What is testosterone?
You may think of testosterone as male hormone, but women make this hormone too. It is just one of the sex hormones that women produce, along with oestrogen and progesterone.
Levels of testosterone in your body gradually reduce as you become older, with many women not even noticing. Others are more sensitive to the changes and sometimes benefit from extra testosterone. Young women who have surgical menopause (removal of ovaries) may notice the change in testosterone more, perhaps because they are younger and because the drop is sudden.
Why use testosterone?
A low dose of testosterone can sometimes be beneficial at improving your energy, mood, concentration and also sex drive (or libido). It does not help everyone.
How is testosterone treatment given?
In the NHS, Testosterone is usually given as a gel, which you rub into your skin. It comes as a gel in a small sachet and you only need to rub a pea- size amount of this gel into your skin. One 50mg sachet should last around 10 days. It should be rubbed onto your lower abdomen or your thighs. In the UK testosterone is not currently licensed for use by women, so it said to be prescribed ‘off licence’. Your prescriber will explain this to you. Testosterone may be given to some women as an implant, but in the UK, these are not easily available.
Privately, you may be given a type of testosterone which is not generally available on the NHS but is licenced in Australia for women. This is called AndroFeme 1. This comes with a measure and is used daily. It is only available on special order and a private prescription.
Usually, you will also be recommended HRT alongside testosterone as well as vaginal oestrogen if needed to treat vaginal dryness.
It can sometimes take a few months for the full effects of testosterone to work; a 3-6 month trial is often recommended.
Are there side effects?
If you use the recommended dose ie a small amount over a week or more, side effects are very few.
Rotate the area of skin you apply it to and do not use more than suggested. Higher doses may lead to unwanted effects such as acne and occasional hair growth.
There is a lack of long term data in using testosterone in women, but data up to five years shows no adverse effect in healthy women after menopause.
Do I need a blood test?
Blood tests are not able to diagnose whether or not you need testosterone but are used as a safety check to ensure you are not getting too much on top of your own natural levels. Blood tests before starting, might be suggested and repeated after 3-6 months on treatment.
Is it available on the NHS?
NICE Guidance on menopause states that testosterone can be considered for those that need it (NG23).
Testosterone can be prescribed on the NHS if the prescriber is familiar with it and is willing to prescribe it ‘off licence’. Some prefer not to take this decision and refer to a specialist for advice before prescribing. Other GPs will have prescribing restrictions which mean they are not able to offer it.