Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Hurdity on April 29, 2018, 08:28:01 AM
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Because of the unavailability of some of the testosterone preparations there has been quite a lot of discussion recently about comparability and which T product is best for women. This is not for me to say – they are developed for men after all – but I have drawn together some basic information (below) about concentration, ingredients, and size of dose so it's altogether in one place which I hope is helpful and will save me writing it out each time someone asks!
The main thing is that Tostran is twice as concentrated as the 1 % Testogel and Testim so for those using a very small amount ( eg tube/sachet) lasting 2 weeks, it can be more difficult to give a consistent amount as variation either way will give more or less to a greater degree than with Testim or Testogel. For those who have higher doses this is probably less of an issue – and may not be an issue anyway – but just a thought! The amount dispensed in each pump of Tostran is very small – only 0.5 g gel (10 mg T) so easier to get closer to the right amount compared to Testogel (1.62%) pump pack – despite Tostran being more concentrated.
The Testogel 1.62% pump pack is more concentrated (by 1.62!) than the sachets but each pump contains 1.25 g gel or 20.25 mg T so unless each pump of gel is transferred to a syringe and dispensed from there it's difficult to gauge the right dose (which going by the totals would be approx 2/3 the amount of Testogel). However Besins state that 2 pumps of the 1.62% Testogel (40.5 mg T) is approx equivalent to 1 sachet of the 1 % gel (50 mg T) (in terms of absorption in men) so maybe less than 2/3 would be needed?
Testosterone gel products currently available (that are prescribed to women)
Tostran 2 % gel (20mg T/g gel) Pump pack
One gram of gel contains 20 mg testosterone.
One press of the canister piston delivers 0.5 g of gel containing 10 mg testosterone.
3x per week = 30mg T
1 pump on alternate days would give same amount of T as Testogel sachet or Testim tube lasting 10 days
(Starting dose for men: 3 g gel (60 mg of testosterone) applied once daily)
One tube of 5 g gel contains 50 mg of testosterone.
Testogel 1 % gel Testim 1 % gel
For a Testogel sachet/Testim tube to last 10 days (large pea-sized blob) would give 35 mg per week = 5 mg per day
(Recommended starting dose for men is 5 g of gel (i.e. 50 mg of testosterone) applied once daily )
Testogel 1.62% gel Pump pack
One pump gives 1.25 g gel = 20.25 mg testosterone
To dispense smaller amounts of these would need to decant 1 pump into syringe?
(Recommended starting dose for men is two pumps ie 2.5 g of gel (i.e. 40.5 mg of testosterone) applied once daily )
Hopefully I haven't made any mistakes but let me know if so!
Ingredients
Tostran
Propylene glycol
Ethanol, anhydrous
Isopropyl alcohol
Oleic acid
Carbomer 1382
Trolamine
Butylhydroxytoluene (E321)
Water, purified
Hydrochloric acid (for pH adjustment)
Testogel
Carbomer 980
Isopropyl myristate
Ethanol 96%
Sodium hydroxide
Purified water
Testim
Purified water
Pentadecalactone
Carbomer 980
Carbomer copolymer
Propylene glycol
Glycerol
Macrogol 1000
Ethanol
Trometamol
Edit 11.6.19 - Testim has been discontinued for a year
Edit 18.11.19 - Testim 1 % gel seems to be available again but manufactured by a different company - it is once more listed on our database of medicines, marketed by Endo pharmaceuticals and manufactured with same ingredients in US...
I hope this is helpful to some of you and will also help you see whether what you have been prescribed the wrong by your GP sounds about right :)
Hurdity x
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That's really helpful, thank you
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Many thanks for the info Hurdity.
Lanzalover x
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Thank you Hurdity great info.xx
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Although a doctor has just told me that the testogel pump is stronger than Tostran not weaker. " It gives 16.2mg per pump rather than the 10mg per pump from the standard preparation so more concentrated to give smaller volume for men but totally unsuitable for women."
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Hi Hurdity,
Hope you're well.
Did you have any thoughts on what the doctor said to me about Testogel v Tostran?
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Hi there - the strength of the gel is most definitely stronger with Tostran. What the consultant is talking about is the pump size and the amount of T in 1 pump. I think I explained this in my separate post?
Tostran is 2% gel
Testogel 16.2 mg is 1.62 %
Gram for gram Tostran contains more T then the Testogel.
However 1 pump of testogel gives more actual gel than Tostran hence more T in 1 pump
1 pump Tostran = 0.5 g gel - 10 mg T
1 pump Testogel 16.2 mg gives 1.25 g gel = 20.25 mg T
Tostran therefore would be easier to dispense (due to lower amount of gel and therefore T per pump), but if you wanted the weaker one then the Testogel would need to be dispnesed into a syringe as others have reported on here otherwise too much comes out at once - and yes this is comprabale to oestrogel for women where 2 pumps is the standard dose.
Testogel 1 % sachets will be available again at some point!
Hurdity x
PS I've just realised that I said exactly the same in my last post! Not sure what else you are asking? Hope I have explained OK?
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Thanks Hurdity. That's very useful .
I was using testogel sachets but have just been given Tostran today .
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I've been using the Testogel pump pack for the last couple of weeks.
I used to make one tube of Testim last about 6-7 days using a pea sized blob. So I roughly estimated that one full pump of Testogel = 3 pea size blobs of Testim.
I've found it surprisingly simple to just slightly depress the Testogel pump to just give me a pea size blob, and it absorbs more quickly than Testim and isn't as sticky.
Bit worrying though that both my GP and pharmacist reckoned I needed two full pumps per day! Just shows you these professionals are far from infallible.
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That's great GypsyRoseLee - and really helpful info :)
Oh dear I am dismayed to hear about Testim though - as I have now been given a whole box of this (my GP prescribed on NHS :) ) which will last ages. Just using up the last of my Testogel sachets - which as you say dries very quickly, and I would be very disappointed if Testim doesn't - (having also gone back to patches form a brief foray into trying Sandrena oestrogen gel which takes ages to dry!!!
That is interesting that you can pump out a tiny amount - but for those of us who use less ( eg I think I use half the amount of the Testogel 1% sachets , that you do) it might be more difficult to adjust although putting it into a syringe is an option. Too late for me now!
Yes very worrying - especially the pharmacist whose job it is to know dosage!!! Well also the GP - who must prescribe it to men and therefore must know that is the dosage for men!!!
Hurdity x
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Thank you for this thread Hurdity. Has been v helpful as I got my first time prescription for 1% testosterone gel this week and then couldn't get it anywhere. So this info helped me decide between 2 %Tostran or testogel 1. 62 ‰(these were the only 2 options that our pharmacy could get hold of) and made for a quicker chat with gp who reissued a script for Tostran. Which I have used for first time this morning. I'm aiming for a 5mg dose max, although I've decided for now I'm going to start a bit lower. The Tostran gel is much runnier than my oestrodose gel and so it was more of a circular patch that squirts out rather than a blob. Was easy to pump out what looked like around a third to a half of the pump compared to a full pump which I pumped and discarded just to see. Hmm, not exact, so I may try the syringe method for a more consistent dose, but by eye I am confident that I'm not pumping out more than half a pump, so am keeping below 5mg dose. This tiny patch of gel wiped easily onto thigh/back of knee and dried very quickly.
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Hmm, actually, the Tostran does stay a little tacky on skin after application. Yesterday I just noted "by eye" that it dried quite quickly ;I was in a hurry and just got dressed once it didn't look wet. This morning, more time and when I run my fingers lightly over where oestrogel (oestrodose I have) was applied after 5-10mins skin feels smooth and normal. Running my fingers over where Tostran was applied it is dry but feels a little "tacky"..... Still at least it's a small patch.
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My gynae says only use my Tostran 1 once per day is this enough? It does seem kind of watery so I pump it very gently onto the bathroom sink enamel and it comes out as a circle with half a pump I think if I depressed it any harder too much would come right out! I do recall my consultant saying some women use this 2 and 3 times a day rubbing it in their arms surely that can't be right? ???
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That does seem like far too much, 2 or 3 pumps a day?!! This Australian study indicictated that 5mg a day was an effective dose and upto 10mg didn't have adverse effects, but that's way less than 3 pumps of Tostran which would be 30mg.
https://www.health.harvard.edu/womens-health/study-identifies-effective-testosterone-dose-for-women.
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... Although it's only a study of 7 women!
