Testosterone sachets - how do you know the right amount to use?

[ClosingTheDoorOnThePast]

I've been prescribed testosterone as part of my HRT prescription and my GP told me that the dosage in the sachet is for men and to use a pea sized amount. I've got the sachets and I'm really not sure how much to use. I mean, I squeezed out a pea sized amount but it seems a bit arbitrary. Is there a way of measuring it properly?

I don’t have your answer I’m afraid but I am intruiged as I’m confused about getting Testosterone in HRT in the UK/on the NHS.
Did you get this via a private GP or via the NHS?
I keep reading the NHS aren’t authorised to use it in HRT but seems some people have been prescribed it…

When I started on it, I was told a packet should last 7 days - if I ran out before that to wait until day 8 to start a new packet, and if there was loads left on day 7 to use it all up. I am also monitored by blood tests and my dose has now been adjusted to one packet lasting 6 days. Mine is on private prescription, I'm impressed you are getting it on the NHS.

No advice OP as I'm in the same position. I had a lot left in the first sachet I opened as I was obviously being too sparing. Ran out before 7 days with the 2nd sachet so I guess it's just learning by experience. Doesn't help that sometimes I can't remember what day I started a sachet on either. It does seem a bit slap dash way of administering a prescribed drug.

It's crazy isn't it?! My dose was a 10th of a sachet, I mean FFS!

My ridiculous solution was to have a piece of paper in the bathroom with the sachet, and each day mark off that I've had some... one sachet would need to last me 10 days and that inevitably meant that some days I had more, some days less, but over the whole 10 day period it would even out. The tally chart thing was more for my sanity so I could see instantly how many days I had to stretch it out for.

I had mine on NHS, prescribed by my very practical and level headed GP. She knew the testosterone would add that little bit of extra that I needed, but GPs aren't allowed to prescribe it for menopause unless the patient has a very low libido... in which case, yes it can be prescribed to treat this very specific symptom. My GP was very good at asking the right questions as I had to specifically say that my low libido was a very big problem for me, and therefore she could surmise that it could exacerbate other things like feeling low, depression, etc. It unfortunately takes a very good GP with a great understanding of what's needed, but balanced with how to move within the boundaries of NHS.

This does seem crazy.

All I can think is to weigh the full sachet on a kitchen scale to check the total, then weigh out each days portions.

Seems I am lucky to get it on the NHS, I'm very grateful. And yes, it was prescribed for low libido. I'm initially supposed to make a sachet last 10 days then can increase to 8 days if I need to. It's such a small amount it's impossible to weigh accurately.

Can you use a measuring spoon to scoop some out.

I have measuring spoons that go to 1/4 tsp size, that would seem to be pea sized amount to me.

It’s all a bit random, isn’t it!

I don’t think the exact daily dose is that critical as long as you make sure you only use one whole sachet every 7 days or whatever time period you were told.

Its 1/8

which is why the private sector give androfeme instead

well done for getting it on the nhs, but you’ll only get the mens ( messy to use) products

I am prescribed one sachet for 8 days. Originally got HRT from private practice, but now from GP nurse and they just put gel, progesterone and testosterone on repeat.

I started out squeezing the whole sachet into a tiny jar (smaller than the individual jam ones you get in National Trust cafes) and then using a syringe to measure out the dose, but that was a horrendous faff and seemed to waste quite a bit, so now I just scoop some out of the jar with a finger.

I just squeeze a pea sized amount out each day and then on the last of 8 days I finish the sachet (if there’s any left). It will even out over the course of the week.

I have a 1ml syringe which came with mine from superdug. I drop out around 0.15ml which looks like a pea but actually the sachet lasts around 16 days. Last time I tested my levels were towards the top of the female range so I don't want to take more.

Also I leave the t in the packet, I just cut the corner off and insert the syringe straight into the packet. I leave the syringe in the packet to seal it after use.

This is what I do too. Occasionally it doesn't last the 8 days but I just go on to the next packet a day early. It isn't a big deal.

