Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[NeverTooOld]

Hi,

I am post menopausal and have been on HRT for 2 years, taking 1 pump of Oestrogel daily and 100mg of Uterogestan every 2nd day vaginally.

The HRT has made a huge difference but after 2 years I still feel there is a piece missing in the HRT puzzle and  I wondered if Testosterone may be the answer. Symptoms of low libido, dry thinning hair, never knowing whether you are going to get up in the morning with a feeling of being great, low, can't be bothered or any mix of those. Variable tiredness and just not feeling 'on it'

I went to my GP and she did a blood test together SHBG and the results came back as follows -

Testosterone            0.6 nmol/l              Range     0.4 - 1.2 nmol/l
SHBG                     138 nmol/l              Range.     19.8 - 155.2
Androgen Index.      0.4.  %

I would appreciate if any of you lovely ladies could interpret these results. I myself think I am low in Testosterone however the GP did not indicate that this was the case as I was still within the range at 0.6.

I have had a repeat blood taken this morning and I will see what the results are with that.

The blood test with the result showing above was taken in the afternoon. Does when you get the test make a difference?

TIA

 

[CeCe]

Hello,

The androgen index is the amount of testosterone available for your body to use.

The normal range is between 0.5 and 6.5.

Judging by your results you are below the normal range for the amount of testosterone that is free for your body to use.

I hope you can get hold of testosterone to see if it will help with your symptoms.

CeCe

[SarahT]

I'm also gearing up with  discussion with my own GP. My testosterone result was 0.2 and frankly my libido is crap.
 In the past it has been muttered that I am within normal ranges, but I am waiting for a day when I feel mentally strong enough to push for testosterone. Surely when levels are on the low side and symptoms are a problem that should be enough to at least trial testosterone?
 I have been arming myself with previous posts as to the best way to approach for testosterone -  all points to libido being the sole reason for agreeing to prescribe, despite other symptoms improving for some ladies.

[NeverTooOld]

I know what you mean Sarah, my GP is the same and has more or less said because my Testosterone is 'just' within normal levels I probably will not get it! What harm would a trial do especially if your blood test numbers indicate that it may be of benefit 🤷🏼‍♀️

As Testosterone is not licensed for use in the UK for women my GP will have to write to the Gynaecology department at our local hospital. It will only be if they give the go ahead that my GP will prescribe it. 😏

She has also said that referral to the Menopause clinic is probably not an option as the waiting time is over 100 weeks!! 😲

Thanks Cece for the info about the actual amount of free testosterone I am testing for. I will use this information as added ammo for pushing to get Testosterone.

[Julia Dizzy]

I had my bloods done for Testosterone as I have been on Tostran gel for a few years at 2-3 pumps a week.

There seems to be some discrepancy in haematology testing ranges, my results were as follows:-

SHBG = 37 nmol/L  - (range 13.00 - 128.00 nmol/L)
Free androgen index = 3 -( range 0.00 - 15.00)
Serum testosterone = 1.1nmol/L - (range 0.30 - 1.67nmol/L).

Gp marked them all as satisfactory.  I got my Tostran gel through a local NHS menopause clinic in 2019, at the time when waiting lists weren't stupid! My Gp continues to prescribe on repeat presription "as per specialist" I'm 67 and hope to stay on HRT as long as I can.

It did make a difference to libido but not for my joints sadly.

Hope you manage to get a satisfactory outcome NeverToo Old!

[joziel]

You have to find out what that "range" is which your GP is using, NeverTooOld. If it is the range for post-menopausal women, then it's going to be low. Because ranges are based on the average and typically most post-menopausal women not on HRT don't have much testosterone!! So for your purposes, the range is useless if it's based on post-menopause.

Look at what the range is for the lab for PRE-menopausal women. That's the range you need to try to emulate with HRT.

By the way, one pump of Oestrogel isn't very much estrogen. That is a very low dose. It is very likely you also need more estrogen for your symptoms. Have you had a blood test done to see how much you are actually absorbing and what your serum estrogen levels are on one pump?

