How do I ask GP for testosterone

[screechyowl]

Have been on HRT for a year now (Evorel Sequi). I've been okay and it is helping a good bit with the tiredness, flushes, mood (rage) etc, but I am still feeling brain-fogged, apathetic, very low in motivation and confidence, zero libido, and just generally flat. I suspect that my ovaries have the shutters down by now (I'm 49) and that my testosterone levels are in the dirt.

I want to ring my GP and ask to try testosterone. I am not sure if the NHS has an obligation to supply it. I really don't know how to phrase the question. If he refuses, do I approach a private practice? Or can I send an NHS script to a private pharmacy? Do the NHS test for testosterone levels in women before prescribing?

A novice about this particular aspect of HRT so would appreciate some advice.

Don't you mean oestrogen not testosterone

One option is to ask to try Tibolone. You have to have had no periods for a year though. Rather than giving you a set dose of oestrogen/progesterone, it gives you (a copy of) the master hormone that is used to make both if those and testosterone. You then have to trust your body to make what it needs. I've been on it gor several years and have really noticed the difference in mood, energy, libido (and chin hairs, but that's another story).

Or just make an appt to discuss your HRT as you don't feel great and see what they suggest, prompting for a trial on testosterone if necessary

Testosterone is not licensed for menopausal women in the UK. It's highly unlikely your GP will prescribe it off license, only a specialist can do that. If there is a menopause clinic in your area you can request a referral, otherwise you'd need to go private.

(NHS gynaes can prescribe it, but the waiting list will be long, and your GP is unlikely to refer you solely for this reason.)

I've tried this and my GP advised me that if I wanted to do it quickly I should go private to get my bloods done etc. It has to be prescribed by an NHS specialist

@Ethelfromnumber73

I've tried this and my GP advised me that if I wanted to do it quickly I should go private to get my bloods done etc. It has to be prescribed by an NHS specialist

I doubt there are any of these in my area (Northern Ireland). If any.

So I have to pay about £250 for a telephone consultation and a private prescription. Jeeez.

My doctor just prescribed it for me, without me even asking. I just listed my symptoms & she recommended it. I've been on her hrt since beginning of Sept. I'm yet to start it as I've got to have a baseline blood test first & there were no appointments available for a week. I'm currently taking 3 pumps estrogel,utrogestan & vagifem.

You have to be settled on your regime first otherwise it won't be effective. You'll need blood tests to check your free androgen index. Mine was extremely low so I was prescribed one pump every other day nor seeing any benefit yet but it takes six months apparently. I had to be referred go an out of county hospital.

@aquashiv is that testosterone? Did your GP refer you?

Yes.

Which testosterone were you prescribed on the NHS aquashiv?

I have previously heard the only prescribe Testogel in a sachet which you then have to somehow divide into ten equal daily doses.

I think the NICE guidelines recommend it for low libido only. Advice is to check baseline blood levels and then monitor them periodically to make sure you don’t go too high. If you don’t see an improvement after 6 months it should be stopped. (This is all from memory so open to correction).

I’m a GP in the South and I know of colleagues who would prescribe it under the right circumstances (though I may be in a bit of a women’s health echo chamber on GP forums).

There are also a number of GPs with special interest in menopause who see women for HRT consults privately dotted about the republic if you could travel. Not sure cost though.

@OneMoreForExtra

One option is to ask to try Tibolone. You have to have had no periods for a year though. Rather than giving you a set dose of oestrogen/progesterone, it gives you (a copy of) the master hormone that is used to make both if those and testosterone. You then have to trust your body to make what it needs. I've been on it gor several years and have really noticed the difference in mood, energy, libido (and chin hairs, but that's another story).

Or just make an appt to discuss your HRT as you don't feel great and see what they suggest, prompting for a trial on testosterone if necessary

The disappearance of chin hairs??

If so I need this!