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[Wrensong]

Sorry ladies - just found I had accidentally posted this earlier in wrong section & can't delete it  ::!  Hope no-one has to read it twice!

Was prescribed T some time ago by a well-respected Gynae to help with the following:-

disproportionate fatigue/poor stamina
muscle loss & weakness
reduced libido

She also said it should improve night sweats & insomnia.  Gynae has since retired.

Have deferred starting T as 21 months after adding full HRT to Vagifem, I'm told that residual night sweats, flushing & room for further improvement with VA suggest insufficient oestrogen, possibly due to poor absorption from my current HRT - Evorel Conti.  Failed trials of alternative combi HRT regimes mean I'm back with the Evorel & therefore (with hair receding at temples) still don't feel it sensible to add in the T.

Poor sleep has long been a problem.  Was never a good sleeper even as a child, but at uni, developed a chronic pain condition that's disrupted sleep ever since.  At the onset of peri & right through to post-meno 12 years later, night sweats have further reduced sleep.  These have thankfully improved somewhat on Evorel but before HRT, were intense & each one long lasting with body seemingly reacting inappropriately in terror as if to sudden danger, making it very difficult to get back to sleep after onset each night.

Have Googled & found many refs to the importance of good T levels for men's sleep & a few to its role in sleep for women, but would be very interested to hear whether forum members who've tried T found it improved their sleep. 

Think I just need hope of improved sleep for the future & am holding on to the thought T might be the missing link.  That said, GP has recently reiterated that the surgery will not allow me to continue on HRT past age 60 (despite osteopenia), due in her words to increased risks.  I thought this thinking had changed with the new NICE guidelines (of ?Nov 2015) and as meno symptoms were severe for a decade despite waiting until 3 years post-meno for improvement before starting HRT, this statement has shocked & scared me, fearing a return to very poor QOL if symptoms return at their worst on stopping HRT.

Any thoughts &/or experiences of improvements (or otherwise) on T would be welcome.

[Hurdity]

Hi Wrensong - you could just delete the words of the post and direct readers to this thread - to save having several on the go!

You're right that if you are still having symptoms of low oestrogen - flushes and sweats - then you should correct this first. You need to be at least on the minimum dose of oestrogen that controls these basic menopausal symptoms before attempting testosterone. The last thing you want is to become testosterone dominant - which is what happens to most women post-menopause who do not take HRT (have you noticed that many older women look like men?). I'm not saying this for vanity - but if you are going to supplement with something - get the female hormone right first!

I took it for the reasons you gave for it being prescribed to you - muscle weakness and pain after exercise ( my own GP shrugged her shoulders, said it was due to my age and wanted to refer me for fibromyalgia - but I was having none of it!), extreme tiredness after exercise and yes the complete lack of libido and very poor response.

Some women find they need a higher dose of oestrogen when using some of the synthetic progestogens which can interfere with the beneficial effects of oestrogen - so you may prefer to try a cyclical HRT, but that would mean having a bleed and having to acclimatise to progestogens and withdrawal each month.

I also wonder about taking testosterone along with an androgenic progestogen like norethisterone and how these interact, and how they affect SHBG ( sex hormone binding globulin) and free testosterone. I don't think there has been sufficient research not least because there is hardly any research on T replacement in women (because it has mostly been unlicensed), so especially not alongside different HRT regimes.

I would suggest that the addition of T in women would have the opposite effect and is designed to reduce fatigue. I do sleep far too deeply and I am extremely tired in the mornings and this is getting worse - but it started well before I started taking T and I had hoped I would be a bit more lively in the mornings - alas no!

Have you seen my thread testosterone here we go in private lives? Probably a bit out of date now and may not answer any of your questions? I'll bump it anyway.

I have never heard of T being used for night sweats - and can't imagine why one would use this in preference to oestrogen. However my gynae did say it was sometimes the missing link for some women - but perhpas this would be women in surgical menopause who are definitely taking a decent amount of oestrogen. I knew mi levels were Ok because I wasn't getting any menopause symptoms - nevertheless soon after starting it I increased my oestrogen dose slightly ( by 12.5 mcg) just to make sure I didn't tip the balance to T dominance!

As for the stop at 60 thing - absolute rubbish. If you are otherwise healthy you can stay on it as long as you like - as long as your GP explains the risks as known. The info on this website for example states that between 60 and 70 the risks are equal to the benefits if you are still experiencing menopause symptoms. The same GP who shrugged at me has got several of my neighbours to come off hRT at over 60 because "it can cause cancer" and to me "let's hope it hasn't already" - needless to say since she said this I have never been to see her and don't intend to.

