Has testosterone made a difference?

[melonchunks]

My gynae is happy for me to trial it but did give me warnings about potential alopecia and that it’s often a placebo. Currently use Mirena and 50mg patches.
59, fit, and BMI 22.5 but would love the oomph that I read about.

I’m keen to read of other women of my age’s experiences

Does it work with and in spite of taking antidepressants? Any one know?

Hmmm. So basically GPs can prescribe testosterone, and we don’t need bloods to do it. but tbh I’ve seen some really poor responses alongside horrible side effects, so I don’t, generally. It’s miserable when you’re responsible for causing someone else irreversible change like significant hair loss, or a deeper voice, or terrible acne with ongoing skin scarring & thickening, (all things ive seen) by prescribing something that they didn’t really need and didn’t actually make much difference.

but I’m generally a very cautious prescriber anyway. I do chat through my reasons with patients, mind; I’m not just “fobbing them off”, I’m trying to provide decent holistic care.

Surely the bad effects are due to user error/over use? There is no way a tiny blob a couple of times a week causes permanent voice deepening and all the things you list.

Some GPs are very switched on and understand that for women optimised on hrt then testosterone will be of benefit too. However some GPs cba and think women's sex life's are unimportant. Mine is very good thankfully.

I think some women do get very affected by a tiny dose.

My mum is in her 70s, never used HRT, but as her natural estrogen levels have declined she's now got an imbalance of testosterone and has female pattern baldness.

So even without supplementing hormones they can do some funny things on their own.

It's not going to stop me trying testosterone (because I'm already on a high dose of estrogen), but I am wary of potential side effects and will take a blood test first.

Honestly, it’s not that clear cut. And it not that I think a woman’s sex live isn’t important (if it’s important for them), it’s that balance of risk vs benefit that we have to make all the time, for everyone we see.

and yes a “tiny blob” is enough to cause side effects - that’s why it works in the first place.

A tiny blob is enough to help libido, not to cause baldness, acne and deep voices which you stated.

The risks are miniscule if used correctly, the benefits to quality of life and relationships massive. Sadly as I say it depends if we have an on the ball gp or not. You should maybe read the NICE guidelines regarding testosterone, really helpful.

Sadly, the women I’ve looked after with these side effects were using the recommended dose for women with low libido.
thats my point. Hence why I won’t generally prescribe it. My licence on the line, so I’m cautious.

Unfortunately you’re incorrect. A “tiny blob a couple of times a week” can cause the side effects @WutheringBites lists. Most are them are uncommon or rare but it is possible even in women taking a tiny dose every few days. It’s unlikely but understandably some women don’t want to take that risk just as some GPs don’t want to take the risk of prescribing it and why some GPs will refer you to a menopause clinic/gynaecologist and let them decide instead.

'My mum is in her 70s, never used HRT, but as her natural estrogen levels have declined she's now got an imbalance of testosterone and has female pattern baldness'

Yes sadly hair loss is common in older women. Nothing to do with testosterone supplementing though.

'Hence why I won’t generally prescribe it. My licence on the line, so I’m cautious'

Mayhe ask advice from another hcp if you're inexperienced or as I say Google NICE, their guidelines may help.

sorry if I wasn’t clear; I am very experienced in this field, and have read the research (not just the guidelines), hence my cautious approach. As I said, my concern is always the holistic care of patients.

You will still have to lie if you get it from Superdrug, albeit not face to face. They ask you several times in forms about your libido and what might be going on there (if libido issues are down to pain, relationship issues etc). They won’t prescribe it unless you have libido issues.

Also the blood test is not looking for low testosterone levels, it’s just checking that they’re not high. My levels were ‘normal’ and Superdrug prescribed testosterone.

There is a difference between a bit of hair thinning with age and female pattern baldness - which is called androgenic alopecia. It is related to testosterone (DHT). The clue is in the name...

It is also very much the same issue which can causs hair loss through testosterone replacement for some women.

"Estrogen can support hair growth but as levels decline during menopause so can hair growth, and there can be shrinkage in hair follicles. For some women, the decline in estrogen means the balance between estrogen and androgen (a group of sex hormones including testosterone and DHT) is altered, which can worsen female pattern hair loss."

www.drlouisenewson.co.uk/knowledge/testosterone-and-hair-during-menopause

Hence why I said- it won't stop me trying testosterone as I am on a high dose of estrogen, but I will be wary of side effects because in some women testosterone replacement absolutely can and does cause severe hair loss. It's a very individual decision about whether to still use testosterone, but it should be an informed decision.

My mum very suddenly went almost completely bald in just the same way a man would - receeded hairline, large circular bald area covering the entire top of the head, she's very upset about it. I absolutely understand why a GP would be wary of accidentally inflicting that on a woman in her 40s/50s.

The fact its just a small blob of something doesn't matter one bit. A small blob of cyanide will kill you. We are all different and what's helpful for some women, can cause significant, permanent side effects for others. A small blob of estrogen gel causes severe migraines for me - for some women it's absolutely fine and helpful.

I'm not a GP who is reluctant to hand out prescriptions, I'm a woman who would very much like to try testosterone (and have been told by my GP she'd be happy for me to do so), but I also understand the relationship between using testosterone replacement and my own genetic predisposition to androgenic alopecia.

