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[Pauline b]

Hi do I need a blood test to check if I should add testosterone into my HRT regime or is it based on symptoms?

[bombsh3ll]

You should go by symptoms, although some people have symptoms that they don't necessarily realise are related to low testosterone until they get better on treatment.

A pre treatment blood test is only required by some providers more from the point of view of making sure testosterone isn't being given to someone who already has high levels, rather than to make a diagnosis of low testosterone.

[Dandelion]

Symptoms.
For me, oestrogen and progesterone were no longer cutting it, even with an increase in oestrogen.

[sheila99]

If you have zero or low libido (and assuming no other causes) I think you're pretty much guaranteed to have low T. I don't think it's quite as cut and dried with other symptoms
Many gps seem to want a blood test before prescribing it now.

[GalwayGirl]

I’m under Newson and they test for it with a range. They have said I need it but I don’t want it. Not sure I believe in it- but that’s just me. I don’t want to add something else in and not sure of evidence but each to their own.

[Kathleen]

Hello ladies.

When I was with Newson Health they prescribed testosterone and said that oestrogen levels need to be adequate because if not, the body converts testosterone to oestrogen and the particular benefits of testosterone are lost.

I used testosterone for a while but never felt comfortable on it although my oestrogen and progesterone doses were always changing so perhaps that didn't help.

I stopped taking testosterone a while ago and a recent blood test showed that my own testosterone is within the normal range so I don't think I will be adding it again.

I wonder if some post meno women naturally convert their testosterone to oestrogen and consequently they don't need standard HRT?.

Take care ladies.

K.

[Dr. Heather Currie]

There is currently only 1 indication for testosterone, which is persistent low libido after all other contributory factors have been addressed. Female sexual function is complex, and adding in testosterone is often not the magic answer!
If all other factors have been covered and the decision has been made to have a trial of testosterone, then that is when testosterone level is measured to check if it is in the upper part of the normal range. If it is, then the decision to try it can be reversed; the aim is to keep it within the normal female range.
Testosterone is converted to estrogen in our fatty tissue.
Testosterone does not fall significantly around the time of the menopause transition, it is a more gradual fall from much earlier. If ovaries are removed, then there is a 50% reduction in testosterone, but even then, not all women who have had such surgery require testosterone. There is no link between testosterone level and symptoms, and no target level to aim for.

There is an excellent podcast about testosterone at  https://www.youtube.com/live/At1pNcq5ky8?si=B5gpgNES_zZhgigB
and a fact sheet at https://www.womens-health-concern.org/wp-content/uploads/2022/12/22-WHC-FACTSHEET-Testosterone-for-women-NOV2022-B.pdf

I hope that this is helpful.

[Kathleen]

Hello ladies.

Dr Currie - Many thanks for your help post.


Best wishes.

K.

[Dandelion]

Testosterone is more than just female sexual function.
Freud meant libido to be joy of life.
Droves of women already on HRT, come online to say what a game changer it is.
This often comes back in long suffering women who did not know they needed testosterone.
It was the free educational, evidence based, science backed content from Dr Louise Newson that spurred me into going to my GP's for a blood test for it.
My oestrogen and progesterone helped but only limited, and I felt resigned to low motivation, low energy, low mood, low everything, until I took my head out of the sand and looked honestly at myself hormonally.
The NHS computer said "No" as my SHBG, FAI and testosterone blood levels were given to me on the app.
I had to go private.
I went to Newson Health, online, who explained to me, using my NHS blood test figures, why testosterone is not available enough for me.
Dr Newson also explains the science why this hormone, the most biologically active in the body, also helps other menopause symptoms, helps the other hormones to work, and prevents risk of future diseases that we see in lots of women.
Newson Health like to pass patients back to the NHS as they cannot figure out why it is so difficult to get this hormone, the prescription of which, to many women, who, as someone said earlier up-thread, don't even realise they need it, when it can prevent a massive burden on the NHS.

[Dandelion]

I’m under Newson and they test for it with a range. They have said I need it but I don’t want it. Not sure I believe in it- but that’s just me. I don’t want to add something else in and not sure of evidence but each to their own.

Dr Newson has done a beautiful job in her podcasts and videos on testosterone, in explaining biologically whey we need it to prevent future major diseases and loss of independence.

[Kathleen]

Hello again ladies.

As I mentioned I used testosterone for a while and didn't feel great on it however this may have been due to other factors such as changing oestrogen and progesterone at the same time.

This is probably a crazy idea but because testosterone can be converted to oestrogen in our fat cells is there an argument for using testosterone only as an HRT? 

Dandelion - I wish you luck with your new regime and I hope that you can keep us updated.

Take care ladies.

K.

 

[bombsh3ll]

I have heard of a small number of breast cancer patients being treated with testosterone only, and I believe some or all of them were on aromatase inhibitors which block this conversion, but I don't think this would have widespread clinical benefit.

Testosterone is much more expensive and hard to access than estrogen, so rather than taking a bigger dose of testosterone which may have undesirable side effects and hoping for it to convert to estrogen, a process which is probably very variable between individuals, it just makes more sense to maintain a healthy level of estrogen and add physiological testosterone on top.

I agree that it is very reductive to think of testosterone in women as just being for low libido, when it has a myriad of functions throughout the body.

The issue of women not being listened to or believed is endemic within medicine and this is another example, particularly where quality of life outcomes are concerned that are difficult to measure objectively, so we are left with the paternalistic dictat that we should only be "allowed" testosterone to make us sleep with men.

I didn't give a rat's ass about my libido, frankly that was a very first world problem as far as I was concerned, but it has helped me massively with other physical issues (and also restored my libido as a side benefit which I wasn't even expecting).

[Dandelion]

Hello again ladies.

As I mentioned I used testosterone for a while and didn't feel great on it however this may have been due to other factors such as changing oestrogen and progesterone at the same time.

This is probably a crazy idea but because testosterone can be converted to oestrogen in our fat cells is there an argument for using testosterone only as an HRT? 

Dandelion - I wish you luck with your new regime and I hope that you can keep us updated.

Take care ladies.

K.

Thank you Kathleen.
I will come back to update you, as my memory will hopefully be better by then, as I don't remember things well at the moment.