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Bumped for various members who have been asking about testosterone and doses (go to first post in thread!)
Hurdity x
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Thanks Hurdity!
X
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Thank you Hurdity!
As much as I have googled and read others posts/links on this topic, I still don't know what it actually does...how it helps with menopause symptoms. Also, over the past few years I have gotten hairier and developed what I would consider acne. Well maybe just crappier skin. Doesn't that mean I have too much this hormone? I am going to be hairier than my husband soon the rate I am going. Arrrrrrrrr 😬 Help!
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Bumped for new member oldonetwo... :)
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Bumped for new member Shelly65
Go to the first post and start from there!
Hurdity x
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Thanks Hurdity, I've done screen shots of your info. Can you please become a specialist Memopause GP? 😉☺️Xx
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Bumped for Muzza and also here is a link to the Chelsea and Westminster leaflet on testosterone supplementation - although the information on products is now out of date:
https://www.menopausematters.co.uk/forum/index.php/topic,39588.msg627850.html#msg627850
Edit: This is the correct link to that leaflet!
http://www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/links/Testosteronereplacementforfemaleandrogendeficiency092017CWAGREED.pdf
Testim gel has been discontinued as far as I understand
Testogel 1% sachets was unavailable for some time but I think is no available again.
As stated at the start of this - there is also now Testogel pump pack 1.62% - see the thread for info.
There is also Androfeme (testosterone) Cream specifically formulated for women but made in Australia and only available by private prescription in UK and is very expensive.
Hope this helps.
Hurdity x
Edited to correct link!
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Bumped for Sooze.
Hurdity x
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Yes Androfeme is manufactured here (in Western Australia) and also a private prescription - as I no longer live there and am now living on the other side of the country I have to order it directly from the company at a cost of $85 (about £45-50)! The bonus is that it is designed especially for women and lasts about three months.
Just for comparison I googled the price for men's product and it came back at $40 (£15-20)! How typical is that??
I went to our local chemist to see if they could order it in, he's actually been able to get it compounded for me for $50 (£20-25)....I'm not sure if it's able to be done like that in the UK? As he explained to me, it's exactly the same ingredients and the same dose, so I'm going to believe him on it. I'm picking it up tonight, and hoping to start asap. At least I can get started on it before hols next week, and can organise myself to order it online from the manufacturer next time. Will be good for comparison at any rate.
Hurdity, is it better to use in the morning or the evening?
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I had the good fortune to spend 40 mins with a specialist pharmacist at the menopause clinic last year, who told me the correct dose for women taking Testogel 16.2mg/g, the pump version, is 2 full pumps per week.
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I had the good fortune to spend 40 mins with a specialist pharmacist at the menopause clinic last year, who told me the correct dose for women taking Testogel 16.2mg/g, the pump version, is 2 full pumps per week.
Thanks Autumn27 for passing this one.
However despite what the pharmacist says I would say this is still too high as a starting dose for some women. The pharmacist will be calculating this on the basis of total amount of T contained in each pump
Two full pumps give 40.5 mg T. With the 1% Testogel/Testim if one tube lasted 10 days this would give 35 mg of T per week which is slightly less. Many of us though need less than this eg my tubes of 1% Testim/Testogel last at least a fortnight so that dose (of two pumps per week) would be too high and personally I wouldn't want to apply it once a week.
Also the other thing is it delivers it as quite a high dose all at once - when given twice a week - and I'm not sure how having a big hit like that will affect women - quite simply there is insufficient information about this as far as I know?
If I was given this pump pack I would still want to start with a very small pea sized blob (petit-pois) daily or a slightly larger one every other day and try for a few months before increasing. Women in surgical menopause may well be fine with higher starting doses due to lack of ovarian production.
Just my view of course!
Hurdity x
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Also to add that the Chelsea and Westminster menopause clinic recommends 2 pumps per week of 2% Tostran as a starting dose which is 20 mg and up to a max of 3 pumps (30 mg) which is less so there is not consistency with advice between menopause clinics either!
http://www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/links/Testosteronereplacementforfemaleandrogendeficiency092017CWAGREED.pdf
Hurdity x
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I'm confused now. If the Testogel pump gives 16.2 mg/g per pump, would not two pumps give 32.4 mg/g? Can't see where the 40.5 mg comes from. I expect it's me being dense.
JP x
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Hello Joaniepat,
"One gram of gel contains 16.2 mg testosterone. One pump actuation delivers 1.25 g of gel containing 20.25 mg of testosterone."
Conolly X
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Hello Joaniepat,
"One gram of gel contains 16.2 mg testosterone. One pump actuation delivers 1.25 g of gel containing 20.25 mg of testosterone."
Conolly X
Oh I see! Many thanks Conolly, all is clear now.
JP x
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Thanks Conolly for clarifying.
Hi Joaniepat and anyone else who was wondering - it can be confusing working out how much of a particular active ingredient is in a particular product! The first figure (ie the % one) give the amount of the active ingredient so if something is 1% it means there is eg 1g of it in 100g of the product so for 1% gel it is usally expressed as 10 mg per 1 g gel. So the Testogel pump pack is 1.62% - approx (just over) half as much again more concentrated than the Testogel sachets and approx 3/4 the concentration of the Tostran gel, g for g.
For products which are dispensed per pump then you need to know how much of the product is contained in 1 pump and then you can work out how much of the active ingredient each contains.
I gave this information about how much testosterone each of the different types of T gel contained in my first post and in fact this was the aim of the thread - but as with all ongoing threads different questions get asked so the first post can get lost. Thanks for bringing this up as it reminds me I will quote it after this post to help others who might be wondering about the other products too!
Sometimes I wonder myself if I'm getting carried away and doing the sums all wrong especially if it's late at night so it's good to question it - my brain does not seem to work as well as it used to (slower!).
Hurdity x
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Because of the unavailability of some of the testosterone preparations there has been quite a lot of discussion recently about comparability and which T product is best for women. This is not for me to say – they are developed for men after all – but I have drawn together some basic information (below) about concentration, ingredients, and size of dose so it's altogether in one place which I hope is helpful and will save me writing it out each time someone asks!
The main thing is that Tostran is twice as concentrated as the 1 % Testogel and Testim so for those using a very small amount ( eg tube/sachet) lasting 2 weeks, it can be more difficult to give a consistent amount as variation either way will give more or less to a greater degree than with Testim or Testogel. For those who have higher doses this is probably less of an issue – and may not be an issue anyway – but just a thought! The amount dispensed in each pump of Tostran is very small – only 0.5 g gel (10 mg T) so easier to get closer to the right amount compared to Testogel (1.62%) pump pack – despite Tostran being more concentrated.
The Testogel 1.62% pump pack is more concentrated (by 1.62!) than the sachets but each pump contains 1.25 g gel or 20.25 mg T so unless each pump of gel is transferred to a syringe and dispensed from there it's difficult to gauge the right dose (which going by the totals would be approx 2/3 the amount of Testogel). However Besins state that 2 pumps of the 1.62% Testogel (40.5 mg T) is approx equivalent to 1 sachet of the 1 % gel (50 mg T) (in terms of absorption in men) so maybe less than 2/3 would be needed?
Testosterone gel products currently available (that are prescribed to women)
Tostran 2 % gel (20mg T/g gel) Pump pack
One gram of gel contains 20 mg testosterone.
One press of the canister piston delivers 0.5 g of gel containing 10 mg testosterone.
3x per week = 30mg T
1 pump on alternate days would give same amount of T as Testogel sachet or Testim tube lasting 10 days
(Starting dose for men: 3 g gel (60 mg of testosterone) applied once daily)
One tube of 5 g gel contains 50 mg of testosterone.
Testogel 1 % gel Testim 1 % gel
For a Testogel sachet/Testim tube to last 10 days (large pea-sized blob) would give 35 mg per week = 5 mg per day
(Recommended starting dose for men is 5 g of gel (i.e. 50 mg of testosterone) applied once daily )
Testogel 1.62% gel Pump pack
One pump gives 1.25 g gel = 20.25 mg testosterone
To dispense smaller amounts of these would need to decant 1 pump into syringe?
(Recommended starting dose for men is two pumps ie 2.5 g of gel (i.e. 40.5 mg of testosterone) applied once daily )
Hopefully I haven't made any mistakes but let me know if so!