You can deny it all you want, but there is lots of evidence that using the standard dose of testosterone used in the correct way can cause excessive hair loss in some women, which is why it is a named side effect and not a theoretical risk. Side effects don't happen to everyone, but there are also lots of women on forums who have to stop using testosterone because it causes them hair loss. It's not just some made up thing by the patriarchy who only care about whether men are getting laid. It's an actual side effect of a drug for some women, just like estrogen can and does cause migraine in some women.

I think women absolutely should have a full understanding of the potential side effects so they can make an informed decision about their own medical care.

If you are a hcp maybe ask other colleagues to see menopausal women requesting testosterone? NICE guidelines are very clear that testosterone should be considered for women optimised on hrt with libido issues. Your personal opinion on what you consider holistic shouldn't be a factor tbh.
NICE is there to stop this postcode pottery with GPs.

I have Trostan, comes in a pump like Oestrogel.

I asked for a referral to one of the Gynae specialists, and they came back to the GP saying they were happy for them to prescribe it. All very straightforward. (Has already had a blood test - normal level, but no libido).

I've been advised to take one pump on 5 out of 7 days. I don't really understand why they prescribe the sachets and expect you to get the dose right!

Been using it for a couple of months - definitely more sexual sensation, but I've also got spots back which I was so happy to have got rid of - the only benefit of menopause having suffered from them all my life. I hadn't made the connection until reading this thread. And my waistline has finally completely disappeared so it's back on a weightloss campaign for me!

This week, I've been refused testosterone by a menopause GP. I've been on hrt for 3 years and my libido has got worse and worse. I'm at my wits end. It's the only remaining symptom I need help with really.

My bloods show my testosterone is the low end of normal. I have all the symptoms of low libido which the BMS suggest testosterone would be appropriate for testosterone to be prescribed.

I'm otherwise healthy. There's no clinical reason not to prescribe it. The GP I saw just prefers not to because she "only knows 2 patients who have found testosterone helpful". I have no mental health issues and no relationship issues. I'm just bloody fed up with being dismissed and told my sex life and happiness is unimportant.

Maybe I'd have been the 3rd patient it helped.... I'm an individual.

I waited 4 months to see her and I felt utterly dismissed. Really despondent. I'm incredibly angry that she decided I don't get to have a chance at a sex life. I'm 46. I do matter.

As a GP, was she right do you think? Do i have any way of now accessing the treatment that I genuinely feel will help me on the nhs?

I went to superdrug, input my blood test results and they've diagnosed me with sexual dysfunction and provided me with a prescription, so it's clearly not dangerous for me to take it. I've been sent all the information and read it all, so I can make an informed decision.

I'd really like to ask for a second opinion from the nhs. Is this possible?

This week, I've been refused testosterone by a menopause GP. I've been on hrt for 3 years and my libido has got worse and worse. I'm at my wits end. It's the only remaining symptom I need help with really.

My bloods show my testosterone is the low end of normal. I have all the symptoms of low libido which the BMS suggest testosterone would be appropriate for testosterone to be prescribed.

I'm otherwise healthy. There's no clinical reason not to prescribe it. The GP I saw just prefers not to because she "only knows 2 patients who have found testosterone helpful". I have no mental health issues and no relationship issues. I'm just bloody fed up with being dismissed and told my sex life and happiness is unimportant.

Maybe I'd have been the 3rd patient it helped.... I'm an individual.

I waited 4 months to see her and I felt utterly dismissed. Really despondent. I'm incredibly angry that she decided I don't get to have a chance at a sex life. I'm 46. I do matter.

As a GP, was she right do you think? Do i have any way of now accessing the treatment that I genuinely feel will help me on the nhs?

I went to superdrug, input my blood test results and they've diagnosed me with sexual dysfunction and provided me with a prescription, so it's clearly not dangerous for me to take it. I've been sent all the information and read it all, so I can make an informed decision.

I'd really like to ask for a second opinion from the nhs. Is this possible?

Just print out the NICE guidelines where it clearly states testosterone should be considered for women established on hrt with libido issues and present to your gp. Ask why they are ignoring national guidelines.
Some GPs don't keep up with newer recommendations. Good luck.

This was a menopause specialist GP.

I'd waited months to see her.

I quoted the guidance at her and she simply said my bloods are OK so she wouldn't prescribe. Point blank refused.

Can I get testosterone on its own? Not started HRT yet. I’m 45 with regular periods albeit they are savage! But I have zero intrest in sex and it’s killing my relationship with my OH. He already takes It for other reasons but injects. Thanks

I’ve just got some from Superdrug and they sent 3 sachets to last 8d how is this a months supply? If 24 doses? Do you use a pea size blob every day? I’m mid 50s been on estrogel & mirena for 10yrs non existent libido so really hoping it may help

Yes a pea sized blob. I don’t worry too much about getting the amount right (and it’s hard to with the little sachets), I just try and make it last about 8 days. You will need a little clip for the sachet to stop it drying out - I use one of those hair slides that people use when they’re putting make up on.

@Rainever if its testogel it's one sachet a week.
Pea sized amount. Sometimes I forget a day and use a larger blob

Thanks do you keep yours in fridge? I’ve got a sewing spring clip that is holding it closed, so 3 sachets isn’t a months supply then? That’s annoying from Superdrug.

Intresting read as I had tests and essentially mine was an ok level (average for my age) but my estrogen was low, so my HRT lady has focused on my estrogen.

But my sex drive is still shit i can’t feel anything down there and I used to have a really high sex drive, so I’m wondering if my “ normal” is low to me. If they say my levels are OK how do I know if that’s OK for me?

Can I still get some, if I was a man I’d have ED.