I don't think it really matters as long as you are applying a pea sized amount daily. I use the Testosterone gel pump which is easier than faffing around with the sachets.

I actually tried to put my gel into a syringe to measure it out but made a pigs ear of it. So now I have the sachet in my bathroom and have cut the corner off and just put a small pea size amount on my thigh each morning. I had my bloods done recently and they came back as very slightly high but it was close to just administering the gel.

I also got mine from my GP and didn't even has to ask for it as my women's health nurse was absolutely on the ball and has supported me so much since having my hysterectomy.

Honestly, I just wing it. I try to note the day I start a new sachet and adjust the daily dose accordingly but in time you will get your eye in. I also find that if I overdose or underdose I feel the difference within a day or so (libido ladies…).

i have the 40mg sachets and make them last 8 days.

Nhs prescription, we have excellent GPs round here.

1/7 for me. I assume the prescribed dose is based on your particular testosterone tests. My GP said don’t worry about getting it exactly the same every day.

I got it on the NHS when I complained about lethargy, not libido. I don’t find it messy. Squeeze a bit out and rub it in.

Re: NHS prescribing... it will depend on your local area prescribing committee whether or not they allow GPs to prescribe or if they limit it to specialist use (and you have to jump through hoops trying to get referred and likely have a long wait). Then it depends on the individual GP/ prescriber being willing to prescribe an unlicensed medicine (as the drug company haven't tested or marketed it for HRT in the UK the prescriber takes on more of a legal risk using it outside of it's license).

Good suggestion by a PP... draw the full contents of one sachet into a syringe and use 1/8th or 1/10th each day... or read the leaflet to see what volume of gel is in the sachet and withdrawal the right amount each day.

This is the tricky bit isn’t it…I have had such hit and miss luck with GPs.

I’ve just put forward an appointment request online but I wasn’t able to say I wanted to be seen for potential perimenopause, nor even mention anywhere about having a low libido. It’s all check boxes of symptoms so I just ticked a wide array of what I am experiencing and hoping for the best when I actually get to speak to a GP (which on average takes up to 3 months here…). I’ll have to remember to mention the low libido specifically when they do eventually call and see if they offer testosterone or not.

@artictern as a first step they probably won’t prescribe testosterone if you’re not already on HRT. I was on oestrogen and progesterone for about 3 years before I asked to add testosterone for low libido, at which point I was referred to the meno clinic at a hospital 1.5 hours away as apparently my local one doesn’t have one 🙄.

Good luck getting your appointment and hope your GP is a bit more forward thinking than mine. I do think if I’d started T earlier I would have avoided some of the atrophy down there. My clitoris shrivelled away to nothing over the preceding years, and although the T has helped to improve sensation, it’s still very small and soft.

The only problem with doing the syringe, is that once the sachet is open, any of the gel that's exposed to the air dries out super quickly. I found I was losing most of my sachet this way.

Oh gosh that’s awful! I somehow wonder if it were men’s penises shriveling away to nothing if they would prescribe it straight away! 💐 I don’t think I can take progesterone as my mother had breast cancer (twice) but I will mention this to the GP. I just heard back and it will be 8 weeks until I can speak to someone as my mish-mosh of checked tick boxes has been graded as routine by the AI.

"After use you should roll the top of the sachet down and seal with a clip between uses."

https://iapmd.org/testosterone

Hope that's helpful

My mum also had BC but having watched the Davina documentary I’m sure my excess weight is more of a risk factor than that.

a bit of a myth that we can’t take HRT as the topical oestrogen and plant based hormones they use now are much less risky than they used to be.

For me the improved quality of life on HRT outweighs the risk of BC. As sad as it is, I’d rather have 10 good years than 30 shit ones.

And yes I’m 100% sure if men’s penises were affected in such a way they wouldn’t have to beg for the medication to sort it out. When you look at the money and research that goes into ED versus menopause it’s shocking. But sadly not surprising I guess.