Questions for those taking testosterone for peri/menopause

[fortyfifty]

Did you increase your estrogen dosage to the highest before trying testosterone or were there other indicators that testosterone was the missing key?

Did you have any luck getting testosterone prescribed on the NHS?

If you pay privately for testosterone, what does it cost you? Can you keep your other hrt prescriptions NHS or do you have to move them all to the private service?

Are there specific symptoms known to be helped by estrogen or progesterone or testosterone? Or is it just a case of hormones being balanced?

I asked for testosterone for libido and flat mood. GP (NHS) rightly recommended doubling oestrogen as I was on a very low dose. That sorted the flat moods. Once oestrogen was optimised I asked again for testosterone for libido and she agreed. NHS prescription, and mine is free as I’m over 60.

My understanding is that if your oestrogen is not optimised then testosterone will just convert to oestrogen, so it’s pointless.

For me oestrogen helped with flat/low mood and forgetfulness. Testosterone transformed my libido (does not work for everyone). NHS will only prescribe testosterone for libido so that’s what you need to focus on.

Can I ask what dose your oestrogen was increased to?

I had testosterone prescribed on the NHS for low mood, without my oestrogen being increased. I am on a medium dosage oestrogen.
My GP referred me to the menopause clinic and my testosterone was prescribed by a consultant who said it may not help my low mood and she was right!
I found the testosterone made me very on edge so stopped using it.

I have a 100mcg patch and daily 5mg provera (used to have utrogestan but couldn't get it so have been switched) I have used testosterone for 7 years now

Oh I am 51

It's been a longish road here. Sorry for long post!

Started hrt aged 44. Clear symptoms of meno, mainly horrific aches and pains and brain fog. Tingling fingers, insomnia, lack of concentration. The odd hot flash but over heating at night had gone on for a couple of years. Really bad doms after exercise.

37.5 was great for a while with cyclical utro vaginally . Had libido.

Caught covid and was quite ill with long covid lasting about 5 mo. About 2 months in libido completely went despite going to 50 and 3 months in hot flushes were back.

Blood tests showed 135 oestrogen so upped to 75, but I really struggled with water retention etc. bloods after 2 months still showed room for increase (still about 250) I still had symptoms.

Periods were erratic and barely there despite cyclical regimen. So went to continuous (it had been 9 months on hrt) and slowly moved to 100 patches(I had to go up in 12.5 stages as too buzzy). I'd been using Utrogestan vaginally as found it too dopey but now found I could tolerate it and in fact it really helped water retention and even some aches. Libido even slightly returned but still having some symptoms.

A friend I spoke to in the autumn who is a Gp and had meno training mentioned using higher utro on higher levels of oestrogen which my Gp was happy to do, though would usually do if over 100. This helped more with sleep and I didn't have negative side effects. I actually think it helped joints too as well as my gut surprisingly. Have had histamine intolerance and loose stools for a while.

I had a private testosterone test last autumn which showed low. I mentioned to Gp a few weeks ago at review. I still wasn't fully ok libido wise and still have some brain fog.

She actually prefers to test testosterone and shbg before starting. Checked oestrogen and thyroid (always does as I'm on thyroxine and symptoms could be thyroid or oestrogen. Not sure if she would with others.) oestrogen was strangely still around 200 so she suggested going to 125 patches and trial testosterone at the same time as was showing very low range when FAI calculated. Testosterone was low out of range. I've only just started so can't comment.

I also have topical oestrogen for doon there but have found I don't really need it as much now.

So I do think it's worth looking at oestrogen levels and also possibly progesterone levels. I noticed that did help with a number of things.

I found the mood swings too much on cyclical and find being continuous is better for me (actually doing the 25/28 thing at my request) Bleeding has been a bit erratic but ok and still settling into this. I've also had a lot of viruses and illnesses plus another bout of covid so don't expect things to settle for a while.

You would normally try to optimise oestrogen as much as possible as that could be what's needed for all the things testosterone is used for. Also progesterone.

My understanding is that if your oestrogen is not optimised then testosterone will just convert to oestrogen, so it’s pointless.

Also though I think there can be more negative side effects.

I was going to just use the 125 for a while to see if it helped but had a fuck it moment and just decided to go ahead and try.

Gp says she finds it's 50/50 whether patients find it helpful and like it or not.

Hi
I’m on 100 oestrogen patches and 5ml daily androfemme testosterone.
I get the patches prescribed by GP and testosterone privately, I think it’s about £90 for a tube that lasts about 3 months. A friend has got testosterone prescribed by her GP so it varies from practice to practice.