Ingredients
Tostran
Propylene glycol
Ethanol, anhydrous
Isopropyl alcohol
Oleic acid
Carbomer 1382
Trolamine
Butylhydroxytoluene (E321)
Water, purified
Hydrochloric acid (for pH adjustment)
Testogel
Carbomer 980
Isopropyl myristate
Ethanol 96%
Sodium hydroxide
Purified water
Testim
Purified water
Pentadecalactone
Carbomer 980
Carbomer copolymer
Propylene glycol
Glycerol
Macrogol 1000
Ethanol
Trometamol
Edit 11.6.19 - Testim was discontinued over a year ago
I hope this is helpful to some of you and will also help you see whether what you have been prescribed the wrong by your GP sounds about right :)
Hurdity x
Just requoting this (the first post) for anyone stumbling upon the thread - in case it's helpful :)
Hurdity x
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Hello Hurdity and everyone else, I would like to try testosterone. I asked my doctor a few years ago for a prescription but she said it was not available at that time. Can you tell me if can now be freely prescribed?
Many thanks.
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Well I suppose it depends on where you are in the country and whether your GP or Consultant will prescribe! In theory it should be easily available, it is now listed as available on "prescription" in the NICE guidelines although described as "off licence" meaning there isn't a womens version but comments on the forum suggest that in practice prescribing is patchy at best Kimberly. I got mine prescribed at end of December by consultant and actually got the prescription last week.
Give it another go Kimberly it is much more common now and in the published guidelines.
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Hi there Kimberly
Just to add to Ladybt's helpful reply - this is what the NICE Guidelines actually say re tesosterone:
Altered sexual function
1.4.8
Consider testosterone supplementation for menopausal women with low sexual desire if HRT alone is not effective.
(With a footnote:)
At the time of publication (November 2015), testosterone did not have a UK marketing authorisation for this indication in women. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council's Prescribing guidance: prescribing unlicensed medicines for further information.
As she says it is hit and miss as to whether it will be prescribed and really it is best for you to be referred to a specialist because there are GPs prescribing it who haven't a clue about dosage and giving incorrect dosing instructions. Ditto some pharmacists. Do ask for a referral to a menopause clinic if there is one near to you and find out in advance whether the clinic will consider testosterone prescription.
You need to have adequate oestrogen levels first so if you are peri-menopausal then you should also be taking HRT before T should be prescribed.
The British Menopause Society has a list of menopause clinics (but some are private):
https://thebms.org.uk/find-a-menopause-specialist/
Hope this helps!
Hurdity x
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Hi, are any of these testosterone preparations bio identical, as I have completely lost my libido.. :-\
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All of them are!
Hurdity x
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Just got prescribed the Tostran 2% gel by a locum doc at the GP, and see that in the older Chelsea and Westminster pamplet that Hurdity also included the link for, it's the third and least preferred option, because of the risk of side effects- presumably because of a higher concentration?
Having said that, in a previous discussion on this same thread, I mentioned that had been given Testogel in the pump form, and been told by Meno Clinic to take 2 full pumps/week which as Hurdity said = 40mg Testosterone.
So now the 3 pumps of Tostran 2% = 30 mg of testosterone.
I always do take a lot less than prescribed, and haven't managed to regularly sustain the testosterone successfully, because I get noticeable heart palpitations and anxiety from it. Maybe I was still giving myself too much!
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Autumn27 - I am on Tostran 2% gel. I don't even push the pump half down and I only use it every other day. I would never use a full pump regardless of whatever a doctor, consultant or anyone else said. I tend to rely on the ladies here rather than the so called professionals. I would only listen to a professional if they were using what they prescribed themselves!
I get the impression less is more as they say!
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General bump as there have been some questions about dosage.
See also latest guidance from British Menopause Society:
https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/
Hurdity x
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Thank you so much for collating this information in an easy to access way
I have some questions to anyone using testosterone as part of HRT
1) if you went private, how much did it cost for a consultation? And can you then get a GP to keep prescribing testosterone?
2) If you got a GP to prescribe testosterone to you, how did you start the conversation? I've twice asked different GP's in my practice to do so and they said they didn't do it
3) if you got your GP to refer you to a meno clinic, how did you get them to do so?
4) if you privately source your testosterone, do you get Androfeme [which seems more expensive] or do you find a way to get testogel or tonstran?
thanks in advance
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Can I ask why you are looking into testosterone and have you tried Tibolone - can only be offered post menopause.
I had a hysterectomy and I waited until I realised patches were just not helping with libido, energy or aches & pains, tries Tibolone didn't make any difference to me. My GP checked my testosterone levels, they were non existent, she was then prepared to prescribe it but as it's an amber drug she had to refer me to a consultant. After delay my GP sent off forms that with permission from consultant she can prescribe testosterone along with aftercare. So hope to have prescription given to me on Thursday at my next hospital appointment.
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Hi Yorkshire Girl and Rockhopper,
thanks for speedy replies. Much appreciated.
I'm wanting to try testosterone as I've been on evorel sequi patches for two years. Many of my symptoms [eg anxiety, sleep, brain fog, vaginal dryness ] are addressed to an extent by the patches but I still have a terrible memory and my sexual pleasure is still much reduced. I wanted to see if adding it in would help me to feel that bit more energetic, sexual and sharper in my thinking. I can dream!
I'll report back with my progress
Miss Shelf
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Miss Shelf - I have no problem getting testosterone from the NHS consultant at my meno clinic and my GP prescribes it no problem. I got it about 5 months after I started a new regime of gel and utrogestan. I found that it helped with my brain fog the quickest (but I know from the forum this is not always the case for everyone). I felt that I was a lot more "present" about 2 weeks after starting. The Libido thing was a lot longer. My responses got better first but my "desire" was a slow burn improvement.
There should be no reason why you cannot get testosterone through the NHS - it is now clearly on the NICE Guidelines. It is easier to get from a GP if you have been to a Consultant but that Consultant does not have to be private.
You could write to our own Dr Currie on the forum - I think the fee is £25 explaining and then I believe (although I have no done it, if she is willing to recommend the testosterone, she writes to your GP recommending that it is prescribed). As she is a renound meno consultant the GP is likely to listen to what she says. It is certainly cheaper than seeing a private consultant at £160-£200 a go or waiting to get to a meno clinic.
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Miss Shelf - I have no problem getting testosterone from the NHS consultant at my meno clinic and my GP prescribes it no problem. I got it about 5 months after I started a new regime of gel and utrogestan. I found that it helped with my brain fog the quickest (but I know from the forum this is not always the case for everyone). I felt that I was a lot more "present" about 2 weeks after starting. The Libido thing was a lot longer. My responses got better first but my "desire" was a slow burn improvement.
There should be no reason why you cannot get testosterone through the NHS - it is now clearly on the NICE Guidelines. It is easier to get from a GP if you have been to a Consultant but that Consultant does not have to be private.
You could write to our own Dr Currie on the forum - I think the fee is £25 explaining and then I believe (although I have no done it, if she is willing to recommend the testosterone, she writes to your GP recommending that it is prescribed). As she is a renound meno consultant the GP is likely to listen to what she says. It is certainly cheaper than seeing a private consultant at £160-£200 a go or waiting to get to a meno clinic.
Hi, do you have the address or email to request this?
Tracey
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Hi TraceyE - go to the top of the forum and go to the contact us part - click there and it tells you about email consult requests.
Also if you put Dr Currie consultations or such like into the search box you will find posts about how best to approach it.
x
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Thank you! :)
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Thank you so much for collating this information in an easy to access way
I have some questions to anyone using testosterone as part of HRT
1) if you went private, how much did it cost for a consultation? And can you then get a GP to keep prescribing testosterone?
2) If you got a GP to prescribe testosterone to you, how did you start the conversation? I've twice asked different GP's in my practice to do so and they said they didn't do it
3) if you got your GP to refer you to a meno clinic, how did you get them to do so?
4) if you privately source your testosterone, do you get Androfeme [which seems more expensive] or do you find a way to get testogel or tonstran?
thanks in advance
Hi Miss-Shelf
If I haven't said so already - :welcomemm:
I initially went privately in early 2015 but this was before the NICE Guidelines came out. It cost £190 and a box of Testogel about £30 but this lasted 18 months! I managed to get another box by phoning the hospital ( 65 miles away) and paid another £20 for the prescription + the cost of another box which lasted another 18 months. That specialist has now retired so last May went to my own GP (the gynae specialist at my practice) and she prescribed it for me - and I'm still using that box - she does lots of stuff off licence. However there is no guarantee that your doc will continue to prescribe what a private consultant prescribes because despite the NICE Guidelines there is no licensed product for women in UK unfortunately.
