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[AndieKC]

Hi ladies,

I was wondering if any of you may have had a similar experience and any words of advice…

Aged 50, sudden early menopause hit at 44, been on estrogen and mirena coil HRT for about 3-4 years now. Resolved unpleasant symptoms like hot flushes, palpitations etc, but I still have symptoms that can apparently be fixed with testosterone. I can’t burn any fat, I can’t build muscle which I need to strengthen my thighs to help severe knee arthritis. I have never regained my mojo, motivation, or any oomph, and I have not felt like having sex for years. Before menopause I built muscle extremely easily, never had a problem with my weight, never had to diet, I trained like a super athlete all my life but now I can barely manage half an hour a day.
GP told me to increase my oestrogen first to full dose (estrogel - from initial 2 pumps to 3 then 4 pumps), then we will do a blood test and see if testosterone could be proscribed. The problem is I can’t tolerate the high estrogen, even on 3 pumps I have digestion trouble, bloating so severe I cannot eat anything, and constant burping. I’ve never had anything like this ever before, it’s not like normal indigestion, and apparently it’s a common side effect of too much estrogen.
Is it true I have to be on highest dose of estrogen to even be considered for testosterone? I’ve tried the higher estrogen dose a few times now, always the same gastrointestinal problems, they stop as soon as I go back down to 2 pumps. My body clearly doesn’t need more estrogen, it needs a little testosterone. Also before menopause I must have had quite high testosterone naturally because I had very hairy legs, chin and upper lip, now I have hardly any face or body hair. Plus the fat burning and muscle building completely changed, and my personality. I also heard on Dr Newson’s podcast that NHS GPs classify blood test testosterone levels of 0.01 as within normal range so won’t prescribe any, no matter the circumstances. Am I wasting my time with Gp, should I go privately to DR Newson? The cost seems so prohibitive. Any advice would be greatly appreciated,

Thank you so much 🙏
AndieKC

[monicap]

Hi Andie

You do not need to go private. If you can't tolerate the maximum dose of oestrogen and he can't give you testosterone otherwise then you need to need to ask for a referral. Make sure it's to a proper NHS Menopause clinic, not a bog standard gynaecologist. My GP also wanted me to try the max oestrogen dose first, before giving me T. I didn't have a problem with it but it didn't help with my remaining issues:

- loss of sensitivity leading to slow arousal
- meh type orgasms
- no bloody get up and go

The oestrogen helped a lot with the GSM (genitourinary syndrome of menopause) and the hot flushes but didn't do anything for these. I've only been on testosterone for ten days or so and I wasn't expecting to the feel the benefits so soon, but my orgasms are almost back to normal. So happy! I was also a rather hairy lady btw!

[monicap]

Also, meant to say, that in the long term you don't need to be on the max dose of oestrogen to take testosterone.

[Seahorse]

Hi My understanding is that you should be fully oestrogenised before you start testosterone, otherwise the testosterone gets turned to oestrogen. Obviously how much oestrogen is required for this varies from woman to woman. Maybe that's where they are confused? They perhaps think fully oestrogenised is the same as maximum dose? I think if symptoms such as hot flushes, night sweats and palpitations etc are relieved then it's considered appropriate to try testosterone. I have been using testosterone for just 10 days too. I was surprised my GP agreed to prescribe Testogel after he contacted the menopause clinic for advice. I have no libido either and also no oomph and motivation. Also hoping it might help with sleep as some people report it does. Fingers crossed! I'd say no harm in asking GP, but do your research first so you can state your case. I knew more than my GP but thankfully he was fine with that and commented that I'd obviously done my research. Good luck.

[VictoryV]

Andie, I agree with others, try your own GP. I’m still waiting for a private MS apt and started testosterone out of sheer desperation. Like Monicap I got good results very early on.

I haven’t seen the podcast you’ve mentioned but my NHS GP has just agreed to put Testogel on repeat without testing. We are reviewing my symptoms monthly instead of testing.
I’ve had no side effects from Testosterone. My legs couldn’t possibly get hairier; if left unshaved I could knit my own knickers!

Good luck.x

[Seahorse]

I'm the same as VictoryV no testing before testosterone. GP asked Menopause clinic re testing they didn't comment but gave link to womenshealthconcern.org which says blood test can't diagnose if testosterone is needed. If I get any benefit I will ask for a blood test in 3-6mths just to double check levels. But I guess if I don't get any side effects my levels will be within normal limits? But it's a learning curve for us all!

[Drew26]

Hi ladies,

Blood tests can diagnose if testosterone is needed. I'm on testogel which an NHS Menopause Specialist asked my GP to prescribe.  I had specific baseline blood tests taken before being prescribed testosterone which were Serum Testosterone, Sex hormone binding globulin (SHBG) and from that the Free Androgen Index can be calculated,  The Menopause specialist asked my GP to prescribe testosterone if my Testosterone levels were below 1.7nmol and the Free androgen Index was under 3.

