Testosterone and Atrophy?

[NotLovingWFH]

I have been using Testim gel for nearly a year along with my HRT, I think it helps a bit generally though it’s had no effect on libido. For last few months I have found I am having to use Ovestin externally upto 7 days a week otherwise my vulval area is so dry, delicate and itch to a point where it keeps me awake at night. The skin gets so dry it actually sticks to my knickers which is very uncomfortable.
I have read that it could be the testosterone that is causing this issue and wondered if any more knowledgeable M’Netters might have more information. My GP is lovely but pretty clueless and just happy to prescribe what I ask for. I think that testosterone is converted to oestrogen post menopause (and I’m several years post) so is the issue in fact oestrogen dominance? I am having monthly bleeds again too and waiting to see a gynaecologist.
Any advice would be appreciated as frankly no point in trying to improve my libido if being touched there is something I just can’t face.

I have no advice as such, however I found a plant based lube which is very nice and comfy, think it's called OB.

@CreationNat1on Thanks for the info, was really just hoping to find a definitive answer as to whether or not testosterone has a negative effect if you already have VA. I think it’s of some benefit but if it does I’m not sure it’s worth it for me.

Could you send a link please? Is it Yes OB?

That's it, Yes OB

sorry you have this problem it’s horrible. I have vulval dermatitis for many years and it was diagnosed eventually by a consultant. I was given oestrogen pessaries at first and these did help initially but eventually weren’t enough and I went on to patches. I use a very strong steroid when I need to and Hydromol ointment on a daily basis to protect the skin. I have been using testosterone for a few years now and am not aware this would cause atrophy. My consultant prescribed it knowing I had vulval symptoms. I use oestrogen patches and Overton cream and oestrogen pessaries. I also use Cetamacrogol cream for washing all over as soap or shower gel can run down the body and irritate the area. I use Yes oil based for lubricant, just find this better for dry skin. I would ask for a referral to a menopause clinic

@NotLovingWFH Sorry I just saw you are waiting on a referral. The other thing with testosterone is you need blood tests to monitor your blood levels to see if you are taking enough. It took a while for me to get the right dose so it could be you aren’t taking enough. Side effects of testosterone are hairiness, acne among others. I think that it sounds more like low oestrogen but I’ve never experienced bleeding as I have a Mirena which is brilliant

I've not ever heard anything about testosterone causing dryness and cracking. My vulva and vagina improved after adding testosterone. I now no longer need Vagifem or Ovestin

Testosterone can cause atrophy - it has that side effect for some trans men, although presumably they take it in higher doses?

This is I think specific to trans women who have a surgically created vagina and obviously specific problems with this.
The British menopause society lists here side effects/disadvantages of testosterone treatment for women and it’s not mentioned.
https://thebms.org.uk/wp-content/uploads/2022/12/08-BMS-TfC-Testosterone-replacement-in-menopause-DEC2022-A.pdf

No, it’s the other way round, it’s trans men who can develop it. But as I said I would expect they’d be taking much higher doses than are prescribed for menopause.

@TiredArse sorry I should have clarified, when I say trans women I meant biological men transitioning to being a woman

I knew what you meant - but trans women don’t get it, but trans men do as the testosterone supplementation shrivels up their vaginas. Ironically some of them end up using vaginal oestrogen.

Ah ok, I’m guessing that is due to very large amounts of testosterone being taken and oestrogen getting very low.

Thank you for the replies, I obviously wasn’t paying attention properly. I’ll keep going and hopefully things will sort themselves out soon.

Join the Vaginal Atrophy group on Facebook as they’ll advise you. Evidence based xx