When I asked my normal GP about doing a blood tests for testosterone (this was pre 2015) she said we can't go round testing everyone who complains ofr tiredness for tesosterone and that was that - she wanted to refer me for possible fibromyalgia diagnosis and I wasn't having any of that!
There is also a thread in private lives I started called Testosterone Here We Go which might have a few points of interest? I'll bump it for you...
Hope this helps and good luck :)
Hurdity x
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Bump for lolalolajone
Hurdity x
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Hi - sorry if it's already on here somewhere, but does anyone know if it's imperative to keep opened Testogel sachets in the fridge (as I read this somewhere). I don't particularly want to keep it in the fridge for all to see! I used to use Testim and it wasn't necessary to keep that in the fridge but it did have a closable cap. I am planning to use a paperclip or suchlike to close up the sachet in use over the week but hoping it doesn't need to be in the fridge!
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Hi I've read some reports that it should be kept in fridge, but I don't keep it in fridge. I leave it on bathroom window sill x
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I don't keep my testogel in the fridge, didn't even know that it should be!
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I used the sachets for 3 years and kept them in the bathroom in make-up bag with paper clip to seal. I hadn't heard of that either - the consultant I saw did not mention this! It also does not mention anything at all about storage in the product info - although the sachets are designed to be used completely by men.... I am sure they use half sachets etc sometimes though or 1.5 sachets?
Hurdity x
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I think the info about Testogel needing refrigeration is on the Chelsea & Westminster NHS Trust website. There is a chart listing HRT preparations under the heading "HRT continuation/discharge plans for GPs". I saw it when googling something else a few weeks ago & mentioned it to a friend who had been prescribed Testogel. She had not been told it needed refrigeration. I don't use it myself, but asked at my local pharmacy where the pharmacist did a search & told me the Chelsea & Westminster details are incorrect. To qualify this, she printed off the Testogel product characteristics which say there are NO special storage instructions - i.e. it doesn't need refrigeration. Unfortunately I've shredded the printout now, so I can't quote exactly - but that was the gist of it.
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Thank you for your replies. Ah that's interesting Wrensong - when I collected the prescription from Boots, the pharmacist had printed out a leaflet from the Chelsea and Westminster Hospital on 'Testosterone replacement for female androgen deficiency syndrome' and within the leaflet it says 'Testogel 50mg/5mls in foil sachet. Second line choice if Testim unavailable. It should be sealed and stored in the fridge once opened.' Sounds like the information may be incorrect in the leaflet (which I assume came from their webiste). I am going to leave it out of the fridge, but sealed by paperclip as Hurdity mentioned. Thanks x
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The information on the PIL that there are no special storage instructions would refer to unopened sachets. It is only licensed for men and they would be using whole sachets. Thus, the C&W recommendation applies to opened sachets only.
JP x
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Thank you Joaniepat - I was wondering that after posting. I was prescribed it a few years ago but never got around to trying it as we could never get my basic HRT regime right. I was simply told (by a very reputable Meno specialist) to keep the sachet closed with a paper clip, as Hurdity does & to make a sachet last 10-14 days - no mention of refrigeration.
Wx
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Cherry - you could maybe email the manufacturer to ask what should be done when used by women - i.e. when a sachet has to last for many days?
Wx
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I will try and do that Wrensong and will report back if I have a response. Thanks x
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I have eventually replied to your PM Cherry x
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Hi there - the product info is available on the web which is what I was referring to (look under the listing on eMC. I realise it does not mention open sachets and I had thought of that too :), but the prescribing info talks about increasing dosage in 2.5 g increments so implying that only half a sachet might be used. If the product was to deteriorate significantly after exposure to air then the storage info surely would have mentioned this i would have thought? Anyway no harm in putting in the fridge. I certainly achieved decent T levels ( + hairy legs!) using the sachets as per my consultant instructed!
I would be interested to hear what Besins says about it though!
Hurdity x
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Bump for debra217
Hurdity x
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Bump again for Bobidy!
Hurdity x
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Bump for margherita
Hurdity x
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thanks Hurdity
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Bumpity bump for AJacynM
Hurdity x
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Hurdity - your first post on this thread has been v useful. I've been using testosterone for 4 1/2 months now. One of my main symptoms was horrible dead leggedness, drowsiness , v bad aches after exercise (not normal DOMs).
I felt like I'd been making an improvement all round til last ten days when lots of these symptoms came back. I've been stuck in bed unable to do anything :-( fighting off depression.
4 weeks ago my dr changed me from testogel sachet, to be used over 8 days to tostran, used once every three days. Looking at your numbers, I think my testosterone dose has effectively been halved?
1 sachet testogel per 8 days: 43.75mg per weeks
Tostran every 3 days: 20.3mg Maybe a bit more - can't do the maths :-/
That's quite a big drop. Wonder if that could be part of current problem.
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Hi Tyaca
Sorry to hear about your symptoms. Not sure what DOM's are?
If you used Tostran every 3 days this would be 23.33 mg per week (10 mg/3 x7) so yes just over half the amount of testogel. Why have you been changed? I think it's always better to use a 1% gel of tesosterone as it is at a concentration designed for the amount that men use. However that's not to say you will only abrob half - it may well be that you absorb more of it.
The main thing is what are your T levels ( and SHBG) as this should ideally be monitored when on replacement T, to ensure that levels remain within the physiological range for women? Also what other HRT do you take, how old are you etc? You might have said elsewhere?
What about libido/response - that's the classic sign of needing T?
Could your symptoms be due to other things eg vitamin or mineral insufficiencies or other hormonal disturbances eg thyroid? Maybe start another thread if about your general health as this is just about T dosage really!
Hurdity x
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Update re Testim gel - Testim 1 % gel seems to be available again but manufactured by a different company - it is once more listed on our database of medicines here: https://www.medicines.org.uk/emc/product/9633/smpc, marketed by Endo pharmaceuticals (branch based in S Ireland but also in US) and manufactured with same ingredients in US...
Another alternative for those who want to use 1 % gel. From personal experience - I like the fact that Testim is in a screw-topped tube so no faffing around with paper clip and folding over the top of the sachet as with Testogel - which is messier - but it takes far far longer to dry and stays sticky for some time (like Sandrena estradiol gel!) whereas Testogel dries quickly....
Would be good to know if anyone has been prescribed Testim recently on NHS (not privately - as you can get anything privately at a cost ::) ).
Hurdity x
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Hi Hurdity,
Was changed by dr (studd clinic) on the premise that it was less messy, (!) though I imagine it was a supply issue with the chemist they work with.
I'm 42, post meno, 4 pumps estrogel, 10 x days utro plus the testosterone. Been doing ok til last month. Not perfect but loads better. No deficiencies at last bloods a month ago.
The dead legged fatigue is such a huge part of things going wrong for me - i just can't access normal life cause I can't do anything. Then I feel like everything is falling apart and it's hard to hold back the depression. So when it came back over the last week I really started to feel helpless. It never occurred to me that I was getting less testosterone now I'm on tostran. I'm going to contact the dr and check my dosage. Halving it seems viscous! Especially as I was doing ok at my follow up appmnt. Even if I switch to every other day it will be less than I got before.
I do feel better now theres a chance my mega fatigue might have an identifiable cause. 3 weeks would be a plausible time frame to start to feel some effects of that.
Thanks for your reply Hurdity. Its really appreciated.
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Hi Tyaca
Sorry to hear about your symptoms. Not sure what DOM's are?
If you used Tostran every 3 days this would be 23.33 mg per week (10 mg/3 x7) so yes just over half the amount of testogel. Why have you been changed? I think it's always better to use a 1% gel of tesosterone as it is at a concentration designed for the amount that men use. However that's not to say you will only abrob half - it may well be that you absorb more of it.
The main thing is what are your T levels ( and SHBG) as this should ideally be monitored when on replacement T, to ensure that levels remain within the physiological range for women? Also what other HRT do you take, how old are you etc? You might have said elsewhere?
What about libido/response - that's the classic sign of needing T?
Could your symptoms be due to other things eg vitamin or mineral insufficiencies or other hormonal disturbances eg thyroid? Maybe start another thread if about your general health as this is just about T dosage really!
