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[elle]

Hi, I have a couple of questions re testosterone treatment
1. Will private practices only prescribe it for low libido similar to the NHS?
2. If I get testosterone privately because my NHS GP can't prescribe, do I also have to pay for bloods/follow up privately? I'm wondering how monitoring happens as my NHS practice doesn't share-care.
3. Has anyone had experience of the above using the Superdrug service for testosterone. It's a cost efficient option for me.
I had my bloods done last week (full bloods and hormone panel) and privately for a baseline testosterone measurement.
Thanks

[CLKD]

The 1st question is : why do U think that U require testosterone if it's not for sexual libedo.

Have U discussed this with your prescribing practitioner who is overseeing your regime? 

There is a reason why many NHS practices don't accept private prescriptions, it mayB down to cost issues. Again, discuss with the GP 2 find out how they stand.  Many years ago my GP asked me :What would U do if my religion didn't allow The Pill?: my response, at aged 16 - "Your Religion shouldn't come into prescribing for any1!"  I've been bolshie ever since 

Sometimes when 1 is using HRT blood tests won't be particularly useful.  I expect to be corrected if I'm wrong.

Let us know how you get on? 

[Ayesha]

While you wait for specific answers to your questions, check out the search box with the relevant words, there have been lots of posts regarding testosterone you might find helpful.

[bombsh3ll]

Many (but not all) private providers will prescribe testosterone for wider indications than just libido.

However you need to think about what the subsequent letter to your GP will say.

If it says "this lady has been started on testosterone for low libido with good effect..." then the GP is much likelier to continue the prescription than if it says "testosterone has been started for mood/joint/cognitive/insert your own reasons" etc. even if it is clinically effective.

Ironically I take DHEA which converts to testosterone, for the worst case of erectile dysfunction you have ever seen (I am unable to stand without fainting due to a brain injury), and it is effective, far from a cure but at least as helpful as my pacemaker and fludrocortisone, but if/when I change to testosterone I will have to say it is for libido to get it on the NHS, even though it is literally to help keep me off my back 😂. It's perverse.

[elle]

The 1st question is : why do U think that U require testosterone if it's not for sexual libedo.

Have U discussed this with your prescribing practitioner who is overseeing your regime? 

There is a reason why many NHS practices don't accept private prescriptions, it mayB down to cost issues. Again, discuss with the GP 2 find out how they stand.  Many years ago my GP asked me :What would U do if my religion didn't allow The Pill?: my response, at aged 16 - "Your Religion shouldn't come into prescribing for any1!"  I've been bolshie ever since 

Sometimes when 1 is using HRT blood tests won't be particularly useful.  I expect to be corrected if I'm wrong.

Let us know how you get on?

I think testosterone would be helpful for low libido in my case, but I also have hypotonia and a connective tissue disorder causing chronic pain. I've heard many women benefit from testosterone in relation to pain and low muscle mass. Not sure if this additional feature will help shift things in favour.
I'm seeing my GP in a month, first appt I can get with her to discuss, she's had letter from meno clinic suggesting tests but I'm not sure what they would be. I thought she'd done a hormone panel but hasn't. Maybe the meno clinic will suggest that but i'm not hopeful I'll get anywhere with it all. She's gone through the BMS approach to blood tests and hormones with me and like you say, they don't seem to be particularly useful. Will def let you know how things pan out x

[elle]

While you wait for specific answers to your questions, check out the search box with the relevant words, there have been lots of posts regarding testosterone you might find helpful.

Thank you! Yes, the forum is really useful, it's where I learnt that testosterone might even be an option, it wouldn't have crossed my mind otherwise.

[elle]

Many (but not all) private providers will prescribe testosterone for wider indications than just libido.

However you need to think about what the subsequent letter to your GP will say.

If it says "this lady has been started on testosterone for low libido with good effect..." then the GP is much likelier to continue the prescription than if it says "testosterone has been started for mood/joint/cognitive/insert your own reasons" etc. even if it is clinically effective.

Ironically I take DHEA which converts to testosterone, for the worst case of erectile dysfunction you have ever seen (I am unable to stand without fainting due to a brain injury), and it is effective, far from a cure but at least as helpful as my pacemaker and fludrocortisone, but if/when I change to testosterone I will have to say it is for libido to get it on the NHS, even though it is literally to help keep me off my back 😂. It's perverse.

[elle]

Many (but not all) private providers will prescribe testosterone for wider indications than just libido.

However you need to think about what the subsequent letter to your GP will say.

If it says "this lady has been started on testosterone for low libido with good effect..." then the GP is much likelier to continue the prescription than if it says "testosterone has been started for mood/joint/cognitive/insert your own reasons" etc. even if it is clinically effective.

Ironically I take DHEA which converts to testosterone, for the worst case of erectile dysfunction you have ever seen (I am unable to stand without fainting due to a brain injury), and it is effective, far from a cure but at least as helpful as my pacemaker and fludrocortisone, but if/when I change to testosterone I will have to say it is for libido to get it on the NHS, even though it is literally to help keep me off my back 😂. It's perverse.

Many (but not all) private providers will prescribe testosterone for wider indications than just libido.

However you need to think about what the subsequent letter to your GP will say.

If it says "this lady has been started on testosterone for low libido with good effect..." then the GP is much likelier to continue the prescription than if it says "testosterone has been started for mood/joint/cognitive/insert your own reasons" etc. even if it is clinically effective.

Ironically I take DHEA which converts to testosterone, for the worst case of erectile dysfunction you have ever seen (I am unable to stand without fainting due to a brain injury), and it is effective, far from a cure but at least as helpful as my pacemaker and fludrocortisone, but if/when I change to testosterone I will have to say it is for libido to get it on the NHS, even though it is literally to help keep me off my back 😂. It's perverse.

