Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: vintagefiend on September 19, 2017, 07:51:06 PM
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Don't know if this is a long shot, but I'm seeing GP tomorrow re HRT and would like testosterone in the mix! I'm anticipating that she won't prescribe it and I would like to go armed with the name of a consultant in the area who does - so that she can liaise with them or refer me to them, or I can see them privately if all else fails! Thanks for any help :)
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Look like there wasn't anyone in the area fitting that description - but how did you get on with the GP and the testosterone?
Hurdity x
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Hi Hurdity- very kind of you to ask! As expected, she said "no". Even the go to menopause expert in the Leeds area (who isn't actually a gynae) won't do it. I'm sure I could get it privately, but I'd write to them first to make sure- before parting with my money!
Thanks again, Jane x
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Hi Vintagefiend, I'm not Leeds but I'm only 10 miles away. My GP referred me to Rotherham hospital to the gynae and sexual health department. I saw a Mr Spooner (now retired and replaced by a Miss Bika) who prescribed me T. (Well it was intrinsa until they discontinued it, and then T). So it can be done if you know how + have a sympathetic GP willing to refer you.
I've met the person at Leeds (who I think you're referring to) and know from my own experience she is anti T. Behind the times if you ask me.
Don't give up, it is worth pursuing, or has been for me. Hope this helps x
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Tibolone has testosterone in the mix, i was on it for a while, best HRT ever
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I'm not too far from Leeds either, but I'm sorry I can't recommend anyone in the area. I tried T, but got some side effects. I'm trialling provera at the moment instead of utrogestan and have noticed some of the benefits of T with provera without the side effects.
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Hi again vintagefiend - just thought I'd make this observation having seen from another thread that you are trialling Premarin. Apparently it is not recommended to take this with testosterone (looking at research on the now discontinued Intrinsa testosterone patches) because oral oestrogen increases a compound called SHBG ( Sex Hormone Binding Globulin) in the blood stream, which binds free testosterone (the biologically active part of T) and therefore effectively reduces libido and other things that T is responsible for. I'm not sure from the paper whether CEE (Conjugated equine oestrogens) as Premarin is, have even more of an effect - but this is something to think about. Specialist gynaes should know this and therefore T should really only be taken with transdermal oestrogen ie patch or gel - this is my understanding anyway.
Hurdity x
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Hurdity, there is a lot on testosterone being taken with premarin. I have looked into this since you mentioned it. It must just be something unique to the intrinsa patches, but itns't applicatble to the gel.
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It's supposed to be more effective with transdermal.
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Thanks Katia - would be great if you have some links to post as I haven't scoured the internet myself - but latched onto that one particular paper which seemed to be very thorough because it compared the effect of the different types and methods of delivery of oestrogen. I do have some other bookmarks so must have another look. Trouble is there is not much research on T in women as far as I can gather - and not doses etc with different preparations and different types of oestrogen. I would be really interested - thanks :)
Hurdity x
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Hurdity, most of it is in the States where they use more Premarin and more T, I think. There is also a formula that includeds premarin and T. For you search Premarin and testosterone you will find it. I'm not sure if it's still available. I have come across that T is more effective with transdermal than oral, but that includes estradiol as well as conjugated. Thinking aloud, it's got to be more than SHBG as the different progestegens would also play a part in the efficacy as some bind and some don't. There are T receptors in the vagina so I wonder if that affects different people's responses, like with Vagifem. It also stimulates the ovaries, which would be different for peri and post.
It is interesting. I'd be interested to know more. I'll have a look, but at the moment I've moved to researching and sorting out my p. We need more individual choices of Ps. I wish we had the one that was on e market in the States where you take it for three days and then break for three days and then take it for another three days. It's norestimate, which I found friendly in the pill. I saw that gestodene was in a trial but can't see where it is in coming to market. Hurdity, it would be great if you have any info on pipeline products.
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I'm using testosterone alongside premarin and haven't noticed any reduction in libido however I think the Premarin has helped with va. I use vagifem x3 a week but since Premarin I don't think I need to and am considering x2 in the future.
I am giving myself the 3 months without changing anything first :)
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Nina, I too find Premarin helps va and joints. Estradiol didn't help those. It doesn't seem to reach the vagina for me and does nothing for joint pains. I'm struggling with finding a P to go with the Premarin.
Hurdity, I was reading that the test for testosterone is unreliable as it is for men. I also read that women around menopause have high androgens. In the States they sometimes prescribe spironalactone to reduce androgens. This is another reason probably why T is so difficult to dose.
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Thanks for the information - will have a look and a Google when I have some time to spare and not tired! In the meantime if you find any links then do post them ::)
Yes - thanks Katia - this is what the gynae I saw also said - that testing for T using existing methods is unreliable and that she didn't do them - instead relying on symptoms. It is presumably be advisable for women on higher doses as I gather from reading on here that some women have achieved levels outside the normal range on replacement T - but whether this is accurate or not I don't know - I know John Studd orders them routinely for example.
Hurdity x
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Hi ladies- just want to thank you for all the advice and names of docs and hrts- it really is all so helpful. I'm going to write at greater length when i have more energy! i feel extremely tired! thought i had a bug but now suspect it's hormonal- as ever :)
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Hurdity, most of it is in the States where they use more Premarin and more T, I think. There is also a formula that includeds premarin and T. For you search Premarin and testosterone you will find it. I'm not sure if it's still available. I have come across that T is more effective with transdermal than oral, but that includes estradiol as well as conjugated. Thinking aloud, it's got to be more than SHBG as the different progestegens would also play a part in the efficacy as some bind and some don't. There are T receptors in the vagina so I wonder if that affects different people's responses, like with Vagifem. It also stimulates the ovaries, which would be different for peri and post.
It is interesting. I'd be interested to know more. I'll have a look, but at the moment I've moved to researching and sorting out my p. We need more individual choices of Ps. I wish we had the one that was on e market in the States where you take it for three days and then break for three days and then take it for another three days. It's norestimate, which I found friendly in the pill. I saw that gestodene was in a trial but can't see where it is in coming to market. Hurdity, it would be great if you have any info on pipeline products.
I've looked up what is available in the States and it is interesting that they produce a tablet with oestrogen and testosterone in it ( I didn't know this) - but the testosterone is particular is methyltestosterone - which is structurally different from testosterone - the biologically identical form in use in UK. In addition the oestrogens in the tablet are either esterified oestrogens (related to estrone) or conjugated equine estrogens (like Premarin). Any effect on libido and when taken in conjunction with these different oestrogens I imagine will not be comparable with the results of Intrinsa due to the major difference in testosterone. I am sure there will be some testing somewhere.....
Haha Katia - sorry I am not privy to any such information - although sometimes things pop up (from US alerts) that are not approved yet here....
Hope your bug is better soon vintagefiend! When you're better would be interested to hear what your doc said ....
Hurdity x
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Hurdity, I wish we were privy to more of what's in the pipeline. I've sent Bayer a message to ask, but not had a response. Wonder how we could find out? There's got to be more products coming
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Hurdity, I was reading that most of our e when we are younger actually comes from T, so there must be some conversion that happens that maybe we lose with meno? Have you come across anything on this?