What would you do (low testosterone)

[Usedtobechilled]

Needing advice please
I'm 38, no libido for almost 10 years, no health conditions that I'm aware of, normal periods etc etc.
Had bloods done and everything is "normal" however my testosterone was recorded as <0.5nmol/L so could be non-existent, who knows.
Anyway my question is how do I go about dealing with this?
I'm of healthy weight, exercise regularly, multivitamins every day, nothing has seemed to help. Superdrug won't sell me testosterone because I'm under 40 and my gp wouldn't prescribe any because you know, might end up with a deep voice 🫠
Any suggestions? Would a private gp prescribe testosterone does anyone know?

My private gynaecologist was willing to prescribe it to me but she said she was only allowed to prescribe it for low libido. She did explain the possible side affects and I decided not to go forward with it.

Topical oestrogen can help a lot with this; the NHS can prescribe testosterone, but it is normally the low-dose men's version. They have just licensed a women's one for the NHS, but it will start to be prescribed in 2026. NHS GP should do it for you, though with low-dose men's one for now, which will work well, there's not much difference between it and the women's one. The women's one just starts with low doses initially.

I would ask for some.

Have a listen to Kelly Casperson MD podcast, shes a uro-gynae in the states.

She recommends 'Addy' which is a testosterone product for women pre menopause. I know that Louise Newson also talks about the same thing tho not sure if it's licensed here.

FWIW I started testosterone in 2023 and apart from slightly more body hair and chin hair, I've had no adverse side effects. And I am enjoying sex more than I have in years and years.

Interestingly my T levels havent increased that much (6 monthly blood tests). But it made an immediate impact for me.

My GP has always prescribed for me.

Good luck.

I did ask my gp to prescribe testosterone however she wouldn't due to the possible side affects but wanted to give me anti depressants (because I'm not happy about the no libido thing)
It genuinely boggles my brain that instead of giving me something that I'm clearly not producing and biologically need even for a couple of months to see how I go, my gp would rather give me anti depressants.
Anyway I said no, I think I'm at the point of having my partner get it because its super easy for a man (😑) to get it online with pretty much no questions asked and then try it myself.

I asked my GP and they refused. Said it was against prescribing guidelines.

Well you need to show her the NICE guidelines, Google them and show them to her. NICE guidelines recommend considering testosterone for menopausal women with low sexual desire, but only after trying HRT and that the HRT has proven ineffective
a trial of testosterone therapy is then suggested. They should also monitor hormone levels to ensure levels remain within the normal female range to avoid side effects like acne or hair growth.

Look at Dr Arif on Tiktok or Instagram, or any of her books, particularly her one on menopause, she's a GP with a special interest in women's health and has lots of the most up-to-date information on all of this. That could be good to show to your GP as well. You should also ask reception if there is any GP's who have a special interest in women's health or menopause and ask to see them instead.

Unfortunately until 2026/7 when it is included in the BNF (prescribing guide) for menopausal women, it's really only available privately as they give a low dose of the men's version. Hopefully having a women specific one (already available in countries such as Australia) will increase GP's knowledge on it and will mean more women have access to it when they need it. It's likely NICE will adapt the guidelines to be somewhat more broad as well.

I'd make a complaint about her to the practice manager because her failing to be up-to-date on research and balance the risks/side effects with the right dosage which should be pretty low - for every medication, treatment etc, it is so important to balance these two things. If she's only interested in going on way with it, which is not prescribing it, it will harm future patients who don't know its an option and then never find out. I hope you can get on it soon. Give us an update about what you do next, you should be 100% able to give this a try if that's what you want.

It is against NICE guidelines so I sort of understand why the GP hasn't prescribed it. However, what I'm amazed by is that they didn't refer you to a Gynae consultant who can prescribe it for you!

I originally had it prescribed privately but then when the GP wouldn't continue, I asked for a referral which the GP instantly agreed to. Have had regular blood checks and been prescribed it ever since.
Slightly different for me as I'm menopausal but it's definitely the route I would be looking to go down if I were you.

Good luck!

