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Menopause Matters magazine ISSUE 81 out now. (Autumn issue, September 2025)

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Author Topic: Testosterone- the good the bad and the ugly!  (Read 38948 times)

pepperminty

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Testosterone- the good the bad and the ugly!
« on: December 28, 2019, 08:21:19 AM »

Hi Ladies, I have been given testosterone to try on the NHS.

What are yor experiences please.

1- what are the positive outcomes for you?

2 - What are the negative things that you have experienced, if any?

3- Are you are of any potential long term issues - eg - does even a small amount -petite pois sized dot every other day eventually build up to give a permanent effect - like excess hair/ seep voice/ body changes  for example which are not reversible even after stopping.

4. What advice would you give others?

Thanks Pepperminty x

PS wishing everyone a fabulous and meno symptom free new year.
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Bobidy

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Re: Testosterone- the good the bad and the ugly!
« Reply #1 on: December 28, 2019, 09:18:13 AM »

Hi

I'm using a pea sized blob of Androfemme cream each day, alternating each leg upper and lower thigh. I'm 3 months in and nothing dramatic as it is early days but I do think it's helping with energy, muscles and tricky brain etc. No adverse effects. I think you will be on a different type though?

It's my understanding that if there are any adverse effects, spots, hair growth etc that these can easily be rectified by a lower dose.

Here's Dr Newsons fact sheet on it https://d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/271/newson%20health-%20%20testosterone%20(002).pdf. Again this is for Androfemme though which is only available privately.

I think there are moves to get a female formulation available via the NHS, hopefully sooner rather than later for my poor bank balance! X
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Bobidy

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Re: Testosterone- the good the bad and the ugly!
« Reply #2 on: December 28, 2019, 09:21:42 AM »

Forgot to say that I had my testosterone and SHBG levels checked at 3 weeks and they are due to be checked at 3 months to make sure that they are in the female range. This can be done via NHS.

Here's the BMS info on testosterone: https://d2931px9t312xa.cloudfront.net/menopausedoctor/files/information/264/WHC-FACTSHEET-TESTOSTERONE-for-women-FEB2019-B.pdf
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Erika28

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Re: Testosterone- the good the bad and the ugly!
« Reply #3 on: December 28, 2019, 04:05:09 PM »

1- what are the positive outcomes for you?

Skin and hair that shines, increase in libido, improved sexual response (sensate clitoris) with more lubrication, vagina more moist, significantly less cellulite and increased muscle mass, more energy and endurance.

2 - What are the negative things that you have experienced, if any?

A little more body hair than usual, some body odour, sometimes libido is too much. 


3- Are you are of any potential long term issues - eg - does even a small amount -petite pois sized dot every other day eventually build up to give a permanent effect - like excess hair/ seep voice/ body changes  for example which are not reversible even after stopping.

Before voice drops, you will notice other symptoms like acne, a very oily hair/face and body odor. I wouldn't worry but if voice does drop, it's irreversible. :( This is why I prefer to inject because applying gel/cream to the skin tilts the ratio in favor of DHT, the strongest androgen as the skin contains a large amount of 5-alpha reductase which converts testosterone to DHT. Gel gave me more side-effects and less benefits. Injecting testosterone was by far, more convenient and provided more benefits and much less side-effects as the T/DHT ratio was more natural. I also started growing thick dark hair where I applied the gel. :(

4. What advice would you give others?

Apply cream to labia, get on pellets or injections. I don't like gel. Start low and if you do apply cream/gel, apply daily for STEADY levels or else you might suffer from fluctuating levels.
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Hurdity

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Re: Testosterone- the good the bad and the ugly!
« Reply #4 on: December 28, 2019, 05:08:32 PM »

Pepperminty

I suggest you read the links that Bobidy gave in her posts as well as the long-running thread in private lives entitled "Testosterone Here We Go" which should have some useful information: https://www.menopausematters.co.uk/forum/index.php/topic,27959.0.html . Also the thread on doses might have some info: https://www.menopausematters.co.uk/forum/index.php/topic,39588.0.html although in the later parts of the thread there is quite a lot of discussion about hair loss etc and also products and approaches from outside the UK etc which are not relevant/available/advisable here (eg compounding pharmacy products and creams).

