What information do I need to go armed with to ask for Testosterone on prescription?

[SurfingApple]

I am 49 and have been on HRT (Estrogel and Utrogestan) for about 6 months. They have improved lots of my symptoms. I would like to try Testosterone to see if that would improve things further.

I had to go armed with Nice guidelines (courtesy of Liz Earle’s Truth About HRT booklet). My GP had not prescribed these before and had to secure agreement from the Trust to do so. What do I need to know and state in order to secure the Testosterone prescription? I am hoping it would improve my libido which the other HRT hasn’t really done.

My understanding is that testosterone is not available on the NHS for women. The only women I know who are on it have got it privately or at a specialist meno clinic from a consultant. There is no testosterone product for women- it's the male version which women use in smaller doses and a GP is not qualified to prescribe this to my knowledge.

Your GP sounds pretty useless anyway if you had to take along NICE guidelines (BTW those guidelines are easily found online- no need to buy a book.)

I want too

Or something else that works

Or can I buy it online?

Thank you Jingling. That’s a shame, but understood.

To clarify I didn’t buy the book to obtain the Nice guidelines. I found out about body identical HRT and the Nice guidelines from the book - supported by other useful bits of information found on here. You kindly advised me (I was under a different username then) too.

I really don't understand why your GP had to dither and ask for 'permission' to give you estrogen gel. It's mainstream HRT and most HRT is bodyidentical . There is this misunderstanding about body identical. Almost all estrogen used in HRT now is body identical- in pills, patches and of course gel. It's simply estradiol. The only exceptions are a few old types like Prempak which used conjugated equine estrogens (CEE.)

Micronised progesterone has been around for years and years as part of HRT so again it's not 'special' it's just GPs don't seem to know anything about HRT!

Re libido. Is it bothering you or your partner that you don't feel like sex? I sometimes wonder if women feel under pressure to have sex because if you dont' feel like it, that's fine- there is no need to try to change anything.

On the other hand, some sex experts advise just getting on with it because not having sex becomes a habit, and the less you do it the less you want it - and vice versa.
Some experts will say the best way to get libido back is to start having sex, not waiting to feel in the mood.

Just to clarify- it's the progestogen in other types that is synthetic, and Utrogestan is body identical.

I miss sex tbh - I am normally the insitgator and quite honestly that's just gone 'overnight' as it were

Ooh, hells bells, can I ask a q (or 3) as you're here?

Why do we have to wait a year with no periods before having the gel? I don't like the patches for a load of reasons. I won't be a year past until February.

How quickly should I have felt a difference on patches, if they were going to work?

Is there an more environmentally friendly alternative to vagifem?

Why do we have to wait a year with no periods before having the gel? I don't like the patches for a load of reasons. I won't be a year past until February.

You don't! Who on earth told you that? You can use Estrogel in peri or post menopause. You can use it with a progesterone taken on a 4-week cycle if periods have not stopped, or daily if they have stopped.
See a different dr!

How quickly should I have felt a difference on patches, if they were going to work?

Usual advice is allow 3 months but it all depends on the dose- if no improvement higher dose might be needed.

Is there an more environmentally friendly alternative to vagifem?
Ovestin cream. It does come with a plastic applicator but you reuse it- it won't wear out :)

Cheers Hellsbells! I've been diagnosed with Fibro, but am also 9 months past my last period. I tried patches, but the unreliable supply, the personal organisation involved in using the right patch at the right time- I don't think it got a fair trial. I thought I'd wait til the year mark, then try again with the gel, easier to keep track of!

I'm just not sure whether any of my current Fibro symptoms are actually meno symptoms!

I have fibro and I had a sudden (post op) meno - it was like the worst fibro/ME attack I had ever had - I was floored completely (Vit D and B12 helped with my fibro)

It's so confusing! I also have underactive thyroid.

Pickle there is no shortage of estrogen gel.
Why are you thinking you have to be a year post meno to use it? I started using it in peri and there is no need to wait till you are post menopause.

The GP said 'patches are best while you are still having periods'. Presumably because the breaks are built in? I'm wondering why I need the break, given that I probably only have at most one period left in me!

pickle Your GP sounds very confused!
(As well as telling you incorrect stuff.)

Maybe do your own reading around HRT because I get the impression you aren't too sure how it works?

There are 2 main types of HRT which come in formulas for women in peri or post men. This includes patches, tablets and gel (with a separate progestogen.)

1 Sequential where you have a bleed. This is for women who are not yet 12 months with no period

2 Continuous where women have not have a period for 12 months

Sequential means you use estrogen and a progestogen on a monthly basis - so, estrogen daily and a progestogen for 12 days each month. 3 days after the end of progestogen each month you have a withdrawal bleed. This is not a period, it's to clear the womb lining to stop it over growing.

Continuous types- estrogen AND a progestogen EVERY day. Using progestogen daily keeps the womb lining thin. You would not have a withdrawal bleed.

Women do not have to use continuous ever if they prefer not to (some women can't tolerate daily progestogens.)

There are patches that are sequential and patches that are continuous. Same for pills.

With gel, you can use it either way- gel daily but a progestogen either 12 days a month or every day . So it's for anyone- peri meno or post meno.

Thanks for starting this thread - stumbled on useful info about ovestin.

Btw, it is quite possible to feel upset about loss of libido for one's own sake (can't recall which pp asked "is it you or your husband?"). I've been single for years but I still don't like the post menopausal loss of libido - to me it feels like a part of me has died.