Hurdity x
Hi Huridity
Just to give background first- my journey is as follows:
Will be 58 in January
Hysterectomy 2008 (subtotal ovaries & cervix remained)
Meno symptoms started 2013 prescribed Tiblone only used for few weeks - caused further anxiety/symptoms
Elleste Solo tablets 2, then 3mg -worked well
Symptoms returned 2016 prescribed Evorel patches 75x2= 150 per week as (skin did not absorb well)
(Still on this dose)
Current estrogen levels are 798 pmol/l - said to be normal and have been symptom free for 3.5 years
SHBG 48.0 - said to be normal
However symptoms have returned during last month- disturbed sleep, palpitations, anxiety & low mood. Libido decreased somewhat as was quite high
Waiting times back to Meno clinic was so long I have just been to specialist in private clinic.
She has suggested I have blood test fir testosterone level and then start testosterone hormone.
Can you give me an idea of what is the normal range for testosterone in women?
My gyni said even if the levels come back fairly normal it's still worth trying as works well for women who have had hysterectomy will help with mood/energy levels.
I eat balanced diet and excercise x2 per week, although work can be stressful I usually bounce back from challenges quite well until this last month.
Any advice or thoughts would be greatly appreciated I have had a quick look on the thread just want to be prepared and was bit concerned Tibolone did not seem to suit me & was wondering if Testogel sachet 50mg over 10 days may have similar effect which has been suggested
Thanks
Jaz
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Bump for Rose B
Hurdity x
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Hi Huridity
Just to give background first- my journey is as follows:
Will be 58 in January
Hysterectomy 2008 (subtotal ovaries & cervix remained)
Meno symptoms started 2013 prescribed Tiblone only used for few weeks - caused further anxiety/symptoms
Elleste Solo tablets 2, then 3mg -worked well
Symptoms returned 2016 prescribed Evorel patches 75x2= 150 per week as (skin did not absorb well)
(Still on this dose)
Current estrogen levels are 798 pmol/l - said to be normal and have been symptom free for 3.5 years
SHBG 48.0 - said to be normal
However symptoms have returned during last month- disturbed sleep, palpitations, anxiety & low mood. Libido decreased somewhat as was quite high
Waiting times back to Meno clinic was so long I have just been to specialist in private clinic.
She has suggested I have blood test fir testosterone level and then start testosterone hormone.
Can you give me an idea of what is the normal range for testosterone in women?
My gyni said even if the levels come back fairly normal it's still worth trying as works well for women who have had hysterectomy will help with mood/energy levels.
I eat balanced diet and excercise x2 per week, although work can be stressful I usually bounce back from challenges quite well until this last month.
Any advice or thoughts would be greatly appreciated I have had a quick look on the thread just want to be prepared and was bit concerned Tibolone did not seem to suit me & was wondering if Testogel sachet 50mg over 10 days may have similar effect which has been suggested
Thanks
Jaz
Hi again Jaz
Here is some info on T in women:
https://www.healthline.com/health/womens-health/do-women-have-testosterone#normal-levels
However it is not usually necessary to measure T before prescribing it - the tests are not accurate for women who are low because the test is designed for the levels that are fond in men so not senstivie at the low end of the scale. Many gynaes don;t actually tests before prescribing. It is often advised to test after T replacement to ensure that levels stay within the physiological range for women - even though they are inaccurate - they would probably pick up if too high.
If you have low libido and especially response - and not taking meds that can affect this eg some ADs, or oral oestrogen, and your oestrogen levels are adequate - then doc should be able to prescribe - off-licence. Some docs are not willing to prescribe T at all - even some gynaes I gather.....
Not sure if low T can lead to palpitations, and the other symptoms you describe though? For me it was defo low libido, absent response, and also lethargy and fatigue combined with muscle pain after exercise and higher than normal exhaustion after exercise. It is not generally indicated for the latter though - but libido. I think low T can affect mood too though it didn't for me.
I would push for a trial of it rather than wait for (inaccurate) levels?
Testogel sachet - sounds about right. Mine lasts longer than 10 days but my oestrogen levels are lower anyway....
Hurdity x
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Found this info on testosterone dosage for women, on Chelsea and Westminster menopause website. Thought it might be helpful for anyone needing to switch from tostran to testogel
https://www.chelwest.nhs.uk/services/womens-health-services/gynaecology-services/menopause-and-pms-clinics/special-notices
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Thanks Rose B - very helpful :)
Hurdity x
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Thank you Hurdity for feedback and link.
I have had my blood test for testosterone back it was 0.7 the secretary told me.
Unfortunately the gynaecologist has not been in to explain if this is typically low or normal.
I remember on a previous thread you did some sort of calculation with SHBG levels (mine was 48.0).
Do theses two figures mean anything?
I am still having problems staying asleep and anxiety/ low mood and low libido. It's quite a big contrast to how I was 6 weeks ago.
Can't believe symptoms can just suddenly come back, all my other blood tests were fine.
Jazz
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Hi Jaz - yes the female androgen index is total T/SHBG x100 so for you this is 0.7/48 x100 (if the units are correct) = 1.46. The Chelsea and Westminster give the range as 1-6 (this is on my scribbled notes!) so this means yours is low - even though tests are unreliable. If your libido is low then I would push for a trial of T replacement but don't expect overight results - it can take several months.
Good luck
Hurdity x
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hi hurdity
i've just been prescribed tostran testosterone to use 1 pump every other day ! but wondering if testogel better i want the one that is going to give me least potential side effects !
thanks
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Hi Sammiejane. I've used both Tostran and Testogel and I've been fine on both . There's no difference in the active ingredient, just a difference in the strength.
I think Tostran is easier to use as you know exactly how much is in a pump x
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Sammiejane - great news that you have been prescribed some T! Dotty has given you her exeprience which is more than mine as I've only used the 1 % gels - Testim and Testogel. However personally I would not take 1 pump every other day to start with but take it low and slow even though you are in surgical meno. The results are not instant and can take several months to fully come into effect. The Chelsea and Weastminster in their 2017 leaflet say twice a week to start up to a max of 3 pumps per week but that is probably not for surgical meno though.... However the BMS info says every other day as you have been prescribed. Not sure why the discrepancy.... however if you want to do as prescribed then that's OK! Just talking about what I would do and I am much older and not surgical in meno!
Good luck with it.
Hurdity x
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hi hurdity dotty
thank you for that dotty hopefully i will be ok on it x
hurdity i am glad i just hope it does improve my hair shedding and balance things out ! i'm just concerned that if it is estrogel causing my hair to thin then this will continue ? dermatology wanted me to stop the estrogel to see but menopause wasn't keen on it that theory and adviced me to try the testosterone .
have you suffered hairloss dotty ! did you find testosterone improved it !
i can but hope , thank u ladies
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I'm using Tostran pump and advised by C&W to use it on alternate days. I found it took about 8 weeks to make a noticeable improvement, and that has been mainly in feeling more resilient generally, more decisive and clear headed. I wouldn't be without it now. I just feel more like my old pre menopausal self. Not much change in libido sadly.
I have had levels checked (testosterone, SHBG, free androgen index) and these have been OK. But also been told that blood tests are pretty meaningless, as not enough research to know what the levels should be for women, and better to go by symptoms. Also, warning signs of too much are a spotty back and being aggressive!!
I'm now having to switch to Testogel soon as cant get Tostran. Have been told to use this daily and make a sachet last 7-10 days. Have also used Testim in same way, when it was available.
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Hi Rose B,
I've just posted on the shortages thread that according to MIMS Tostran is back in stock.
BeaR.
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Testim and Testogel are preferred ( by the Chelsea and Westminster) as they are 1 % gels (wheras Tostran is 2 % so greater margin of error and potential side effects due to spikes in T levels). I think it is now possible to get Testim as I reported earlier but not sure if anyone has managed this yet?
Hurdity x
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Hi Sammiejane....no I don't suffer with hair loss. If anything, my hair has got thicker as I've got older x
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hi Dotty
can i ask which regime you are on now estrogen progesterone and testosterone! before u added in testosterone how was hair ? i concerned that as mine is shedding loads and got remarkable thinner on estrogen only that testosterone may not help ?
hurdity
my chemist have the testogel in stock do you think i would be better on this then tostran as not had it before ? my menopause gave the doctor a choice of 3 which i assume is testim testogel and tostran but i rather start of with weaker one !