That's good to know that they consider and are aware that there are other benefits to taking testosterone. Good point that I tick the right boxes as far as the GP prescribing. I understand their hands are tied, even if they'd like to help. Sorry you're having trouble with your own issues, it's a minefield to navigate the system. Do you monitor your DHEA via bloods etc? Is your GP happy for you to take it, or is it something best not mentioning? thanks

[sheila99]

I haven't gone the super drug route but if want it on the NHS it has to be for low libido. Because there isn't a product licenced for women available on the NHS normally your GP needs it to be prescribed by an expert. I'm not sure if super drug count but you can ask. You can ask for a referral to an NHS meno clinic for it but it may take a year or more to get an appointment.The NHS will probably want a blood test for testosterone levels first. If you don't get it through the NHS they won't normally provide follow up care. I think there's a strong correlation between low testosterone and low libido, I'm not sure there is for other symptoms, but a blood test is the only way to know for sure.

[elle]

I haven't gone the super drug route but if want it on the NHS it has to be for low libido. Because there isn't a product licenced for women available on the NHS normally your GP needs it to be prescribed by an expert. I'm not sure if super drug count but you can ask. You can ask for a referral to an NHS meno clinic for it but it may take a year or more to get an appointment.The NHS will probably want a blood test for testosterone levels first. If you don't get it through the NHS they won't normally provide follow up care. I think there's a strong correlation between low testosterone and low libido, I'm not sure there is for other symptoms, but a blood test is the only way to know for sure.

Thanks for that Sheila, I've just checked and for women, Superdrug don't actually initiate a testosterone prescription, they only provide it if you've already been prescribed it. Yes, I had to wait a year last time for meno clinic but at the time I didn't know how testosterone could be related to my condition so it wasn't discussed. My GP has a service where they write to the meno clinic with your questions then get back to you. I'll find out what they say in a months time. At least it will point me in one direction, probably private but fingers crossed! I don't really know where to start and costs involved when it comes to trying to get it privately but will start researching to get the best options.

[bombsh3ll]

I buy my DHEA from iherb and monitor my own bloods annually.

I doubt my GP would know what DHEA is.

The reason I use DHEA and not testosterone is partly cost and access but also because I am on the combined pill for suppression of ovulation.

DHEA has been studied for safety and efficacy in women on the COCP,  but testosterone has not.

I maintain testosterone levels in the upper quartile of female healthy range and FAI of 5.

When the time comes for me to graduate from COCP to MHT I may try testosterone.

However if the effects are no different and I have to pay through the nose for it, I will happily continue with DHEA.

[elle]

I buy my DHEA from iherb and monitor my own bloods annually.

I doubt my GP would know what DHEA is.

The reason I use DHEA and not testosterone is partly cost and access but also because I am on the combined pill for suppression of ovulation.

DHEA has been studied for safety and efficacy in women on the COCP,  but testosterone has not.

I maintain testosterone levels in the upper quartile of female healthy range and FAI of 5.

When the time comes for me to graduate from COCP to MHT I may try testosterone.

However if the effects are no different and I have to pay through the nose for it, I will happily continue with DHEA.

That all sounds sensible and it sounds like it's working well for you. I'm guessing a GP won't prescribe it as an alternative if they are unhappy prescribing testosterone, but I may bring it up with my GP and request an androgen test. Hopefully the meno clinic have suggested this in their letter. There certainly seems to be good feedback on iherb for DHEA.

[bombsh3ll]

A GP would never prescribe dhea but a bottle of 100 is about £8-9 which is less than the English prescription charge,

It's known as the poor man's testosterone.

Obviously conversion varies between individuals so it is wise to check testosterone before and after.

If someone was a poor converter they may be better taking testosterone directly.

[elle]

A GP would never prescribe dhea but a bottle of 100 is about £8-9 which is less than the English prescription charge,

It's known as the poor man's testosterone.

Obviously conversion varies between individuals so it is wise to check testosterone before and after.

If someone was a poor converter they may be better taking testosterone directly.

Thanks, I'll see what the menopause clinic come back with. If they don't want to do tests then I have a private baseline total testosterone test I got done a few months ago for what it's worth. If I decide to use the DHEA I'll do another test before starting then again a few months later. Can I ask, the self monitoring you do, are you looking for increase in oetrogen and testosterone levels? I'm just wondering what bloods I should be doing if I did take it. I notice there is some concern that DHEA "may" increase the risk of hormone-sensitive cancers due to its conversion into estrogen and testosterone.

[bombsh3ll]

I check testosterone, estradiol, FAI and FSH yearly.

I am in Zoely for my COCP otherwise there would be no point checking estradiol if I were on an ethinylestradiol based COCP.

My targets are to maintain:
Testosterone in upper quartile of female healthy range.
FAI around 5
Estradiol > 400 pmol/L
FSH < 7 IU.

The DHEA hasn't changed my estradiol, however I am not looking for it to do this as I have adequate estradiol from the Zoely plus the small amount that suppressed premenopausal ovaries secrete.

I have no concerns about hormone sensitive cancers as I am breast free (non-carrier within BRCA2 family, risk reducing mastectomies prior to availability of genetic testing) and have been on continuous combined pill for 16 years so extremely low risk of endometrial cancer.

I do not believe gonadal steroids "cause" cancer, otherwise young women would all be riddled, but that they can hasten the growth of malignancies already present, which in many cases facilitate detection prior to metastasis, partially explaining the better survival rates of women developing breast cancer whilst on HRT.