Also please DISREGARD  Erika's advice re application of gel or cream to labia WHICH SHOULD NOT BE DONE. Also the advice just to go by side effects to determine dosage. None of this is correct nor advised by BMS or makers of the only T product for women - Androfeme:

Here is the extract from Androfeme info:

"The usual starting dose of ANDROFEME® is 5mg testosterone (0.5mL of cream via applicator) applied once daily to the inner aspects of either the lower torso or upper outer thigh. Absorption may be more variable if applied to other areas of the body. The dose can be varied according to severity of symptoms and clinical response.The patient should have a follow-up blood test taken within three weeks of initiating treatment. Levels should be maintained at the upper end of the normal therapeutic range for females. The dose should be titrated as deemed appropriate. Follow-up should occur at 4 weeks and a full evaluation of the treatment be undertaken at the conclusion of the third month. Clinical trials have shown that there is a four to eight week time lag between starting testosterone treatment and an improvement in sexual motivation. If there is no improvement in symptoms after 6 months of continuous therapy then alternative treatments should be considered.The mode of administration is via the transdermal route (topically)

Do not apply to the genitalia or perineum, unless required for a specified purpose *

Women should be made aware prior to initiating testosterone treatment of the lack of long term safety data associated with testosterone use in women. Treatment with ANDROFEME® should be on a short term basis – 3 months with regular monitoring (see Directions for use) – and it is at the physician's discretion if treatment is to be continued.Caution should be exercised when patients are taking products that may decrease sex hormone-binding globulin (SHBG) or increase free-testosterone levels
."

*this is not specified in the leaflet. T gel also should NEVER be applied to genitals because there is no knowing how much will be absorbed and supraphsyiological levels could result (ie higher than occur naturally) with resultant side effects.

This is what I said on the "Testosterone here we go" thread about monitoring T levels:




"Notwithstanding the inaccuracy of single blood tests, in the case of testosterone - the "male" hormone (ie they have 10 x the amount we have) I would say it is advisable to get levels monitored to keep T levels within the physiological range for women. When I was first prescribed it by a gynae four years ago she said it can take up to 4-5 months for the effects to become fully implemented due to cellular changes, and I understand that some side effects can be difficult to reverse? Also some changes will be more subtle and the obvious side effects you mention may only become apparent (in some women) with free T levels much higher than normal (taking into account SHBG)?

This is what the British Menopause Society says:

"Although it is not mandatory to perform testosterone level estimation prior to or for monitoring treatment, it can be useful. A low FAI < 1.0% in women with symptoms of low sexual desire and arousal, supports the use of testosterone supplementation. Repeat estimation at the 2-3 month follow up visit can be performed to demonstrate if there has been an increase in levels, though clinical response is of paramount importance. It is also useful to demonstrate that values are being maintained within the female physiological range, typically < 5%, thus making androgenic side effects less likely."

https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/

In general I totally agree with the "Go by how you feel" philosophy when it comes to hormones - but I think we have to be a bit more cautios with testosterone replacement - not least because there is so very little research into its replacement in women as part of HRT"




Please do exert caution and treat this hormone with respect - after all we are women and we do not want to tip the balance too much towards T over oestrogen. And as said - long term data are sparse.

Having said all that pepperminty - good luck with it and hope it works for you! There are plenty of us here using it off-licence (either small amounts of T gel for men through NHS or Androfeme for women, privately) in the correctly prescribed way (ie through reputable gynaes - BMS etc) and there will always be someone to share their experiences. :)

Hurdity x

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pepperminty

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Re: Testosterone- the good the bad and the ugly!
« Reply #5 on: December 28, 2019, 07:17:43 PM »

Thanks ladies for the interesting replies, ( I am a bit rushed at the mo)

the lack of long term data worries me slightly. I am concerned what the irreversible side effects might be? And the hair loss issue! The specialist that gave me the gel sachets was quite blase` about it!

I thought of trying a mini petite pois blob every other day.
Could you take it for 3 months and then stop and then stop for 3 then take again, on and off, would that stop a build up of side effects? Is T accumulative? Does it reduce back when you stop?

PeppermintyX
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Hurdity

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Re: Testosterone- the good the bad and the ugly!
« Reply #6 on: December 29, 2019, 09:20:47 AM »

Hi pepperminty

Sorry I didn't mean to alarm you in any way! I wouldn't normally post in quite such an over-cautious way about T but just trying not to encourage a "gung-ho" attitude towards this hormone! I was exactly like you about T ( and in fact about every treatment when I've started - including local estriol pessaries years ago back in the day when still very much peri!). You have been prescribed it by a specialist and are being monitored that's the main thing and provided you aim to maintain T at physiological levels (though monitoring) then that is the best we can hope for. I have used a petit-pois sized blob of 1 % gel daily for 4.5 years and my T level is just marginally above the ref range although when combined with SHBG my Female Androgen Index is still quite low.

