've been prescribed bio identical hrt via the NHS for peri symptoms. This includes oestrogel, utrogestan and a tiny dose of testosterone. It's made a significant improvement to my libido and wellbeing. Testosterone is also a women's hormone so it makes sense of supplement both. The doctor who prescribed it said it's actually very protective against various conditions and most older women would benefit.

Emerald13 Wed 06-Dec-17 18:52:09

I think that your sex drive is influenced more from your poor body image and the way you feel for yourself. I feel sometimes old and exhausted and that feeling makes feel and look unsexy and boring I think. I'm thin too and try to gain some muscle mass to feel more comfortable with my body. Take care!

PollyPerky Wed 06-Dec-17 18:57:07

I've been prescribed bio identical hrt via the NHS for peri symptoms.

This is body identical HRT. The media has made up this term 'bio identical' which drs don't use or recognise. In the US, bio identical means 'compounded' (offlicence, made for each patient) so there is a big drive amongst UK consultants to get people to stop using the term.

Oxford Going from your latest post you have to give the HRT time to work. You sound as if your mind and your body image are affecting your sexuality.

Hair coloured? New hairstyle? Contacts? Make-up make over? Vaginal HRT? Do them all and start to feel better about yourself!

Oxfordblue Wed 06-Dec-17 19:01:03

Hi Alligator77, what make/brand are you taking? All going ok? Maybe I can switch?
Yes been reading about the testosterone & definitely feel I’d benefit from it.

PollyPerky Thu 07-Dec-17 09:00:57

You need to give the estrogen time to work smile
It's not advisable to add in testosterone right from the start because it will cloud the issue of what you need and how much.

Testosterone is not only for libido- it's for muscle strength and energy too and can have side effects. If you add it in now you won't be able to see the wood from the trees (which hormone you need more or less of if you have any side effects.)

If you feel under pressure to have sex and be sexual, that's another issue that needs to be talked about and your partner needs to be more understanding and patient.

alligator77 Thu 07-Dec-17 09:35:59

hi Oxfordblue - I was prescribed the additional T after I'd been on the estradiol and utrogestan for a few months. The brand is Testim and I make a tiny tube last 7-10 days. Some days I don't take it at all. It definitely has a positive effect on libido and I find it also has an anti-depressant and anti-anxiety effect - my hair and skin looks a lot better too since I started the additional T. I've been taking it for a year and no negative side effects. The doctor told me we have receptors for testosterone in almost all tissues and that it's an essential hormone for women's health as long as you stick to an appropriate dose. Hope this helps smile

alltheworld Sat 09-Dec-17 05:33:44

Mr panays nhs clinic sees new referrals within 6 wks. Ask to be referred

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