Quality of life is very definitely important!!!! Your surgery is out of date! There are updated recommendations on HRT from the British Menopause Society/ Women;s Helath Concern. Here is a fact sheet from BMS:
https://thebms.org.uk/publications/consensus-statements/hormone-replacement-therapy/

I would direct your surgery to this in the politest possible way if they do not comply with your wishes!

You might need to try a different hRT before trying the T - what have you tried so far? Also I can't remember how old you are.

Sorry if this is a bit disjointed- I just wrote things as they came to be and then looked back at your post. Hope it helps anyway....

Hurdity x

[Elizabethrose]

Haha, that is a bit of a wild statement Hurdity,

'The last thing you want is to become testosterone dominant - which is what happens to most women post-menopause who do not take HRT (have you noticed that many older women look like men?).'

I don't know of any older women 70 plus who have taken HRT and certainly none who now look like men. Do you by any chance have a scientific paper that you could post here to back up this statement. I'd be most interested to read it.

[Tempest]

Oh, gosh! No. I was just sitting talking to a lovely lady called Liz who I mentioned in one of my other posts who is now 62 and had an oopherectomy at 42. She used HRT for 5 years and then had to stop after extensive testing by specialists of incredibly bad - and I mean BAD - migraines that occurred on any type of ERT.

Liz looks nothing like a man - lovely shoulder length bobbed hair, clear fine skin and not a bad figure! She also works in an incredibly demanding role still - so has energy. No beard, no moustache or otherwise swarthy features. (P.S. - no heart disease, osteoporosis, diabetes or menopause symptoms of any kind nowadays - hers went after 18 months off HRT fwiw). xxxxx

[Elizabethrose]

My mother has beautiful thick hair, almost unlined skin, has only just started greying and went through meno at 45. Heart as strong as an ox, never broken a bone, brain as sharp as a pin. I only hope I'm like that at that age! We should never generalise, we all react to hormonal changes in different ways, no two of us will be the same. HRT is great for some and not necessary for others. I'm sure few of us will suddenly morph into blokes.

[Mbrown001]

Neither my mother or my aunts ever took HRT. They all lived to a grand old age, in fact my mother is still with us at nearly 95.
Not one of them looked like any man I have ever seen. They were ladies through and through. Yes they probably had the odd chin hair but that would be dealt with.
Not something that any new member who can't take HRT would want to read. A very sweeping and depressing statement.

I maybe missing something though as I'm not well informed re scientific papers on this subject. So if there is anything that I need to read then I would be very interested.

Lovely to hear your mum is doing really well ER. Long may it last. Although my mother now has dementia she still remains feminine and ladylike I'm glad to say.

Mrs Brown

[peri]

To return to your original question Wrensong I don't believe testosterone does help sleep but I do feel progesterone does, or that has been my experience anyway x

[Tempest]

Your Mum's sound like wonderful ladies, ER and Mrs Brown!  xxxxx

And yes, Peri - Prog. can help sleep as my Consultant told me, but I understand a few ladies on the Estrogel/Utro thread have said that they feel restless at night on it and bladder frequency due to it's diuretic effect and possibly burning has been a problem too for some. Alas, quality sleep can be so elusive during the meno. years and pinpointing one cause can be tricky! xxxxx

[Freckles]

Hi Wrensong

I am prescribed a tiny amount of daily Testim gel as well as Oestrogel gel and progesterone tablets under  Studd's regime, plus vitamin D as I also have osteopenia (for those who don't know, it's limited bone density before  you reach osteoporosis status).
Been taking a tiny bit of Testim (testosterone gel) daily for the past 9 months.
The regime has changed my life- physically and emotionally- so much for the better.