I have it privately from Louise newson clinic. 1/8th of a man’s sachet daily

Dr Michelle sands at glow natural wellness in Wyoming America does a lot of hormone stuff like Louise newson here.

Have a google. It’s dear though and I don’t know if she does What you're looking for but I’ve had other things. I sent a spit test off and got it analysed. Unlike our medics they video chat with you to explain all your levels, rather than just saying they are all fine because quite frankly GP’s don’t understand all the female hormone levels over here. It’s pathetic. PS their progesterone is the same yam based one our nhs does free so don’t waste your money in that if you can get it prescribed if you / anyone reading this needs it.

I went private for this, they have started me on HRT first and then if things haven’t improved I’m going to get testosterone too. Testosterone is low side of normal. But I would say private is the way to go because it’s always off label as there isn’t a product aimed at women available just yet. One came in around August but not fully available yet.

NHS GPs are not meant to prescribe testosterone, in Wales the computer system simply won't let them do it (likewise higher than normal doses of oestrogen).

My understanding of the NICE guidelines is that you are supposed to prescribe oestrogen hrt first, then testosterone. Which isn't what you are asking for.

When you say that your bloods are normal, who is interpreting them? A low/normal fsh indicates that you are not in 'normal' menopause, but can be an indicator of hypogonadotrphic hypogonadism if you are under producing oestrogen, but the oestrogen ranges are extremely wide at each point in the cycle, so judging that seems to be a guessing game, unless your hitting extreme lows.

Also, decent doctors tend to like to know why things are happening before they prescribe drugs to treat them.

As a women approx half of your testosterone is produced by the ovaries and half (via DHEA) from your adrenal glands, and <0.5 would be considered really very low and indicate something not happen right in your adrenals, but why? who knows? maybe see a endocrinologist privately get them to look at your blood results and do some more tests. But masking it with someone else's prescription before you've exhausted a few more proper avenues would be ill advised.

@Periperi2025 thats crackers that GPs can't prescribe.

My GP prescribes me 100mcg oestrogen and Testogel. I'm in the south of the UK and none of this has been from a meno clinic and all via NHS.

They also remind me when I need my 6th monthly blood tests to check meno levels.

I appreciate that buying/using it in an unconventional way is ill-advised however this has been a problem for such a long time and I'm tired.

I have raised this so many times with docs/nurses and nobody is interested. One doc said i might have no libido because I had been with my partner for a while (3years 😑). This was when I was about 29 years old.
I can't prove it or find anything to support it but I am convinced that when I had the implant put in it it has had long term effects. I had to have it taken out early because of the side effects and I think its been a continuation from that and for some reason it's tanked my testosterone.

It's been 10 years. I don't think I have any other underlying issues because I managed to conceive immediately when trying to get pregnant and from everything I've read if there were other issues I probably would've struggled if there was something else going on.

Honestly, you just need to get a referral to a Gynae Consultant via your GP. I've never heard of one refusing to refer. Yes, it's a bit of a wait but at least you're in the system.

And the low libido due to being with the same partner for 3 years?? Jeez. No words at all.

Get yourself referred. You owe it to yourself and your partner. Come back and tell us how you get on!

Referrals can be refused, there is a threshold for a referral that must be met, one for normal ones and one for urgent ones. Then gynecology consultants (same for every secondary care speciality), can reject a referral a GP has sent, if they do this they often send a few sentences of advise, and say if it doesn't work for 10 months for example then refer again.

@Usedtobechilled I would ask about being referred to a local menopause clinic, for a one-off appointment (again you may not meet the threshold as you haven't tried HRT, so menopause clinic will say you and your GP hasn't done/tried enough yet), so may write back with advise first which would make sense with current guidelines but not incoming guidelines. Then your GP can continue the prescription. The new women's version will be available once NICE and the BNF finish guidelines so sometime in 2026/7. For now the guidelines are HRT has to have been tried, I'd look into vaginal oestrogen or other topical gel forms of oestrogen and try that first. Or go private as the men's versions are licensed privately at a very low dose for women.