I wouldn't take it on an "on-off" basis personally - as the gynae who originally prescribed it to me said, it can take several months for all the phyisiological changes to take place ( although reasonably it will take some time for them to be reversed so maybe that would be OK?). Personally I would take a small but regular amount. Make sure you have the blood tests that the gynae recommended - at least for the first year - to see how your body reacts.

I can't remember what other hRT you take and whether you are post-meno?

If you keep within physiological limits, and apply to the site of your body recommended ( ie not genitals - vagina or labia!!) and start very low there should be no irreversible side effects because your body is designed to have testosterone! I get hair growth on my thighs but that is a minor inconveninece and I've never stopped so no idea if the hairs will become sparse and disappear if I stop!

Do read the private lives thread I linked to and Bobidy's links and hopefully you will be reassured.

Good luck and hopefully you are reassured, will take the plunge, and start to see some benefits soon :)

Let us know!

Hurdity x
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pepperminty

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Re: Testosterone- the good the bad and the ugly!
« Reply #7 on: December 31, 2019, 08:23:25 AM »

Hi Hurdity,

 thanks for the reasurrance, like yourself I am very cautious. I am probably over peri or just about to be and I am  on Femoston- but the gynae did not want to change my HRT as it works at the moment, although not perfect ( but as we know it is lucky if you have no issues). She felt that changing to transdermal or utro would be worth trying when we are sure I have gone past peri in a year or so. Personally I so not want to rock the boat at the moment although I would like to try with a no bleed regime. But years ago I had the coil and my legs balloooned. I will read the links thank you. The gynae hasn't recommended any tests yet, but I will have an appointment in 4 months to see how I get on.

Peppermintyx
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Bobidy

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Re: Testosterone- the good the bad and the ugly!
« Reply #8 on: December 31, 2019, 09:40:35 AM »

Hi
I was really nervous about starting testosterone as it sounds so unnatural and masculine for us right? However I soon found out it's just another abundant hormone for women that we lose during peri/meno (Particularly post hysterectomy) and effects us in lots of ways.

I posted a really good podcast about testosterone a few weeks back that you may want to listen to, which was really informative and should put your mind at rest. It was Dr Newson and Liz Earle and all evidence based. There has been research and Australia is all for it, hence the Androfemme. The UK seems so backwards about women's healthcare which is outrageous! If you are nervous about it you might want this private female formulation, but it is costly. One tube lasts me 4ish months so 3 tubes per year will be about £250, which is ridiculous I know. But I don't drink or smoke or use fancy cosmetics etc so I can justify it to myself.

It is good to be cautious but as long as you have the blood tests done to maintain your levels you should be fine I'm sure.

There is some talk on here at the mo about applying it to ladybits. I really wouldn't advise it! Each to there own of course but the application details for Androfemme are very clear.

The battle is getting a fully informed NHS doctor who knows what they are talking about and will support you with the full hrt regime (oestrogen, progesterone, testosterone and VA treatment). But it sounds like yours is good.

X
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Erika28

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Re: Testosterone- the good the bad and the ugly!
« Reply #9 on: December 31, 2019, 04:44:59 PM »

Interesting article/study:
http://www.tahomaclinic.com/Private/Articles1/Testosterone/Davis%202015%20-%20Testosterone%20in%20women%20the%20clinical%20significance.pdf

Quote
Several studies have investigated the use of intravaginal testosterone in postmenopausal women without breast cancer. Intramuscular testosterone propionate has been shown to induce proliferation of the vaginal epithelium in postmenopausal women.23 A randomised controlled trial24 involving 75 postmenopausal women with symptomatic vaginal atrophy and sexual dysfunction compared 1 mg testosterone in combination with 0·625 mg conjugated equine oestrogen given vaginally, 0·625 mg conjugated equine oestrogen alone given vaginally, or placebo. The greatest improvements in vaginal atrophy and sexual function were seen with combined conjugated equine oestrogen–testosterone therapy. In another study,25 80 healthy postmenopausal women were randomly assigned to 0·625 mg conjugated equine oestrogen cream, 300 μg of testosterone proprionate, polyacrylic acid, or placebo given intravaginally three times each week for 12 weeks. Compared with placebo, intravaginal testosterone was associated with significant improvements in sexual desire, lubrication, satisfaction, and pain during intercourse, whereas conjugated equine oestrogen only resulted in a significant improvement in desire.25 The favourable effects of testosterone in these studies could result from local aromatisation of testosterone to oestradiol. A small open-label pilot study reported by Witherby and colleagues26 showed favourable effects of intravaginal testosterone in postmenopausal women with breast cancer who were taking aromatase inhibitor therapy. Objective and subjective measures of atrophic vaginitis improved and concentrations of oestradiol in serum, measured by a highly sensitive radioimmunoassay, remained undetectable in most women. These studies are provocative but are limited by their small size. The open-label study by Witherby and colleagues26 suggests that aromatisation to oestradiol is not required for testosterone to improve vaginal atrophy. However, further studies are needed before vaginal testosterone can be considered for the treatment of vulvovaginal atrophy in women with or without breast cancer in the clinical setting
« Last Edit: December 31, 2019, 04:47:58 PM by Erika28 »
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pepperminty

