Bioidentical progesterone/estrogen/testosterone

[Riverside1]

Anyone here taking this kind of combination of bioidentical creams? I am not menopausal and still have regular periods (45) but have been prescribed these by the Marion Gluck clinic as I had low levels of all of them (despite low LH and FSH). I react to just about everything and have a lot of health issues (chronic headache and migraines, fatigue, muscle problems) that have as yet not got a clear diagnosis, so giving this a try. At this point the potential benefits outweigh the risks

Anyway would be interested to hear from anyone with experience of them and how they made you feel.

thanks

Why do you feel confident? it's more a question of medical ethics than the nurse being underhand.

The information from the BMS says that the use of testosterone for women was withdrawn (as implants) in 2012 due to costs. The only other option is gel, which is now only available 'off license' (see BMS link on that thread .)

IME off licence means a) rarely if ever in the NHS unless a dr is willing to take full responsibility for the individual patient and b) usually only from a consultant who is willing to do the same. I don't know legally if a nurse is covered to prescribe something off licence.

Many GPs will refuse to prescribe drugs that are off licence because of possible litigation.

I'm not disagreeing that a wait to see the right person isn't the best way forward- did it come over like that?

Because a nurse attached to a doctors practice will act according to the best practice as set out by the GP's.
I can only speak from personal experience and am happy to continue using the testosterone prescribed to me by a gynaecologist of such eminence.

well, you seem to know best but I still wonder who would be held to account if there was litigation from a script- the nurse who was signing it or the dr who she was working under? You are getting yours from a consultant which just seems to prove the point that it's the main source of testosterone- I've known other women personally who have only been able to get it that way, despite having very compliant GPs re. HRT generally.

Funny old tone in your message.......
HRT is such a contentious issue, but a hugely important one for the welfare of a reasonable percentage of middle aged women. If we have to just use a GP for referrals on this matter then so be it; better to see someone with a depth of knowledge and information.

No funny tone intended- honestly! I just thought you had some personal knowledge of all of this. I have never had HRT from a GP, only a consultant who specialises in meno. But I do know of someone whose GP is very keen to meet all her needs re. HRT but not testosterone. The only people I know (of via other forums) get it from a consultant.

Nick Panay's private clinic is booked up until August!

Do we know how long a wait and cost for Prof Studd?

I waited 3 weeks when I booked last November. Initial consultation cost was £300. Bloods were extra; taken to give an overall picture of body performance, not to individualise hormone treatment. Other than testosterone my prescription is licensed by the NHS, as previously mentioned. And I had a bone density scan, never had one previously. Including prescription, best part of £1000. I guess the waiting time difference between the 2 specialists is that 1 is still working in NHS with a lengthy wait to see him with GP referral so patients are opting to see him privately. And the other is in private practice only now. Hope this helps.

Thankfully my GP was OK with referring me to Nick Panay, and today I booked the appointment - for the 4th August!!! SUCH a long time away but I'm sure the time will pass quickly. In the meantime, any advice for keeping a bit of oomph, va-va-voom or get up and go?

Do you think he'll prescribe testosterone at the first clinic or will I have to wait another 3 months after the first consultation?

FINGERS CROSSED!

August will be here before you know it. You could try pleading or shackle yourself to his desk until he writes out a prescription!! In the meantime; run, cycle, swim, paint nails, bake, sing out loud to a rockin' tune, new underwear. Some or all of the above are guaranteed to put a spring in your step. Until August 4th.......

According to the posts on the Menopause Matters forum, NHS GPs are not allowed to prescribe testosterone. I know of someone who had to see a consultant to get it despite having a GP who was very cooperative with all other aspects of HRT (eg prescribing for the over-60s, long cycle, etc etc.)

