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Original poster

To loose my shit at my GP?

211 replies

Peoplecoveredinfish · 25/10/2025 13:12

I was prescribed testosterone by gynaecologist on 16/9. I have chased this three times, and had no response. I’ve still had no response, but I see from my record that the practice has written to the gynae. They’ve been pretty good about menopause, but this is a shitty misogynist policy.

TLDR: We don’t prescribe testosterone for women because it would be off licence. We prescribe off licence medication all the time, but we won’t prescribe this one, because we aren’t familiar with it and we don’t think women really need it. We think women need counselling for their made up symptoms. Even though we are not specialists and the specialist has asked us to do this, we think we know better.

The actual letter…

We have recently been receiving an increasing number of letters from the menopause clinics requesting us to prescribe testosterone for patients who are menopausal but have an intact uterus and ovaries and feel their menopausal symptoms are not being fully controlled on Oestrogen replacement therapy.
As you are aware, this medication is not licensed for women in the UK, so a clinician can only prescribe it off licence.
While there are many drugs that GPs do prescribe off licence, these are medications that we are familiar with, and there is known evidence to prove their efficacy and safety.
The GMC guidance around Good medical practice clearly states that “14 You must recognise and work within the limits of your competence. 16 In providing clinical care you must: a) prescribe medicine or treatment, including repeat prescriptions, only when you have adequate knowledge of the patient’s health, and are satisfied that the medicine or treatment serve the patient’s needs, b) provide effective treatments based on the best available evidence.”
Also “You are responsible for the prescriptions that you sign. You must only prescribe medicine when you have adequate knowledge of your patient’s health. And you must be satisfied that the medicine serves your patient’s need.”
The British Menopause Society states “Randomised clinical trials of testosterone to date have not demonstrated the beneficial effects of testosterone therapy for cognition, mood, energy, and musculoskeletal health. Further better designed studies are required with these health issues as primary outcome measures as some individuals report improvement of these symptoms. Until these data are available, the primary indication for testosterone should therefore be for HSDD following a biopsychosocial approach.”
We are thus unable to continue issuing testosterone prescriptions to our patients whom you have seen in clinic and advise they need testosterone. We expect you as the secondary care specialist in this area to manage these prescriptions and continue to issue and monitor their safety in those patients.
We would kindly request that you avoid telling our patients to contact the surgery for the GP to continue the prescriptions for testosterone. Furthermore, any letters we receive requesting this, will be returned with a TCS letter.

OP posts:
DuchessofStaffordshire · 25/10/2025 17:12

MeridaBrave · 25/10/2025 17:02

I’ll also say - I knew about the need for a HSDD diagnosis to get TRT on the NHS. Although I wanted TRT for many reasons including mood it was lack of libido that I presented as main symptom to the BUPA menopause specialist, and as a result the only symptom that went onto his letter to the GP.

I hope it's working out for you?! I think I'm finally on the right combo and I feel like a new woman. Full of energy, thinking much more clearly and I actually want to have sex again.

Bulbsbulbsbulbs · 25/10/2025 17:07

The issue is the lack of studies into testosterone for women. Why hasn't this been done? Because why spend money on a study to help old, pointless women, that's why.

I'm on testosterone and for me it has been amazing. I was unable to have an orgasm before I started taking it. So that part of my life would be over without this drug. It has also increased my energy and drive ( but this part is in my head apparently, it doesn't work for that)

MeridaBrave · 25/10/2025 17:02

I’ll also say - I knew about the need for a HSDD diagnosis to get TRT on the NHS. Although I wanted TRT for many reasons including mood it was lack of libido that I presented as main symptom to the BUPA menopause specialist, and as a result the only symptom that went onto his letter to the GP.

BerryTwister · 25/10/2025 16:58

OP would you be happy for a GP to remove your appendix if you needed it doing? Or perform a coronary artery bypass?

If your job involved driving a car, would you be happy to have a go at driving a bus with people in it?

Your GP’s letter is perfectly reasonable. In the past 20 years, more and more work that was traditionally done by hospital doctors has been pushed into general practice. GPs have accepted this additional workload and responsibility, if they feel clinically competent to do so. But they have to draw the line somewhere. GPs can’t be expected to take clinical responsibility for treatments that they are not licensed to prescribe.

In a few years time testosterone will probably have been used enough for the risks and benefits to be established, and it will be licensed for GPs to prescribe. But until then, it should be prescribed by doctors who have the expertise to defend their actions. GPs don’t have that expertise, as they’re generalists.

InTheFiveRiverValley · 25/10/2025 16:56

You would be unreasonable to lose your shit.

You would not be unreasonable to go to your GP about your HSDD, if that should happen to be one of your menopause symptoms though...

