Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Annie0710 on July 15, 2017, 08:37:45 AM
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My gp prescribed more T gel for me yesterday and then about 10 mins later phoned me saying she wants me to have a full blood count booked then every 3 months for the first year and annually thereafter. I asked why and she said T users are at risk of an increase in red blood cells which can be dangerous. She supports my hrt regime but said it does need monitoring
I'd never heard of this, and all my bloodwork since 2012 showed crappy red blood cells, and below range haemotocrit (sp?) so I'm hoping it's increased it in a good way not a bad one
I've looked this up and there's lots of info on the net
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Annie0710 - I haven't come across any information about long term health implications of T use as I didn't think there was anything much so if you have any that you've come across and you've bookmarked that would be good. I'm sure there will be some long term effects so if there is anything untoward then we need research because this is where prescribing practice might be outstripping sufficient research info...
We are only replacing T at very low levels to within physiological range so it would be interesting to know if there are some adverse effects?
Hurdity x
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She said it 'can ' raise HB levels to a dangerously high level and they want to monitor it
I'd never heard of it so googled it, it seems rare, but I've got to go along with the tests to be prescribed it
the research seems to be from males prescribed it
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Yes Shortie I think this gp has read up about T replacement as she didn't seem knowledgeable, panicked and called me back to say about the regular tests, it's a full blood count they'll do so will be interesting what the levels are
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Even the pharmacist was questioning me about the gel, I came out and said the same to my other half that I'm only replacing what I'm not producing any more, it's not like I've just got some heroin !
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My gp said she's happy to prescribe tibolone if I have annual blood tests too. Better safe than sorry but as mentioned we're using such small doses and any androgenic effects will be noticed immediately, that is think we'll be alright.
After 6 month's use of testosterone, my levels measured within range (whatever that is).
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She didn't mention testing my T levels just the whole caboodle in a full blood count, she didn't mention androgenic symptoms just this high HB risk
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GP's always panic about T, bit sad really as it's not Crack just a naturally occurring hormone and I'm sure that mega-beards and the formation of a penis might alert us to possible overdosing should that occur!
Sx
Haha - I think that might be a bit too late! ;D ;D
Hurdity x
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I've just been searching for further information about this.
I can't find information about testosterone in women and haemoglobin levels at all, but to me it doesn't sound reasonable to extrapolate research results into testosterone supplementation in men for whom it is the dominant sex hormone, to women who supplement within their physiological range, although there is very little research into T supplementation in women at all!
However long term effects into cardio-vascular risk amongst other things have not been studied so I would welcome being monitored by my doc - provided the doc also measures things such as cholesterol and HDL, LDL etc too.
Though I'm happy to use it (T) myself I find the lack of research info into long term use of some concern.... I hope someone somewhere is doing a study or two?
Hurdity x
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I think she's googled it and seen it reported with men then worried even more !
I'll have to remember to book the blood test this week
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The only thing I'm worried about Shortie is that she'll take me off it !
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:-) x
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I don't think you've started a panic Annie0710!
However as I said despite the most eminent gyane in the land prescribing it - as far as I know there still have been no properly conducted long term studies into safety and efficacy of T replacement post-menopause and I think all who take it should be aware of this. As we know this most eminent gynae prescribes treatments which are not according to prescribing guidelines ::) - of course this is great - but I understand why other gynaes are a bit more reluctant. The information about long term impacts are most likely anecdotal unless there is an ongoing study?
I'm not worried unduly - but I do wonder about taking it well into my 60's and long term - I feel it really is into the unknown despite the replacement being within physiological range, and I would also welcome being monitored - but so far I am still using the T that I obtained privately (reluctantly) more than 2 years ago and that gynae has retired so at the moment I'm in limbo (re NHS) until this lot runs out!
As I've said before the NICE Guidelines were pioneering in suggesting T replacement in women but the prescribing of it has outstripped current knowledge I would say (as I sit here waiting for my morning T blob to dry!!!!). :)
Hurdity x
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I'm a bit of a risk taker when it comes to feeling better than I have been
Could be the Tostran or could be the 2.5 pumps of oestrogel but my fear of social situations is lessening, only slightly, but any improvement is welcome
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Great - so am I!!! Glad to hear you are experiencing improvement - long may it last!
Hurdity x
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Annie - interesting that you mention decreased anxiety. Sorry to go off subject ::) I've increased sandrena gel to 2 sachets per day - I've never felt so chilled. No anxiety whatsoever! This has only happened in last 2/3 weeks since increasing dose - The difference in my personality is dramatically different (in a positive way) :) I also removed all supplements whilst I was waiting on shipment of new ones arriving after consultation with Claire S Darling - so I know for sure it was the increased estrogen ;)
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Aw I'm glad you're seeing improvement Daisy, you deserve it
Mine isn't massive but a definite slight improvement x
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Thanks Annie - I'm walking on egg shells as the fear of going backwards still lingers :-\ . On advice from Claire Snowdon I reduced estrogen last two days trying to follow a pattern of a natural cycle. The anxiety started to creep back :'( I am able to handle it though as it's not anywhere near as bad - but I thought it was worth mentioning. I could be in a honeymoon period - that's my concern. Hopefully I keep heading in this positive direction.
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My gynae is wary of T ( can have a trial if I want ) because she feels it is being used to regularly without understanding that it can raise the " cholesterol lipids " in women , and these should be checked. In some women quite significantly.