I was prescribed the testosterone after my levels were tested at a private clinic and found to be low. My Oestrogen levels were fine when tested. I had given up on my GP at this point after years of banging my head against a brick wall. Others will be luckier with their NHS doctors so it’s always worth going that route first.

I’m not sure the testosterone is doing a great dealm, but my mood and libido have improved a little so I’m sticking with it for now.

I can’t tolerate progesterone, even utrogestan it seems, but I’m trying desogestrel and it seems to be ok at the moment.

My main worries right now are headaches and crushing fatigue, though that could be to do with work pressures and other issues! I’m still not feeling ‘balanced’ but it is getting there… very slowly.

Good luck… there’s no magic bullet unfortunately. Diet and exercise make a massive difference to me but it’s hard to stick to sometimes when I’m so tired.

Hmm, interesting.

So testosterone isn't necessarily the right thing for everyone.

Do NHS GPS ever measure hormone levels or are people being tested privately? I assume there is a range of optimum levels for women?

I am on 75mg estradiol at the moment, via patches. Utrogestan for half the month. I do feel better during the weeks I take utrogestan.

Overall, I'm still over anxious too many days - that on edge feeling, waiting for doom to come. And I still have that flat feeling. I've flights booked for a holiday in less than 2 months but keep forgetting about it and haven't felt the inclination to book accommodation or plan what we'll do. I'll get it done eventually and will enjoy the holiday, but in the past, the planning and anticipation would have been enjoyable too.

Is there still hope that increasing my estrogen to 100mg will help? I'm certainly already better than I was a year ago, pre-medicated, and having panic attacks. But I can't continue as I am now and have thought about ADs if they would lift my mood (even though I know I'm not depressed)

Mine has measured testosterone level prior to prescribing but she seems v good on hrt. She said she likes to to get a base line. I don't think you have to have it prescribed though, it should be based on low libido / symptoms

It would be better to have an oestrogen test to check if you're absorbing.

Mood is supposed to be helped by levels of 400-600.

What are your bleeds like?

*to be prescribed

She's nhs

I am currently trying to get my oestrogen levels up in order to get testosterone

They were going up nicely then dropped (possibly dodgy batch of 100 oestrogen patches). I now am on 125 patches. I’m using a 75 and a 50 patch.

I am getting blood tested in a couple of weeks. My doctor has said she is happy to prescribe testosterone so long as my oestrogen levels are over 400.

I’m getting it prescribed for low libido which is the only reason it can be prescribed in the UK, but also feel I need it for muscle growth and energy. I’ve been working out for a couple of years and finding hard to build muscle. My free androgen index is 1.1. You are normally treated for low testosterone if your levels are under 1. So I’m not officially ‘low’, although pretty close tbf but I have symptoms so my doctor is happy to prescribe.

That's interesting re levels. I feel mine were going up nicely and then dropped.

What type of patches?

My FAI was similarly low but not off the scale.

Is desogestorel body identical?

Sorry it seems that to prefer tests first:
https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/

"It is recommended that total testosterone levels are checked before treatment to establish a baseline for future monitoring and to ensure that levels are not in the upper range before treatment is commenced."

I haven’t increased my Estrogen above 50 dose although sometimes I think I should.

I wanted to try testosterone for low libido and energy/motivation.

I get my estrogen through the NHS but it is quite hard to get an appointment so I haven’t tried to talk to my GP about upping my estrogen or stating testosterone. I still get my estrogen that way.

I get my testosterone through Superdrug. I had to do a blood test first which cost about £50 then the testosterone is 8.99 for 24 days worth. The blood test results had a normal range from zero to a number that would be high (and probably mean you couldn’t have the prescription) so no indication of what is a low level from them. I think it needs to be repeated three months after you start to make sure it hasn’t gone too high.

It is supposed to be just for libido ( how you can get it prescribed) and has helped with that. I haven’t felt more motivated and energised as I had hoped. I think I am more spotty and sweaty which is not so great.

I will discuss with my GP at my year review - probably need to up my estrogen. Maybe she will add the testosterone to my nhs prescription? I do hope she doesn’t throw me out of the NHS system.

The criteria Superdrug have is that you need to be on estrogen for three months first and have a low libido.

This is Newson on testosterone

bjgp.org/content/70/693/203

Hi - no it’s not, it’s a mini pill. I have such a bad reaction to progesterone I thought it was worth a try…. Not sure it’s the best thing, I have a review next week so will see what doc says.

tackytriceratops

My bleeds are erratic. Just had a 50 day cycle. Prior to that 24-35 days apart. Sometimes starts with a bang and I flood. Other times it's patchy and not very heavy at all. This has been going on 2-3 years. Prior to hrt, I had a few missed periods eg 50- 60 days apart.