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Sammiejane...if it's the testogel in a pump pack then it's stronger than the Tostran and not as suitable. The Testogel in the sachet is better than the Testogel in the pump pack. It's not as simple as one being weaker. I used to use 1 sachet of Testogel over 7 days which gave me 50 mg of testosterone over the week. One pump of Tostran gives you 10mg of gel so if you use it 5 times a week you are getting the same amount of testosterone. Once you know how much. A pump is then you can adapt it to using half a pump. I have used both and I'm not sure which I prefer. The sachets are useful if you go on holiday. I hope that makes sense.
I use 4 pumps of Oestrogel, 100mg of Utrogestan daily and testosterone. It works for me. I haven't had any side effects . I've been using this regime for nearly 2 years.
Try not to worry about it. I worried like mad to begin with about all of it, but now have no worries at all. X
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hi dotty
do you use the 100mg utrogestan orally or vaginally ?
i think perhaps if i'd taking estrogen and progesterone together from day one my hair situation may of been different but as i have no womb they said no need for progesterone but the minute i've started estrogen on its own i've shed hair where as when i took the pill i never did as this was combined ! i'm starting testosterone monday and i'll try tostran and if shedding doesn't improve i can take progesterone . it's strange how some women in surgical menopause get all 3 hormones together and haven't had issues with hair loss i guess cause there all being supplemented at the same time but my concern is now because the won't give me blood test for progesterone how will i know if i have an imbalance between estrogen and progesterone . i currently take 2 pumps estrogel and if i were to add in progesterone it would be 100mg orally every day would this be ok or would i need more estrogen ? my levels were tested 10 days apart and one said 368 nmol and then the other 10 days later 113 nmol but i guess as you take 4 pumps and 100mg and your hair has been fine would 2 pumps be to low for 100mg prog does this make sense !
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hi dotty hurdity
sorry forgot to add that i'm worried as it's been shedding on estrogen only it will continue regardless of the testosterone being added !
before hrt my hair got thicker through menopause and grew quicker and yes i lost hair when i washed it but not when i brushed now i get both hairs on the floor stuck to clothes on other people we find a random hair in cuboards lol it's upsetting me a great deal and if it doesn't improve then i have to stop it as i'm not willing to loose all my hair i already feel 80 when i'm 40 !
thanks ladies so nice having you all to talk to when one is so alone
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Hi it's 100mg of Utrogesten regardless of whether you use 1, 2, 3 or 4 pumps of Oestrogel. There is no need to worry about the balance of oestrogen and progesterone. I take the utrogestan orally at night. X
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hi dotty
that's good to know !
i guess i'll see how things go would you agree take testosterone first then add progesterone as last resort as i don't have a womb or should i take progesterone first before testosterone !
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morning ladies
please help i'm having a complete freak out ! has anyone been on estrogen only and had hair shedding , then incorporated testosterone and it stopped and hair improved .
i'm due to start testosterone today and am so scared !
my dermatology want me to stop estrogel for 4 months as they believe it's what is causing my hair to shed and thin , ie not necessarily the medication but estradiol itself . menopause want to add testosterone as my levels are low but will this make my hairloss worse or improve it ! i want to turn the clock back can't cope anymore i started hrt to relieve the symtoms i was having mainly vaginally but it hasn't changed that at all and now i have moods up and down which may coincide with my estrogen levels being 368 on minite and then only 113 the next ! i don't know if i'm coming or going , dermatology have confirmed hairloss got worse in last 3 months and i can see and feel it but i'm scared to stop and scared to add in anything else i just wish i had been given all 3 hormones from the start like some women and then maybe my hairloss wouldn't of happened , i had some thinning around my face only minor in the 4 years i wasn't on hrt following hysterectomy and hair was lovely and thick and didn't have a widening parting but now hundred times worse !
hurdity are you out there need you advise right now
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Estrogen prolongs the anagen (growing) phase of hair so that shedding is reduced on estrogen.
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erika28
not for me my shedding has been triggered by starting estrogen and is getting worse i'm starting to think it is the estrogel would swapping to a different estrogen like sandrena gel or patch stop it shedding ?
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Sammiejane, I understand you're scared, especially if you've been on a hormonal rollercoaster. You could start with a very tiny amount of testosterone and see how it goes.
Don't bite my head off but I strongly believe you need more estrogen. In my opinion; if you're still haven't found relief of symptoms but menopause consultant or specialist told you your estrogen is sufficient because it's high enough to protect your bones than I would find another ''expert' on the double. Some women just need estrogen in higher doses, especially because you're still young.
If you felt better on patches then Estrogel then patches would be a better choice.
You've tried progesterone but you've experienced hot flashes, so if estrogen is already low then progesterone won't make it better.
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hi alicess
my estrogen isn't classed as low any more hence why they have given me testosterone .
i've been under a dermatologist for hair loss and they have said it's telegen effluvium or chronic telegenic Eff which has been triggered by hormones the same as when women are pregnant they can shed hair . i understand that other issues can play a part but bloods all normal no autoimmune issues been tested the only thing that's changed is added in hormones and so many women seem to be loosing hair on the estrogel ! my hair was fine before i started hrt so it's either and imbalance in my opinion or medication i do have low T though x
all my symptoms are relieved ie hot flushes etc vaginal dampness still an issue but not as bad since i reduced ovestin i think my vagina was becoming to wet !
i will try a blob of testosterone and see it says every other day but i'll start just twice a week i think !
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hi lola50
i feel exhausted by going round in circles my menopause wasn't bothered by the fluctuating levels and yes i'm surgical menopause at 35 yrs no hrt for 4 yrs felt great no symtoms started hrt at 40 and felt awful last year on it and now have more issues then when i started.
menopause said i have enough estrogen to protect my bones which seems to be there only concern sod everything else my flushes have gone so when it dips to the low level it must still be enough my mood is more stable but vaginal and hair loss still an issue.
dermatology want me to stop estrogen to see if shedding stops then they will no for certain it is medication induced ! as i had no hairloss prior to starting hrt !
menopause disagree and think maybe a hormone imbalance as i have low T and this may help but then could make it worse .
i did a brief 5 weeks on the patch estradot 50 and upped to 75 to combat flushes but then they went out of stock and i chose estradot as it listed hairloss as a rare side effect whereby estrogel states post marketing results since estrogel came on the market have reported hairloss / alopecia but frequency is unknown ?
estradot suited me but then went out of stock so had to go back on the gel and i only swapped to the patch because the last two blood test i had showed my estrogen level drop from 195 to 104 and then recently it was 368 and then 10 days later 113 x testosterone has remained around 0.7, 0.6, 0.8, 0.9
so the plan menopause have said is not to change the estrogen as swapping to sandrena gel or a patch will make no difference , i disagree ? can't have tablets due to smoking and GI issues !
so the plan is add testosterone see what happens if dosent improve libido hair energy go up to 3 pumps estrogel and the. if still no improvement add in progesterone and if continues then to stop hrt as it won't be benefiting me in terms of the reasons i started taking it in the first place , i know my flushes will come back but to be honest they had pretty much gone with being 5 years post meno x i would still continue vaginal estrogen though
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morning ladies
please i need advice !
i have started my first pump of tostran today and applied to my abdomen ! i put it in this morning as i rub estrogel on at night to inner thighs,
it states in the leaflet to apply same time each day and alternate between inner thighs and abdomen . can i apply to inner thighs if i put estrogel there the night before ?
when is best to apply the testosterone and to what area !
how long till i notice it's effects ?
and anyone had side effects i could expect !
to be honest reading the leaflet didn't help as totally freaked me out. it says to apply one pump every other day but is this to much ?
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Hi I put the testosterone on my inner, lower arm and rub in with the other arm. I think it’s Professor Studd who advises this method.
I believe it can take 6 months for testosterone to reach full effect. You need to be patient .
I think I’ve explained in a previous post how the dosing of testosterone works. The latest guidance is to use 1 pump every other day. But everyone is different. I’ve used testosterone for nearly 2 years now and have had no side effects. X
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https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/
Have a read of this Sammiejane x
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hi dotty hurdity
sorry forgot to add that i'm worried as it's been shedding on estrogen only it will continue regardless of the testosterone being added !
before hrt my hair got thicker through menopause and grew quicker and yes i lost hair when i washed it but not when i brushed now i get both hairs on the floor stuck to clothes on other people we find a random hair in cuboards lol it's upsetting me a great deal and if it doesn't improve then i have to stop it as i'm not willing to loose all my hair i already feel 80 when i'm 40 !
thanks ladies so nice having you all to talk to when one is so alone
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???