[NeverTooOld]

Thanks Julia, I will wait and see what results I get with my second blood test and take it from there 🤞🏼

Joziel, that's interesting, I'll have a dig around the internet and see what I can find failing that I will ask my GP about the 'range' used.

Originally I was prescribed 2 pumps of Oestrogel together with 100mg Uterogestan daily via mouth. Unfortunately I was unable to tolerate the Uterogestan orally and descided to try it vaginally but only every 2nd day due to it apparently being better absorbed. I did not realised that you could take Uterogestan vaginally until I hit on this wonderful forum. ☺️

I find that 1 pump of Oestrogel seems to solve most of my symptoms but as you say maybe not the fatique etc. I found on 2 pumps I felt 'wired' hence reducing it to a level I found ok with.

I've never had any blood tests since starting HRT two years ago to see what my estrogen/progesterone levels are, that may be something I need to get done.

Ah the neverending rollercoaster of menopause 😂

[SarahT]

Thanks for posting that Julia,

I am actually still in perimenopause (age 57, grr) so my 0.2 range must be even worse than I thought. And my gp is actually licensed to prescribe testosterone so I am really going to push now.

[sheila99]

NeverTooOld if you find anything useful could you post it on here please? Testosterone levels seems to be a recurring theme on the forum so it would be useful for others. I have a sneaking suspicioun that 'within normal range' is normal for meno and far less than you feel good on (though I may be wrong). I think Hurdity posted that if you're not on T your levels are so low the test isn't very accurate.

[NeverTooOld]

Sheila99 yes I'll keep you posted as to how I get on.

I think you are right, the GP's/specialists more often than not just see 'ranges' and if you are within them assume everything is all good instead of using your numbers in conjunction with symptoms etc. 🥴 It's a good get out clause for not prescribing testosterone 😕

[laszla]

Regarding the Free Androgen Index (FAI), recently, and crucially, the British Menopause Society declared that it should no longer be taken into consideration and that only the total amount of testosterone should be considered.

This will be a considerable step backwards for many of us, already there is a ludicrous reluctance to prescribe T and this could make things worse, especially for those with a high SHBG.

They have based their decision on a paper called 'A Reappraisal of Testosterone’s Binding in Circulation: Physiological and Clinical Implications'.
The gist of the reasoning is that "evidence that ‘free’ testosterone is the biologically active testosterone fraction is lacking".

They have also produced a Global Consensus Position Statement on the Use of Testosterone Therapy for Women. If these papers aren't fully accessible online, the BMS will email them to you for anyone wanting to follow up.

[WildOtter]

My testosterone was within normal range but the low end.  I managed to persuade my GP to prescribe and it makes a huge difference to how energetic and "present" I feel.  Much less brainfoggy and definitely improved libido. I was feeling about 90 years old, I feel myself again now. 

[Suziemc]

I had a blood test at end of last year, the normal  range on my results for testosterone (59 at the time, 10yrs post meno) was given as 0.2-1.3 nmol/L and my result was 0.4 nmol/L and therefore 'normal'
My SHBG was 40.4 nmol/L, with the normal range quoted as 23.6 to 110.6.
Think that all calculates out to FAI of around 1.

My GP can't/won't prescribe testosterone although she did agree that i might benefit from it for my complete loss of libido. I eventually decided to pay Newson Clinic for testosterone appt and have been using it since September. I'm amazed at how much my energy levels have benefitted from it as well as a return of my libido.

Long winded way of saying that even though you show within 'normal' range you might benefit from testosterone but you might have to be able to find the money to pay for private consultation to get it.

[SarahT]

Thanks Suzie,

I have an appt early Jan finishes with my gp. My level was 0.2 and an am still peri. I'm not giving up the right for testosterone. I am wanting my libido stronger again and any energy boosts would be a great bonus. Let's see how my gp sees this though. Am looking to go private if I need to.