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[MrsMitch]

Hello ladies. I'm a little over 3 months on testogel and I'm very pleased with the changes I've experienced so far, bar one.
The bladder problems I had, needing to pee very frequently,
frequently waking needing to go a lot through the night and always feeling like I could pee again even when I've just been are much improved.  I've even been to work for around 5 hours and not needed to go at all a couple of times.
Libido is astonishing tbh! Vastly improved to the point my husband is telling me he's too tired now!!
I don't know if testosterone has an effect on weight, but im not particularly watching what I eat and my weight is stable, which is unusual for me.
I've just had about a month of spots on my chin which we're getting me down a bit because I was getting quite a few at once and just as I thought they were going, I'd get more. But for the last 2 days I've had none.
So I've had a blood test as per meno specialist request and I have no idea what the results mean, the GP messaged me saying they are too high and to use the gel every other day and repeat blood test in 6 - 8 weeks.
Can anyone decipher the results,  please?
Serum testosterone 2.3 nmol/L
Serum sex hormone binding globulin 50.4 nmol/L
Free androgen index 4.6
Are these too high? Thank you.

[chopsuey]

Ideally you need to know the reference ranges used by the lab that analysed your blood. The lab I used for my last test had an upper range of 1.42 for total testosterone. My specialist said there isn't much research about safe levels in women but she would want me to be under 2 to continue prescribing.

It used to be said that it was important to know the Free Androgen Index score, as if there are high levels of SHBG, not all of the testosterone may be available for the body to use. However, there seems to have been a bit of a shift in thinking on this now, certainly by the BMS. See the link below

 https://thebms.org.uk/wp-content/uploads/2022/12/08-BMS-TfC-Testosterone-replacement-in-menopause-DEC2022-A.pdf

The upper limit for FAI from my lab was 3.63, so depending on the values used by your lab, again this may be on the high side.

Great that you are feeling lots of benefits though. Do you think you are able to measure out the correct amount for each dose? I use Androfeme, which is designed for women, so don't have that issue but imagine it might be a bit tricky trying to divide a sachet up into several doses, which I think you have to do with testogel?   

[MrsMitch]

Thank you, Chopsuey. It's not easy to measure out the correct dose tbh. Some weeks I seem to finish a sachet in 6 - 7 days, others 9 days so a bit all over the place. If I do finish it sooner than 8 days, I wait until what would be day 9 to begin the next one. The problem is there's very little control over how much is squeezed out so no matter how careful I am, sometimes a big blob comes out, that's when I then skip a day to compensate for what I imagine is a double dose.
I'm reluctant to have to start paying for Androfem plus I have read on here there are some ingredients in it that aren't terribly good for you. So I'll persevere at the moment. 
How do I find out the reference ranges the lab uses? Should I be asking the GP for that?

[chopsuey]

Yes, the GP should be able to give you a print out of the reference ranges.

I didn't realise there was stuff in Androfeme that wasn't all that great - seems to be the case with some other products, like the titanium dioxide in Utrogestan. But, I like having a product designed for women for all the reasons that you have described. For me, it's the cost of it that is the real issue.

Although Androfeme comes with a syringe, it is a nightmare to use and you end up leaving a fair amount of it in the syringe, which is wasteful. So, I weigh mine and would have suggested you try the same with testogel,, but is sounds like controlling the squeezing out bit is the hardest aspect.

Hopefully one day, there will be a better range of testosterone products designed for women., that are available on the NHS.

[joziel]

Androfeme has a lot of parabens in it, so I also don't use it.

With the testosterone gel, did you apply it the day of your test? It's best not to apply it the morning of your test or you will catch the peak of it. (Same with Oestrogel if you use it.)

The spots on your chin are likely caused by testosterone because that's known to be a symptom of taking it - but usually settles down and not necessarily a sign of it being too high.

You should have access to your results with ranges included. You can access these via the NHS app if you download it.

Write the date you opened a sachet on the sachet in permanent marker so you can always refer back and make sure each sachet is lasting 8 days. I think every other day would be too little, to be honest. If I were you, I'd aim to make each sachet last 10 days instead of 8 and then re-test without applying gel the morning of the test.....

I'm with Newson and I'm pretty sure they said they want the FAI to be under 5, which yours is... so I wouldn't worry too much, it's not really high. See https://www.balance-menopause.com/menopause-library/understanding-hormone-levels-in-the-blood/

[MrsMitch]

I think the cost for the Androfem would make it difficult for me too because I assume I would have to get a private consultation to be prescribed that? Plus the cost of the Androfem itself.  Also my GP practice is not helpful in prescribing something that has been originally prescribed privately,  their attitude seems to be that you should carry on getting private prescriptions if that's how you start with any meds, they won't take over from a private specialist and give repeat NHS scripts. But you may correct me if it is available on the NHS, I'd understood it isn't. 
I do write the day I start the sachet in my diary so I know where I am with it and fortunately my GP spoke to me prior to the test and so i hadnt applied the gel since the afternoon before my blood test. I do have a follow-up appointment with the meno specialist in November so hopefully she'll be able to look at my test results and advise, I don't trust my surgery to get it right. I'm just going to look at my test results on the surgery app to see if there are any notes on ranges.

[MrsMitch]

So looking at my test results online, it reads as follows: Serum testost: 2.3nmol/L [0.1 - 1.4]
Serum s.h.b.g: 50.4 nmol/L [27.1 - 128.00]
Fai: 4.6 [0.2 - 3.6]
The site says they do not publish the reference ranges but that the test results should contain them - so would they be the figures in brackets?
If not it says to either contact the GP for them or the lab that carried out the test.