DuchessofStaffordshire · 25/10/2025 16:50

The whole thing is just bloody frustrating so I feel your pain. I've lost count of the number of face to face, telephone and other interactions I've had with numerous GPs over the last year or so. I got so unwell at one point that I was suicidal and my marriage nearly ended. I finally managed to talk to a more clued up GP (totally pot luck also a relief) who started me on Estradiol gel and progesterone. I later asked for testosterone to be added, citing the many benefits and was told they'd only prescribe it for lack of libido. Funnily enough my libido waned shortly after.

MeridaBrave · 25/10/2025 16:47

Annoying, but it’s not expensive to get privately, I think it would cost roughly £90 a year (2x tostran canisters) plus a consultation.

However, there needs to be a wider discussion about licensing testosterone for women. The current product for men, tostran, would be perfect if it was one pump per day instead of one every second day so really just need a half strength version.

JoWilkinsonsno1fan · 25/10/2025 16:44

I think you are being unreasonable- I do not want my GP prescribing something that is not in their sphere of competence, this is quite specialist stuff and actually many GP’s won’t prescribe it, alongside a list of other medications some adhd drugs, anti-psychotics, chemotherapy medications etc - these are all consultant and specialist led prescriptions- which once someone is settled on the drug can often be transferred over to the GP.

GPs cannot be specialists in everything- it’s in the title ‘General’ Practitioner.

duffed · 25/10/2025 16:41

I had this issue - the gynae insisting the gp could continue the prescription and the gp saying they couldn't for menopause

In the end, The gynae diagnosed me with Hypoactive sexual desire disorder, and that seemed to be the magic label to allow the gp to prescribe it under the local guidelines.

It made me furious, as if I said I was trans it seemed much easier to get hold of it.

OnthePisteAgain · 25/10/2025 16:41

I had mine prescribed privately for the first 2 prescriptions, then after a second blood test, the menopause clinic suggested I ask my surgery to take over the prescribing, as it does cost a lot privately. Luckily, my NHS surgery have a menopause expert and she was happy to prescribe from then on. I have a yearly blood test, and it has massively helped with libido.

Manxexile · 25/10/2025 16:31

Swiftie1878 · 25/10/2025 13:23

I think your GP is within their right to refuse, tbh, if they are uncertain about if/how it will help you.
Why doesn’t your gynae prescribe it? They want you to have it, so why pass the prescription responsibility on to someone else?

This ^

As a retired NHS manager I'm a bit concerned that the hospital specialist would try to pass responsibility for issuing the scrip onto the patient's GP rather than do it themself.

I'd say the fault here lies with the specialist and not the OP's GP.

@Peoplecoveredinfish shouldn't be losing their shit with their GP, but with the specialist.

However, they might find the quickest way to resolve this is to ask the GP surgery's practice manager for assistance. Although it's not the GP's fault the surgery might be able to get the specialist to issue a scrip quicker than the OP herself can.

Ihad2Strokes · 25/10/2025 16:29

I've had a stroke & my GP won't even look at anything menopause related 🥲

rainingsnoring · 25/10/2025 16:23

Peoplecoveredinfish · 25/10/2025 16:07

I hope to achieve a change in the sexist and regressive blanket policy that my GP practice will not prescribe testosterone to postmenapausal women AGAINST modern medical guidelines, clinical evidence, national trends and current best practice when requested by their specialist. AND has requested that the specialist does not ask them to as per normal practice. I am not throwing my toys out of the pram because they won't prescribe it to me specifically.

I'm still collating my response, but so far the NICE guidelines say 'should consider' the BNF says 'administer under expert advice' 24 out of 42 ICBs say under expert guidance and only one says should not be prescribed. Three practises county wide are obstructive. The rest are on board with this process. Which is the accepted process for providing specialist meds from consultants. There IS now a UK product licensed for women and the British Menopause Society is incompletely quoted. They are wrong and out of date. Which is not in itself an issue - because they are 'unfamiliar' and yet refuse to prescribe in the advice of the specialist who IS. Which is an issue.

If they don't have a single GP (out of twenty or so) competent or willing to become competent to prescribe under expert advice according to NICE and BNF guidelines requested by a consultant when it's clearly a national practice and when they prescribe it for men with no issues, then they need to address their skill set and recruit one. NOT ignore the patient and ask the consultant to stop treating them appropriately. That's not a clinical decision. It's either a personal bias or cultural misogyny. It's not professional and it is not about competence.

Show quote history

Is there a particular reason why you can't write to them in a calm way instead of 'losing your shit'?
It looks as if Androfeme was licensed only 2 months ago. Prior to that, testosterone was not licensed for women in the UK. The fact that they prescribe for men is irrelevant and so is your imagined bias against women. You need to calm down and present the facts.

dammit88 · 25/10/2025 16:15

Why can't the specialist prescribe it for you?

Silverbirchleaf · 25/10/2025 16:10

Just read your latest post, have you had any from the consultant at all? Some gps will issue it once it has first been issued by the consultant, but will not issue the first prescription. Is there a shared care arrangement?

FullBl00m · 25/10/2025 16:10

Seems fair. They’ve asked the specialist to prescribe for you because it is outside the GPs competency, that’s safe practice. You are unreasonable to “lose your shit”.

