Testogel or Tostram?

[WombatChocolate]

Afternoon. I’m due to have a telephone consultation with GP. I’ve been on oestrogel and Utrogestan for 4 months. Sleep is much better, but still zero libido and feeling anxious.

At initial consultation, GP said testosterone could be considered after 3 months if no libido improvement. That’s what I’m calling about. Of course, I mig not speak to the same GP and they might not be keen, but if they are, is Tostram or Testogel the way to go? Are they prescribed for different purposes?

If the GP is reluctant, should I ask to be referred to menopause clinic? Should I mention the 2015 (updated NICE guidance) which says that if oestrogen and progesterone hasn’t done the trick for libido, testosterone should be tried off licence?

Is there anything else I should know or say to improve my chances? I’m hoping to try it….obviously for it doesn’t work then Inwont be continuing.

thanks.

I got mine by focussing on Libido (pressure on marriage etc) and being fairly firm but pleasant, acknowledging that it would be off licence. Someone recommended testagel if given the option so I asked for that.

It's working for me.

Thanks - that’s so helpful. Will update after my appt.

They're both prescribed off license for lack of libido in women, one in sachets and the other in metered pump dispenser. However other things can also be considered such as local estrogen which some women find helps bring back the tingle! Sounds like your GP is pretty knowledgeable and confident in prescribing tesosterone - plus able to do so as availability and options as for HRT can depend on where we live.

Testosterone was discussed here a couple of days ago - about 32.5 mins in www.bbc.co.uk/sounds/play/m0016xqh

Also see this on the BMS website: thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/

Had my appointment now.

On positive side the GP was positive about prescribing testosterone for me, given Ive had some months in HRT and libido not improved. Said she had prescribed before but not frequently so would look up what was available and tell me about dosages and risks….all good.

BUT, she then went in to prescribe the male quantities for me…I’m pretty sure. I wasn’t entirely sure as she was speaking, as she was prescribing me Tostran as she said they didn’t prescribe Testeogel, and as I’d read up on Testrogel more before, I thought my doubts could be wrong. But I immediately went and checked and are pretty sure she prescribed me the male amounts.

She said to take it daily and to have 2g. I’ve looked at my bottle and that’s 4 pumps per day. She said the bottle would last me 30 days and then I’d need to return to her - when Ia she’d how long it would last.

But now I’ve looked at British Menopuase Soc pages and on here, I can see the women’s dose is 0.5G or 1 pump, just 3 days a week. That’s a huge amount less, the pump pack is meant to last well over 6 months and not just 1 month.

I guess it means I won’t need to return so quickly, but it’s actually quite worrying as if I took the amounts she prescribed my risks of the negative possible effects would be pretty high.

On one hand I do t want to tell the surgery about it, because this kind of thing will make them all even more reluctant to prescribe off label and women will struggle to get T. However, it’s a pretty serious thing I think and again highlights the lack of knowledge and fact she didn’t instantly and easily have access to the info about women’s doses. Not everyone will check online like I have!

Anyway, will have a first go tonight. Have read a few threads with people who had too much to start and sound they went sex mad. I’m hoping for improved libido, energy and va va voom, but don’t need to be sex mad! Will report back, but interested to hear from anyone else using Tostran.

Ouch! No you don’t want to be taking that much and hopefully she hasn’t prescribed the same to other women. We do hear this happen though. You should signpost the BMS link to your surgery and ask for clarification - I’m sure they’ll be grateful if anything.

resources GPs have available to them should back this up gpnotebook.com/en-gb/simplepage.cfm?ID=x20200222102023335581