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Re: Testosterone- the good the bad and the ugly!
« Reply #10 on: December 31, 2019, 07:14:35 PM »

Thanks for posting Bobidy,

I am working myself up to it, and I will start very slowly. I will look for the pod cast.

Have a great new year.x

Peppermintyx
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k1bnv

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Re: Testosterone- the good the bad and the ugly!
« Reply #11 on: January 04, 2020, 04:09:01 PM »

Hello
I have been on 0.5ml of Androfemme for about 2 months now. (Alongside ustrogen, ustrogel and estradot) Aside from some sporadic dark hairs on the thigh I put it on there have been no adverse effects. Energy levels up, strength in the gym going back up libido increased and have also noticed less cellulite. Also I do find myself feeling more assertive and confidant but not sure if that is placebo. Good luck :)
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GypsyRoseLee

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Re: Testosterone- the good the bad and the ugly!
« Reply #12 on: January 04, 2020, 04:59:55 PM »

Hi PM, lovely to see you.

I have been using a pea sized blob of Testogel for 3 years. I apply every morning to the underside of my forearm which is where Prof Studd advised me to apply.

The hairs on my forearms/wrists are definitely darker and more noticeable but I just have them waxed every 4 weeks, so not an issue. The hair on my head is definitely thicker, according to my stylist. My voice hasn't changed at all. Neither has my facial hair.

My libido isn't noticeably stronger, but find it easier to orgasm and they're more intense.

The last time my T level was tested it was quite a bit higher than the female average range, but I think it's balanced out by my 4 pumps of Oestrogel.
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Erika28

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Re: Testosterone- the good the bad and the ugly!
« Reply #13 on: January 04, 2020, 10:34:54 PM »

My libido isn't noticeably stronger, but find it easier to orgasm and they're more intense.

I recently started using a cream, applied to my labia, as per the doctor's instructions, containing estradiol. This is prepared by a compounding pharmacy, I live in Canada.

Within about 10 days, I noticed my clitoris as well as my nipples became quite sensitive and my orgasms are more intense. My attraction to men has also significantly increased.
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pepperminty

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Re: Testosterone- the good the bad and the ugly!
« Reply #14 on: January 05, 2020, 08:12:48 AM »

Hello
I have been on 0.5ml of Androfemme for about 2 months now. (Alongside ustrogen, ustrogel and estradot) Aside from some sporadic dark hairs on the thigh I put it on there have been no adverse effects. Energy levels up, strength in the gym going back up libido increased and have also noticed less cellulite. Also I do find myself feeling more assertive and confidant but not sure if that is placebo. Good luck :)

Thanks K1 bnv- great it is working for youx

Hi PM, lovely to see you.

I have been using a pea sized blob of Testogel for 3 years. I apply every morning to the underside of my forearm which is where Prof Studd advised me to apply.

The hairs on my forearms/wrists are definitely darker and more noticeable but I just have them waxed every 4 weeks, so not an issue. The hair on my head is definitely thicker, according to my stylist. My voice hasn't changed at all. Neither has my facial hair.

My libido isn't noticeably stronger, but find it easier to orgasm and they're more intense.

The last time my T level was tested it was quite a bit higher than the female average range, but I think it's balanced out by my 4 pumps of Oestrogel.

HI GRL,

soo pleased that you have found a regime that works for you! Yes the high estrogen should counter act the T. I am on a lower dose etc, so am very cautious. It is the thought of hair loss that concerns me. My tablet form also increases my SHBG, so my free T is not what it should be ( if i am reading my previous results correctly). But changing is not an option at the moment.  I am procrastinating daily - should I wait until I hit my later 50's and change my HRT to gel or patches and then do the T I wonder?
I know that what I am taking is causing more muscle aches , as they went with a previous HRT I took ( prem pac C) but I had horrendous other side effects. X





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