Silverbirchleaf · 25/10/2025 16:08

I’m with the gp. A gp is legally responsible for any prescription they write and also are under no
obligation to prescribe what a consultation recommends (Nb. It’s a recommendation, not an order). If you want to loose your shit with anyone, loose it with the consultant for not giving you a prescription.

Original poster
Peoplecoveredinfish · 25/10/2025 16:07

rainingsnoring · 25/10/2025 14:37

What do you hope to achieve by 'losing your shit' at a professional who is behaving professionally and in line with their competencies @Peoplecoveredinfish? If you were only prescribed the testosterone by your specialist 5 weeks ago, you should still have some left anyway.

I hope to achieve a change in the sexist and regressive blanket policy that my GP practice will not prescribe testosterone to postmenapausal women AGAINST modern medical guidelines, clinical evidence, national trends and current best practice when requested by their specialist. AND has requested that the specialist does not ask them to as per normal practice. I am not throwing my toys out of the pram because they won't prescribe it to me specifically.

I'm still collating my response, but so far the NICE guidelines say 'should consider' the BNF says 'administer under expert advice' 24 out of 42 ICBs say under expert guidance and only one says should not be prescribed. Three practises county wide are obstructive. The rest are on board with this process. Which is the accepted process for providing specialist meds from consultants. There IS now a UK product licensed for women and the British Menopause Society is incompletely quoted. They are wrong and out of date. Which is not in itself an issue - because they are 'unfamiliar' and yet refuse to prescribe in the advice of the specialist who IS. Which is an issue.

If they don't have a single GP (out of twenty or so) competent or willing to become competent to prescribe under expert advice according to NICE and BNF guidelines requested by a consultant when it's clearly a national practice and when they prescribe it for men with no issues, then they need to address their skill set and recruit one. NOT ignore the patient and ask the consultant to stop treating them appropriately. That's not a clinical decision. It's either a personal bias or cultural misogyny. It's not professional and it is not about competence.

OP posts:
Jumpeduppantrygirl · 25/10/2025 16:03

This is nothing to do with your GP not fulfilling their obligations as your Primary doctor. They are actively refusing because they disagree with the prescription. They have stated that there is insufficient evidence to support the drugs use off-label for your symptoms. If your consultant knows otherwise then they will be able to furnish the GP with relevant evidence. Thats all that needs to happen.

FreddysFingers · 25/10/2025 16:02

I understand your frustration, and I 100% sympathise with your predicament - you should be able to access the treatment you need as determined by a specialist consultant. However, reading between the lines of that letter, it appears to me to be a massive arse covering exercise RE the prescribing off license. I'm not sure on the dynamics of it, you would think that if a GP was questioned over it, they could refer the 'powers that be' to your consultant's letter, but maybe it doesn't work that way 🤔. The only other thing I can think of is that they are part of a different trust, and don't want to open the floodgates by facilitating these prescriptions because of the cost. Either way it's absolute shite for you - can you get your testosterone from the hospital instead, or go private? (I know you shouldn't have to, but it's an option).

HellsBells67 · 25/10/2025 16:00

Please don't lose your shit at your GP. They are only working within the guidelines. Campaign for change or ask the specialist to prescribe it if she is so happy for you to try it.

Justputsomeyoghurtonit · 25/10/2025 15:57

Recycledblonde · 25/10/2025 14:54

I’ve recently been prescribed testosterone by my GP post bloods showing suboptimal levels but they can only prescribe it for loss of libido according to her. I have blood tests every 3 months.

My GP wants me to have bloods every six months, but in reality I have to remember to send myself off for bloods every 9-12 months! I don't think they particularly care as I've been on it for 2yrs and my levels have stayed low (though my libido has gone up massively).

I feel for you op, that's absolutely rotten. My consultant (private) wrote to GP to tell them to give me 4xtubes estriol each prescription and my GP was very happy to do so.

My GP was also v happy to give me testosterone off her own back, no consultant involved. It does seem that some GPs are amazing at this stuff. My surgery is all female partners which really helps.

SingingOcean · 25/10/2025 15:55

Greencactusgirl · 25/10/2025 15:38

Not comparable as Viagra is not an off-licence drug when prescribed for erectile dysfunction.

Show quote history

Funny that. I'm sure women's health will be prioritised similarly as soon as they hear about the menopause and what proportion of people are affected.

BotterMon · 25/10/2025 15:48

Take it up with your gynae. Your GP has a procedure in place that you don't agree with. You're not the expert. Why would you want to take a medication with no proven scientific research that it actually helps? If you want it then pay for it yourself via a private gynae.

loubielou31 · 25/10/2025 15:48

Our GP surgery has recently sent a letter to all patients saying something along the lines of medications recommended by hospital specialists need to have the prescription filled by the hospital clinic. I have no idea how the ongoing care works but it seemed to me to be something to do with budgets. And it definitely wasn't limited to women's health.