Re the discussion over testosterone for women, this is from the Menopause Matters website.

www.menopausematters.co.uk/testosterone.php

This paragraph refers to availability

Previously in the UK, testosterone could be given in implant form or patch. However, the patch has now been withdrawn and the implant is only currently available in some clinics who have been able to obtain a source from outwith the UK. The implant involves the insertion of a pellet every 6 months under the skin using local anaesthetic. A tablet form of HRT, tibolone, contains a combination of estrogen, progestogen and testosterone and can be taken by women who are postmenopausal. The inclusion of testosterone can be particularly helpful for some women. Testosterone gel is sometimes used but is currently only licensed for use in men in the UK and would be used in a smaller dose for women only under specialist advice. At the moment it is usual to offer testosterone therapy only to women who are already using systemic estrogen treatment.

So, I'm still unclear how a nurse is offering it!

Well I was seen at Nick Panay's clinic today. Got Testim gel (make a tube last 7-10 days), estradot patches and estradiol pessaries.
What can I expect from the testosterone and how quickly?
So excited!

ljb12 - I haven't been on this forum for ages but I use testosterone (testogel). A tube lasts me ages - I am sure it lasts about two weeks so I have a very s mall amount indeed but it;s made a huge difference. The consultant I saw said it can take 4-5 months to fully take effect. Not sure how soon I noticed a difference but it's worth the wait! I just use a pea sized blob. How old are you and what dose Estradot are you using? Best not to use too high a dose of T gel if you're on medium/low dose of oestrogen. I use 50 mcg Estradot patch.

Incidentally the NICE Guidelines released Nov 15 make provision for testosterone to be prescribed off-licence on the NHS. Here is the wording: "Consider testosterone[1] supplementation for menopausal women with low sexual desire if HRT alone is not effective." but with this caveat as a footnote:
"At the time of publication (November 2015), testosterone did not have a UK marketing authorisation for this indication in women. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council's Prescribing guidance: prescribing unlicensed medicines for further information."

Hi ljb12
Delighted to hear your appt with Nick Panay was fruitful; hope you're feeling the benefit.

I know this is an old thread but this may help future readers. I would not recommend the Marion Gluck Clinic. I've read mixed reviews, mainly negative. After doing some digging around I came to the conclusion that the clinic has paid for PR and media appearances, the clinic's doctors qualifications are dubious, they're rude and as others have mentioned the fees are astronomically high and I have paid for other private doctors so can fairly compare like for like. It isn't just me, one other friend feels the same - we were all at different stages of our gyne health but left horribly let down and feeling ripped off circa £1000. My sense is Marion Gluck has seen a gap in the market to make money from women who are pretty desperate and she's the 'face' of the operation but outsources the actual 'doctoring' treatment to freelance doctors who come and go, so there is no continuity of care. For the price paid this isn't good enough. It made me ever more thankful for the NHS but the challenge is finding the right person who'll listen and then treat you. I hope this helps as I'd hate for anyone else to get their hopes up and basically get ripped off.

I wonder how you got on with a referral from GP to Nick Pannay? I tried that I went to see a Miss Eden consultant gynae and NHS Trust who tried to fit me into her one treatment model anti-depressants and hysterectomy. I asked her to refer me to a specialist in his field Dr Pannay who along with Studd does not accept (and I feel the same) that PMDD is depression is clinical - instead its hormonal. I've just emailed Studd as the Eden lady put me on Oestrogen (after I said I suspected I was estrogen dominant) 1 x pump a day which has caused weight gain (surprise, surprise), abdominal bloating, sugar cravings. I've lost two stone this year and just gained a stone back. This after she told me I was too fat! I've had hormone issues since I was 11. I'm so sick of being fobbed off. I've emailed Studd to see if I can get a price!

Drinks I do think oestrogen is sometimes offered as a catch all solution, when sometimes the actual issue is the effects of falling progesterone and testosterone. It seems to me that increasing oestrogen would just exacerbate that issue? Because it's all about the balance of all the hormones, not just the levels of one individual hormone. But I may have misunderstood this?

You've misunderstood :)

Peri and meno symptoms are caused by loss of estrogen and erratic levels. There is no debate over this.

We only produce progesterone each month after ovulation. Otherwise we don't have it. Post meno we don't have any at all. It's also progesterone that causes PMS .

If you are having peri meno symptoms you need estrogen.