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Professor Lumsden is very wary of prescribing it too for these reasons. xxxxx
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It is the cholesterol aspects and the possible effect on cardiovascular system that niggles at the back of my mind too as my cholesterol is high and I don't know what it was before I started taking T. We need to know what the long term implications of this are, and especially if T replacement within the physiological range, produces metabolic effects (eg on cholesterol) that are different from before T replacement eg when we were younger and T was at the same level - if you see what I mean.
Hurdity x
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Update since this morning - I had another look at the Intrinsa paper and it had this to say about cholesterol:
Lipids
No differences were noted in total cholesterol or triglyceride levels between INTRINSA-treated
patients and the placebo-treated patients during the 24-week double-blind period in either the phase II
or phase III studies or with additional therapy up to 52 weeks.
However it was only looked at for 52 weeks and I'm sure like Maryjane I have read elsewhere that they can increase - but can't find where.... It is clearly an area where top gynaes disagree (ie Studd and Lumsden) - and this has to be due to lack of information I'm sure?
Anyway many of us are taking it and many more will do so - but let's hope some info comes out in due course. Trouble is that trials take a long time if we want long term data.
You've started something here Annie0710!!
Hurdity x
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Interesting Hurdity everyone's opinions in the medical are so different , even when all are the top of there field.
I go back in September/ October and will discuss further as to wether she has more updated information. As she does prescribe it , but is cautious with it , not willy nilly.
Makes it so hard for the likes of myself " jo public " , who alot of our minds are muddle fuddled a lot of the time. 😉
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I love your term "muddle-fuddled" - that just about describes a menopausal foggy head!!!
Hurdity x
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I did find some medical references from Medline on the issue of cholesterol and testosterone excess. Seems mainly linked to polycystic ovary syndrome but that's the most typical cause of high testosterone relative to oestrogen - seems to relate to both balance between and absolute levels. Seems like medical term is hyperandrogenism.
General papers here
https://www.ncbi.nlm.nih.gov/pubmed?linkname=pubmed_pubmed&from_uid=18615851 (https://www.ncbi.nlm.nih.gov/pubmed?linkname=pubmed_pubmed&from_uid=18615851)
I also found this paper debunking various myths about use of testosterone supplementation in women - its fully referenced and thought it could be of interest. http://www.sciencedirect.com/science/article/pii/S0378512213000121 (http://www.sciencedirect.com/science/article/pii/S0378512213000121)
KatyB
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Thanks,very interesting reading. :)
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I like that last link, thanks Katy!
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Thanks KatyB! - Very interesting. Must have a look at some of those references in the second link when I've got more time. I seem to remember I bookmarked that one but forgot about it ::)
Hurdity x
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Thanks Katy B 😊 Will be interested in the scientific ladies amongst you opinions. 😊
As from what I read it could be the next piece of the jigsaw re my VA ? 🤔
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Thank you KatyB, an interesting read indeed. The article addresses so many myths and misconceptions.
Why isn't this common knowledge? Is this enough to change my gp and practice manager's mind?
What stood out for me was how long testosterone has been prescribed for pre and post menopausal women; since 1938!!
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I'm printing this off - going to study it and bring to gp with me! Thanks Katy
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A tide of menopausel womwn prinring off info and saying SEE. 🤣
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:rofl:
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I found another recent article also debunking the various myths - from following various menopause specialists on Twitter (Twitter's a great source of info!) - hope it loads from this weird looking link but I expect you will be able to find it if not....:
https://menopausedoctor.co.uk/wp-content/uploads/2017/06/testosterone-ten-tips.pdf?utm_content=bufferf25a5&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer
This one is also fully referenced (note to self: follow up these refs when less busy!).
Hursity x
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Good article, it explains it in easy to understand terms x
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Thanks Hurdity ......I am on her page also re my VA , minus my dogs this time .
Will have discussions with my gynae , as MAY be part of my jigsaw , re muscle weakness , depression, can help vestibule for some etc etc.
I have a twitter account , but forgotten all passwords etc 🙈as I say my muddle-fuddled menopause brain. 😏 Xx
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I posted a while back about the new treatment for VA in US using DHEA capsules (licensed and approved). I'm not sure how it works in relation to oestrogen and tesotsterone - ie whether it is converetd into oestrogen in vaginal tissues. Sorry I haven't time to look it up - should be gardening :)
Do rejoin twitter - and follow MM, British Menopause Society ( @ PostReproHealth I think now) and Louise Newsome etc - all sorts of nuggets of info crop up. I get notified on my phone but don't have time to read them all!
Hurdity x
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Girls I'm popping back to this thread for advice. I visited private GP yesterday and mentioned zero libido - everything else is gradually improving bar the libido. I also talked about testosterone and she said ask at meno clinic - but commented that even endocrinologists at her private clinic wouldn't prescribe for women.
Any advice for me on this one?? I was thinking of getting full hormone profile done through NHS before attending meno clinic appt. but I know nothing about average/below average levels of any of the hormones!! So not sure if that would help??
Thanks in advance
DaisyB xx
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Personally I wouldn't ask for testosterone levels to be checked, you could shoot yourself in the foot if the levels are 'acceptable'
My levels were average yet I presented with every single symptom of T deficiency and so far it's doing me no harm, only good things
If you get no joy, unfortunately if it were me, I'd be seeing one of the famous specialists who you know will prescribe, others might disagree but I'm only saying my thoughts on the subject
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Hi Annie - yes i think you're right but I will need a strong argument if I'm to persuade meno clinic. Failing that I will pay private but I just feel more comfortable with female gynae. I'll wait to see what clinic says about it first.
DaisyB x