Hurdity x
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Hi. I have been using tostran gel for few months while HRT gel and utrogestan. I'm bit confused when my specialist said one pump of tostran gel three times a week she did say every other day. Doe s it mean use it on mon wed and Friday two days off then mon wed Friday. ? Is that right. Let me know thanks
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Hi. I have been using tostran gel for few months while HRT gel and utrogestan. I'm bit confused when my specialist said one pump of tostran gel three times a week she did say every other day. Doe s it mean use it on mon wed and Friday two days off then mon wed Friday. ? Is that right. Let me know thanks
I keep to the same days each week, Mon, Wed and Fri x
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Hi hope you can help me out. I'm on Tostran gel along with HRT gel and utrigestan. I was told to take on pump of tostran gel three times a week. Is that mean mon wed Friday two day off over the weekend then mon wed Friday? Is that right ? Let me know thanks
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Hi Minniecc
Yes that sounds ok. I use it Mon Wed and Fri and sometimes Saturday too x
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Hi there
I use this site very infrequently but am aware that you are a regular poster. I did a search on Tostran gel and came up with your very comprehensive information, comparing the three T gels.
A year or so ago, I tried T gel and was given Testim (tiny tubes), just to try. To be honest it didn't make much difference and so we concluded that I didn't need it. Fast forward to July this year, when I had an oophorectomy. Again, it was very much a 'wait and see'. I have telephone consultations with the Oxford Radcliffe menopause clinic. A fantastic doctor there suggested (due to a crash in energy a month ago), that I could try T gel again. She suggested Tostran 2% . I'm aware that various gels go through phases of unavailability and the Boots pharmacist said the only one she could get for me was Testogel. She said it was more concentrated but if I used a smaller amount......
The doctor at JRH said Testogel is absolutely not recommended for women as it is such a high concentration that it's impossible to get the dose right. She said not to use it and to wait until the others were available. Today I have just picked up Tostran gel. (What a palarva.. .haha).
I just wondered if you were aware that this was a higher strength. I'm not a medical professional and I know you are not either, but my specialist doctor does not recommend this.
I'm rushing this off, as tight for time right now. Just wondered what your thoughts were.
H x
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This is incorrect re the concentration unless a new product has been produced (but can't see anything)? However what she is saying in essence is the same thing (but it's not due to the concentration).
The highest concentration gel is Tostran at 2 %
Then comes the Testogel pump pack at 1.62 %
Lastly the sachets or tubes of Testogel or Testim at 1 % (Testim was unavailable but looks like it is now produced by a different company - it is losted on the databse of medicines anyway).
The CONCENTRATION (of active ingredient testosterone) in the gel is different from the TOTAL AMOUNT of testosterone in a given measure of the gel.
If you look at the first post in this thread you will see the amount dispensed per pumped dose or tube. The Testogel pump pack delivers a large AMOUNT of gel per pump so the total T in that pump is much greater - if you used it all that is!
The Tostran pump pack only delivers a very small amount of gel per pumped dose (ie press on the pump) so even though the concentration is higher the amount for a single dispensed dose is lower.
If you squeeze your own dose from the 1% sachets or tubes then you just use a pea-sized blob and because it is only 1 % there is less likelihood of varying the dose with the lower concentration than with 2 % gel.
I think this is where the confusion lies.
Before the Testogel pump pack was produced the Cheslea and Westminster recommneded the 1 % gels in the first instance with Totsran being secondary - the reason being as we only use a tiny amount as women (this will depend to some extent on the individual) it is more difficult to give a consistent amount if you didn't want to use a whole pumped dose - which I wouldnt for example (because I make a Testogel sachet last longer than 10 days so the equivalent with Tostran would be less than a pump).
Precision in these things, as always, is key!
Hope this helps and clarifies and good luck with it?!
Hurdity x
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Hi Hoffgrad
You are right that the Testogel pump pack is more concentrated but the Testogel sachets are less concentrated and easy to use. X
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2 or 3 pumps of Tostran per day.. ??? ??? ::) blimey that sounds a bit scary! but when I got mine, my prescription was wrong cos it said 1 pump every day for 5 days!!!! but I knew that wasn't right.
I use half a pump twice a week and can manage to only half depress the pump = pea size blob! Have been doing this since February (although I started on half pumps 3 times a week,(wanted to start slow and easy to see what happened), then 2 full pumps twice a week to get levels up as the half pumps didn't give any side effects and then once it had settled after 3 months dropped to half a pump twice a week which seems to keep everything level.
I have never had any of the others because they were discontinued by the time I started.
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2 or 3 pumps of Tostran per day.. ??? ??? ::) blimey that sounds a bit scary! but when I got mine, my prescription was wrong cos it said 1 pump every day for 5 days!!!! but I knew that wasn't right.
I use half a pump twice a week and can manage to only half depress the pump = pea size blob! Have been doing this since February (although I started on half pumps 3 times a week,(wanted to start slow and easy to see what happened), then 2 full pumps twice a week to get levels up as the half pumps didn't give any side effects and then once it had settled after 3 months dropped to half a pump twice a week which seems to keep everything level.
I have never had any of the others because they were discontinued by the time I started.
Hi Ladybt - sorry I am confused about your comment re 2-3 pumps per day. I haven't looked back over all the pages of the thread but did someone say they had been prescribed this? If so :o indeed! Very scary!
That's interesting re your dose Ladybt and very helpful to others that you can manage to pump out half a dose and the fact that such a low dose is sufficient and makes a difference.
Hurdity x
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I myself was only flicking through and that's what my eyes saw Hurdity but hey ho, I wasn't having a very good day yesterday...in fact I asked my husband twice if he had asked me something (and he hadn't...so I was hearing voices!! ::) ::) I think my brain was being very "LOUD"! I was probably seeing things too!! :stupid: :stupid:
oops sorry but haven't time to check... anyway the continued low dose is ok because I used higher doses in the first instance for quite a while to get the levels up. Seems easy enough for me to maintain and the Tostran pump is fairly responsive so you can get half a pump easy enough...well I find it so. x
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Hi,
I wanted to reply to Sammiejane's hair concerns and also the testosterone discussion as both are relevant to my experience as well.
Re the hair shedding (and dermatologist is fine for dealing with that too unless it's something very specific or mysterious): In my experience with telogen effluvium, it is indeed caused by a change in estrogen, but in my case and in general, a drop in estrogen.
As an example, during perimenopause, I was put on microgestin, a low dose bc pill. When i got off that, about three months on, my hair started shedding massively. All over, on my brush and when i'd grab a bunch of it, not in a specific place. Seriously terrified as I have thin, fine hair as it is. This is similar to what happens after pregnancy, yes. The drop in estrogen caused a shedding cycle, though it didnt' start immediately. This generally does stop and grows back in, and it did stop and reverse itself.
Unfortunately, I started another lower dose pill, lo loestrin, then after about a year stopped that. I have since begun taking Duavee (Duavive in UK) which is an HRT much lower than either bc pill, and sure enough, in about three months time, shedding again. This is a shedding cycle, from what i understand– a reaction to a drop in estrogen, and in general will right itself, just have patience. The estrogen itself, or taking more estrogen, generally does not cause this type of hair loss. (everyone has different reactions to things, and there could always be some other reaction to it of course). But it seems likely the telogen efffluvium is a finite cycle of shedding caused by going from one level of estrogen in your system to a lower level.
As far as the testosterone: I'm in the US so things are little different, but it's still quite frustrating that a hormone preparation that has not been shown to cause any actual harm in prescribed amounts is readily available to men but seriously guarded from women for no other reason than cowardice by drug companies. That said, it is fairly commonly added to the HRT mix here as well. I requested it from my gyno as I needed help with disappeared libido and overall, general low energy and general feeling bad issues, no hot flashes. (52 and not quite in total meno but almost).
I had been taking bc pills in peri and they kill the libido for me, and now taking duavee (low-ish dose oral estrogen and a SERM). I have always had trouble with bc pills even when young, for the same reason, and they would make me feel generally emotionally awful. I have read that oral estrogen cancels out free testosterone that our bodies use, and I'm making a guess that that is totally what happens to me. and also that my T overall is lowered by menopause.