I did loads of clinical research before seeing Studd privately (had no choice as my 12 year GP insisted at 56 years I was too old  for HRT and anti-depressants were the way forward). Clearly hard of thinking clinically
Anyway, a long and often repeated story by me in the past:
1. I only discovered I had osteopenia when I saw Studd re my left hip pains so you need MORE, NOT LESS oestrogen, ideally in gel form (it's safer and more effective than tablets) and I would haven't found this out on the NHS.  My GP told me to find an osteopath in Yellow Pages!
2. Very small daily doses of Testim (the size of small pea) gel are clinically proven to improve libido, improve energy, motivation, assist sleep, etc.,  in women.
3. You need testosterone in very small but adequate levels to help the oestrogen levels/HRT work effectively together.  In other words you need BOTH.
4. I do NOT have my own beard/excessive hair growth on my face or body since being on the regime, only my head hair which was thinning at a alarming rate, due to lack of appropriate hormone levels.  It's growing well now and my hip pains have now gone.  Skin has improved dramatically, I sleep well, no VA, no low mood.
It's has given me more energy, improved libido, more motivation, stable mood, etc., etc.
5. SO very small doses of Testim are fine to take with other HRT preparations and are actually needed to enhance those.
6. I am a Chartered Scientist, amongst other many relevant professional qualifications, and sad geek that I am, spent months researching HRT options before deciding on my current which works extremely well (for me).
7. The NHS HRT "guidelines" are just that - "guidelines".  No reason you have to stop due to your age at all especially if you have osteopenia - you will  need on-going oestrogen treatment (ideally gel format) as you will be at high risk of osteoporosis later on in life
8. I do realise some posters on MM may mean well by posting their subjective comments on treatment regimes and their views on  particular hormones prescribed for treatment of menopausal symptoms. But if they aren't qualified medical practitioners, it's just their subjective views, not from a trained medical  professional with all your health records to review.
9. Always a bit dodgy to take advice from an untrained poster on the internet regarding your health options in my view (including me)! 

Personally I would research as much as possible before considering treatment option, as I did.
But in my personal experience and in considering all the numerous research papers I read before hand, if you have osteopenia you need the maximum dose of oestrogen possible  for you  to prevent  osteoporosis in the future, daily Vit D, and tiny amounts of testosterone to work effectively with the oestrogen regime.

If you want all the clinical research papers confirming this do let me know and will happily forward thses on.
Good luck but read carefully other poster's  subjective views, is my suggestion.
Freckles x

 

[Tempest]

Great post, Freckles! I believe your approach is the most sound way of ensuring you receive effective treatment and before I embark on HRT again, I am now researching all my options and looking at those specialists best placed to offer me what I need within the private sector as I've had very luke warm treatment (I'm being kind here) since my surgery via the NHS. I have wasted 2 years and experienced must distress trying (nay begging) for treatment.

Sadly, this holistic approach isn't offered via the NHS and I am awaiting the results of a DEXA re-scan. Needless to say, I shall be devastated if I've lost significant bone density by not being able to secure any HRT at all for the first year following my surgery, despite no contraindications. I'm impressed that Professor Studd is so thorough when it comes to considering bone density and offering all ladies vitamin D - it's a must that is woefully neglected by the NHS.

What also worries me is that the NICE guidelines state that Testosterone should be offered to women who need it following hysterectomy  (and especially oopherectomy), but in my case and many other women's cases here on MM who are in a similar position to myself, they are denied it.

I'm so very glad that your regime is working wonderfully for you - another very happy Professor Studd lady! xxxxx

[Noheroicsplease]

Thanks for these posts.

Freckles, interesting post, thank you. Is there any issue with taking testim with synthetic progesterone? Did Prof Studd state this at all?

x

[babyjane]

I normally bypass HRT threads as I have no knowledge or experience of the stuff but the title of this thread caught my interest.  I sleep well now but I didn't used to.

I can't comment on the HRT issues but I felt I wanted to respond to the generalisation that 'most older women who do not use it end up looking like men'!  Where did that come from?  My mother never had HRT in her life, of any sort and she was a dainty, feminine gentle woman.  My mother in law was less petite and had heavier features but would never have been mistaken for a man.  I favour male attire and short hair on the whole but I have never seen anything remotely masculine looking back at me in the mirror. In fact I have a friend of a different sexual orientation who looks far more mannish (by choice) than I ever would 

I think it is unwise to make generalised statements without back up as it is guaranteed to cause a backlash as can be seen in the responses in this thread 

Freckles, thank you for your contribution regarding osteopenia and hip pain, I have both but have not gone down the HRT route by choice.  My mother had the same but it never developed into osteoporosis and she was fit and healthy into her 80s and would still be here today if stomach cancer (as a result of a lifeltime of pernicious anaemia) had not got hold of her. So I will take my chances, I am too old now to worry about all the ifs and buts and maybes of my choices.

[Wrensong]

Thank you to everyone who has responded to this thread - I really appreciate the advice & will go back through it carefully when I have more time later.   I had no idea the topic would turn out to be so controversial & now wonder whether I shouldn't have asked!  I know all advice was well meant and apologise if anyone felt upset by any of the content.

[Elizabethrose]

Wrensong, nothing you said was in any way upsetting or controversial. Your posts are always polite, informative and well considered. I feel sure everyone is very happy to help you in any way they can, please ask away, you are a lovely member and we value your contribution too. x

[Tempest]

Absolutely what Elizabethrose said, Wrensong! You said absolutely nothing wrong and we are always happy to help in any way we can. Much love! xxxxx