[joziel]

Yes the ranges are in brackets. I think you are at the very top of the acceptable range. (I know you might be slightly over on the range given there.)

I'd just reduce a bit by making a sachet last a couple more days - and the day before, apply your dose in the morning (not afternoon).

Symptoms are very important and if you are feeling great and have no symptoms of high T, then being very slightly over range really isn't an issue IMO.

[chopsuey]

I think the cost for the Androfem would make it difficult for me too because I assume I would have to get a private consultation to be prescribed that? Plus the cost of the Androfem itself.  Also my GP practice is not helpful in prescribing something that has been originally prescribed privately,  their attitude seems to be that you should carry on getting private prescriptions if that's how you start with any meds, they won't take over from a private specialist and give repeat NHS scripts. But you may correct me if it is available on the NHS, I'd understood it isn't. 

Yes, at the moment Androfeme is only available by private prescription and therefore involves a private consultation, so it does make it quite expensive. I was started on it under a private meno specialist, for brain fog and low energy levels, which it definitely helped with but that's not grounds for NHS prescription of testosterone. As the GP knows it is for this and not libido, I doubt very much I'd get any form of testosterone on the NHS now.

Based on your results, I agree you should reduce the amount of testogel you are using a bit but still keep it daily, not alternate days like your GP suggested.     

[MrsMitch]

Thank you ladies, you've been a great help. One more thing, at the moment I seal the sachet of gel I'm using with one of those plastic clips you use to close any packet of food. Do you think it would be OK to transfer each sachet, as I open it, into a tiny clear pot with a screw top lid on it? I just think it would be easier to divide the doses if I can actually see how much there is. I could work out the size of say 10 doses per sachet much easier and scoop out the right size dose each time. There really is no way to control how much is squeezed out otherwise.
I've got some tiny little travel pots that I've never used, usually you would put cosmetics in them.

[Hurdity]

Hi

I've used tesosterone gel for nearly 10 years starting with Testogel sachets ( the 1 % gel - no longer available) then to Testim (tubes with a screwtop - much easier to dispense) and when that was discontinued (again!) back to Testogel sachets - the stronger  one ( 1.6% ) with the same issue re paper clip over the end.

I've never ever measured out doses nor kept a record of how long the sachets last and have always gone by my original prescriber back in 2015 to us a "pea sized blob". The stronger the gel the more likely there is to be variation in the amount squeezed out - so Tostran at 2 % will vary more than Testogel 1 % (if it was still available). My sachets have always lasted way longer than the guidance suggests - and my results have always been within range and libido (or rather response) is fully restored.

Put another way the weaker the dose the smaller margin of error if your blobs vary slightly.

Quite honestly I wouldn't worry about transferring it or weighing it out and just get used to how big the blobs are by eye. The 8 days is based on the average dose suggested for women of 5 mg per day and the sachets contain 40.5 mg but as already stated there is very little information on the right dose for women.

For me if I squeeze out a bit too much I just leave some of it on my finger and wash it off rather than applying it. I really don't think it's that crucial. Testosterone I think has a longer half-life than estradiol so for example to product info for Testogel says:

"When treatment is stopped, testosterone concentrations start decreasing approximately 24 hours after the last dose. Concentrations return to baseline approximately 72 to 96 hours after the final dose."
https://www.medicines.org.uk/emc/product/13255/smpc#gref

whereas for estradiol, the product info eg for estradot says:
"Since estradiol has a short half-life (approximately one hour), serum concentrations of estradiol and estrone returned to baseline values within 24 hours following removal of the patch."
https://www.medicines.org.uk/emc/product/7226/smpc#gref

...so small daily variations in the amount applied should not have a significant effect, I would have thought?

Hurdity x

[Dandelion]

Thank you, Chopsuey. It's not easy to measure out the correct dose tbh. Some weeks I seem to finish a sachet in 6 - 7 days, others 9 days so a bit all over the place. If I do finish it sooner than 8 days, I wait until what would be day 9 to begin the next one. The problem is there's very little control over how much is squeezed out so no matter how careful I am, sometimes a big blob comes out, that's when I then skip a day to compensate for what I imagine is a double dose.
I'm reluctant to have to start paying for Androfem plus I have read on here there are some ingredients in it that aren't terribly good for you. So I'll persevere at the moment. 
How do I find out the reference ranges the lab uses? Should I be asking the GP for that?

What are the ingredients in androfeme that are bad for you?
I did look up a list of them but apart from almond oil just saw a load of chemicals.

[MrsMitch]

Thank you Hurdity, very helpful of you I appreciate you taking the time to post.
With regards to the ingredients, I read that Androfem is full of parabens. Not that most other everyday products aren't full if them too, even some food, but I just wasn't sure there was a good reason to have it.
So I'm going to post about some concerns I have by starting another thread elsewhere but after speaking to a lady I know yesterday about testosterone,  she's on Androfem and was encouraging me to pay for a private consultation and get Androfem.  But to justify the cost (she says she's spent £1k getting her meno issues sorted) I need to know if Androfem is loads better than testogel.  Is it going to do something that testogel isn't or would I simply be paying to get the same results I'm getting now?

[chopsuey]

Testosterone is testosterone, so as long as you are able to work out the correct dose for you with the testogel, it should make no difference. With Androfeme, as it's been designed for female use, that has been done for you, that's all.

It sounds like you need to reduce what you were previously using a bit, but that may have also happened if you'd been using Androfeme. I use the recommended dose, but my total testosterone levels are probably at the upper limit of what my specialist would be happy with, to continue prescribing it. I guess I must absorb it well.

I wouldn't spend money that you don't need to!

[MrsMitch]

Thanks Chopsuey, I assumed both products must give the same results but you've confirmed that assumption.