My serum T was 0.8nmol/L and the Free Androgen Index was 0.7 so that was low and GP presribed the testosterone as intructed and put on repeat

So many Gp's don't know enough about prescribing HRT and especially about the role of testosterone for women. We produce 3 times as much testosterone in our fertile years than oestrogen so it's a very important hormone and not just a male one!
I'm 25 days into using testogel and I feel much clearer headed, I have more energy and motivation and I'm hoping the improvement in my libido will follow in the weeks to come. 

[Postmeno3]

Drew....So you didn't have to wait till you were "sufficiently oestogenised"? You got testosterone alongside HRT? I wish someone could explain to me why:
1. Testing is denied, postmenopausally.
2. Medics aren't clued up on the benefits of testosterone beyond libido, which it doesn't always address and
3. This waiting till oestrogen is "balanced and stabilised" is so important when testosterone may be the more important hormone!

[VictoryV]

Hi and Welcome Drew26,

Thanks for sharing and I’m delighted it’s working for you too. I totally agree about many GP’s not understanding our need for Testosterone. Losing hormone production very nearly forced me to retire and left me too scared to open my own front door. Embarrassing but true.

I was apprehensive about having my blood tested because I don’t have a Menopause Specialist to advise my GP about the correct levels; I was scared they’d stop prescribing it!

Good luck with the libido 

[pollywollydoodle]

Drew....So you didn't have to wait till you were "sufficiently oestogenised"? You got testosterone alongside HRT? I wish someone could explain to me why:
1. Testing is denied, postmenopausally.
2. Medics aren't clued up on the benefits of testosterone beyond libido, which it doesn't always address and
3. This waiting till oestrogen is "balanced and stabilised" is so important when testosterone may be the more important hormone!

The reason prescribers prefer to wait until there's a decent level of oestrogen is to avoid any unwanted androgenic effects eg acne and a variety of others. I've had quite bad breakouts from testosterone, not acne but definitely some skin issues. It stopped when I dropped the dose. Some of the androgenic progestins can cause this too.

[Postmeno3]

Yup, but how do they know there's a decent level without testing? This is my concern. Very postmenopausal now and on oestrogen-only hrt (hysterectomy), I could be forever if going on symptoms only. Why does Dr. Newson et al not put people through all this? 🤔

[pollywollydoodle]

Yup, but how do they know there's a decent level without testing? This is my concern. Very postmenopausal now and on oestrogen-only hrt (hysterectomy), I could be forever if going on symptoms only. Why does Dr. Newson et al not put people through all this? 🤔

I imagine it's because you're paying, and they will order tests if they have any concerns, you'll also pay for the tests. Have you considered private testing?

[VictoryV]

Yup, but how do they know there's a decent level without testing? This is my concern. Very postmenopausal now and on oestrogen-only hrt (hysterectomy), I could be forever if going on symptoms only. Why does Dr. Newson et al not put people through all this? 🤔

I’m shocked.
A) I thought the NHS prescribed T to women who had had a hysterectomy.
B) I thought private specialist’s were dishing it out.
Postmeno3 - I would write to your GP and include links to the BMS clinician help PDF.

[Drew26]

Hi Postmeno3,

I'm also post menopausal after starting the menopause journey at age 42, I'm now 55.  Not liking the journey much I can say!

When I saw the menopause specialist I had already been on oral HRT for some time - first Kliovance and then Kliofem but I was still suffering awful anxiety, rage, mood swings, awful night sweats, joint aches and pains and zero libido, so I asked my GP for Testosterone which of course she refused but offered to refer me to menopause specialist, who changed my HRT to body identical HRT  -  Oestrogel and Utrogestan which I used for 6 weeks before I had the Testosterone blood tests done. So yes I had to wait until I had tried the new HRT regime before bloods were done.

I think it is important to be properly oestrogenised before starting Testosterone and I agree Testosterone is not just for libido, I genuinely feel much clearer headed and more motivated since starting Testosterone. Having my HRT changed to Oestrogel and Utrogestan has also been life changing, anxiety is gone, mood and rage is much improved and the night sweats are gone. I feel more like me than I have done for the last 13 years!

xx

I think the key for me was seeing a menopause specialist who was absolutely amazing, I don't think I would have got this far if I had just had to rely on my GP.  GP's aren't taught that much about menopause in medical school, which is crazy seeing as half their patients will go through the menopause.

[Drew26]

Hi Victory V,

Thanks for the welcome 

I know exactly what you mean  - I haven't retired either but so many times I wanted to and going out was a struggle when I didn't even want to speak to another human being- I felt like I had become someone I didn't even recognise.  Sadly many women have retired and given up worthwhile jobs because of their menopause.

I've got have repeat testosterone bloods done in December before I see the menopause specialist again, I'm interested to find out what they will be too see how well I am absorbing the Testogel.  It's such a lottery too in finding a specialist in menopause on the NHS, I am very lucky to live where I do that I had access to this.

Fingers crossed for the libido too 
xx