Anyway, the stuff works wonders for me!! I began using oral testosterone prescribed my my gyno and made by a compounding pharmacy. Wanted to avoid the oral formulation and am now using a testosterone cream, also compounded. It definitely brought back a good bit of my libido but also, even more pronounced, my "sense of self" that was seriously missing since peri. It's actually kind of like a miracle. I use one or two clicks a day. The cream is 4 mg/gm, and each click is 1/4 gram of the cream itself, which means I am using 1-2 mg of t. per day. I use it on upper thighs, upper arms, lower abdomen or vaginally (alll recommended by doc and pharmacy).
Regarding hair loss from T, which is also what the OP was worried about: This is a different kind of hair loss that TE. one of the (mild, uncommon and reversible, apparently) side effects of T supplementation is male pattern balding which means a receding hairline (or top of the head). If you had any of that, it would be separate from the other hair loss and unrelated to estrogen (unless more estrogen would balance out the t and cancel this side effect, not sure).
I think i might be experiencing very mild side effects to the T: more hair on my arms, legs and face and a teeeeny bit of receding at my forehead. That said, the hair on face etc is very fine, and the thing is, i always had it when i was younger, along with very fine blond leg hair and arm hair. With the beginning of peri, my hair (ie leg hair) just basically went away, which was convenient but a teeny bit disturbing. So the possible mild side effect of T is pretty much what I had before? No voice deepening or anything scary though.
I do plan on upping my estrogen next, supplementing the Duavee with a low dose patch, and then trying the patch by itself (along with progesterone of course) to see how i do on something other than oral estrogen, which, though I love the idea of being protected from cancer, don't love the idea of oral estrogen. But I'm pretty sure I'm keeping the T, it's the brightest spot in this hormone mess so far.
hope there's something helpful in all that. ; )
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I got my first batch of Tostran today :) very happy. One container of 60ml it should last me a long time.. ?
Re the application on the forearms... does this area become hairier. I don't have any hair here. Where is the best area for application that does not encourage hair growth?
Thanks all
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And 'what's the best time of day to apply... AM or PM?
Thank you x
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I don't put my tostran on the same place every time, I move the site around and no TraceyTracey I haven't got any hairy bits growing :) , nor do I have a very deep voice :)... don't worry, you shouldn't be using enough to grow hair. I have heard of ladies getting sprouting the odd one sometimes but no you wont get hairy patches as such. I haven't grown any hair on any of the sites I use. Sometimes I put it on one arm, then on the inside of my knee, then down by the back of my ankle, sometimes just above my hip bone...I just move it about.
I put it on in the morning on the days I use it which is 1 pump 3 times a week or when I remember if I have got destracted in the morning. It doesn't seem to make any difference (well to me anyway..) what time of day you put it on.
My container has lasted a year! yes it lasts a very, very long time x
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"Regarding hair loss from T, which is also what the OP was worried about: " - cityrat - as the OP, you will see I said nothing at all about hair loss from T as far as I can make out! This thread was started to give clarity about the different doses of gel and the products available because there was some confusion and especially re pump packs and sachets etc and how much should be prescribed. As often happens threads meander away from the actual topic which is fine and we always try to help!! So this one wasn't about hair loss although it has been raised. No probs though - just sayin' - as I was the OP.... :)
I did start another long running thread in private lives called Tesosterone Here We Go - and it would be really helpful to add your experiences to that one so that when women want to find out they can have a look? https://www.menopausematters.co.uk/forum/index.php/topic,27959.0.html
Ladybt - unfortunately I do have hairy patches ::). I'm going to update the T thread in private lives now!! Tracey Tracey - I will post my answer on that thread? Hope that's OK LadyBT and Tracey Trcaey?
Hurdity x
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hi city rat
thank you for taking the time to reply
i completely understand where u coming from re hairloss
some back ground for me i took birth control throughout my 20s and up till i was 32 only stopped to have children however i've never noticed any change in my hair after giving birth i noticed a slight increase in hair shedding not massive and have mega thick hair so not noticible at all. after birth of my 3rd child i went on the copper coil as i didn't want hormonal pill again, noticed no change in hair from stopping pill or after birth of son even 3 years later no change maybe as i had my own hormones. at 35 i had all removed hysterectomy and ovaries removed i had no symtoms of menopause other then 2 flushes a night following operation (lucky) forward 4 years at 39 i started getting vaginal symtoms nothing else maybe a bit emotional too but nothing major also no hairloss following hysterectomy (low levels all hormones) other then slight thinning of frontal hairline but not noticeable and my hair grew quick and thick and whether this was because i had slightly more T then other hormones not sure as levels following op were never tested . at 39 i decided to try hrt for vaginal symtoms as thought as i had dampness i had prolapse and things felt heavy down there but not really dryness ! more watery discharge so prolapse was ruled out and couldn't discover incontinenece after several test so i started elleste solo mx40 patch and was referred to menopause specialist i was doing ok on patch up to about 5 weeks in then started getting chest pain and i'd walk to work and be out breath feeling like i couldn't breathe and lasted a good 30 mins after arriving at work i went to the gp who listening to my heart and lungs as i was scared but all ok and advised me to stop the hrt patch which i did around week 6 symtoms went away about 2 weeks later i had my appointment at meno clinic who advised me as i smoke and didn't suit that patch to go on estrogel along with vagifem as thought my symtoms below could be VA so i started this regime ( no hairloss throughout this ) about 5 weeks into this regime i started shedding hair not excessively but shedding and i noticed when i brushed because before i wasn't i looked at side effects on leaflets with medication and thought it's vagifem as the estrogel leaflet didn't mention hairloss so i swapped the vagifem to ovestin which is what i?m using now x hair shedding continued it started about november 2018 and continued through till march and then slowed a little not much but still shedding and forward to dec 2019 hair is noticeably thinner all over and hairline has receded behind ears i've lost a lot nape of neck and the little girls at the back of my neck have completely fell out after seeing dermatology several times 3 months apart they advised me hairloss had got worse so recommended i stop the gel and continue with ovestin cream as this is only obsorbed locally and not much is detectable in blood stream so would have no effect on hair .
this is what i have done and is coming up 8 weeks and hairloss has slowed down i've gone from brushing out 15 hairs to only 2-4 now and when washing 120 ish hairs down to under 50 .
now i don't know whether the estrogel itself has caused my hair to shed i don't think low estrogen in my cause has caused it as my levels of other hormones were also low what i think is the increase in estrogen unopposed has caused an imbalance between E and P and T ratio
so i?m going to try gel again combining with P and see as i can't add T till i have good level of estrogen but i've noticed over the 8 weeks it get better and that is because my estrogen level is more back in line with P and T
if the gel and utrogestan dosent work then i will change to a patch
sorry long winded but yes everyone's experience is different and it's not always low estrogen i think in natural menopause this could be the cause as you have other hormones but surgical menopause is totally different and i know a few friend of mine who are on estrogen only and have hair thinning because of surgical meno because taking estrogen on its own causes imbalance in hormones x
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hoffgrad
i too like you are under the menopause clinic in oxford at JR
DR Barber is my consultant
i've had early surgical menopause at 35 started hrt at 39 everything gone and to was put on the gel !
can i ask if you have had hysterectomy or early meno your age what stage you are at any side effects of hrt you are on i?m looking to change .
i was also perscribed trostan to use a blob 3 times a week haven't used it yet as i've currently stopped my hrt due to hairloss
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This is incorrect re the concentration unless a new product has been produced (but can't see anything)? However what she is saying in essence is the same thing (but it's not due to the concentration).
The highest concentration gel is Tostran at 2 %
Then comes the Testogel pump pack at 1.62 %
Lastly the sachets or tubes of Testogel or Testim at 1 % (Testim was unavailable but looks like it is now produced by a different company - it is losted on the databse of medicines anyway).
The CONCENTRATION (of active ingredient testosterone) in the gel is different from the TOTAL AMOUNT of testosterone in a given measure of the gel.
If you look at the first post in this thread you will see the amount dispensed per pumped dose or tube. The Testogel pump pack delivers a large AMOUNT of gel per pump so the total T in that pump is much greater - if you used it all that is!
The Tostran pump pack only delivers a very small amount of gel per pumped dose (ie press on the pump) so even though the concentration is higher the amount for a single dispensed dose is lower.
If you squeeze your own dose from the 1% sachets or tubes then you just use a pea-sized blob and because it is only 1 % there is less likelihood of varying the dose with the lower concentration than with 2 % gel.
I think this is where the confusion lies.
Before the Testogel pump pack was produced the Cheslea and Westminster recommneded the 1 % gels in the first instance with Totsran being secondary - the reason being as we only use a tiny amount as women (this will depend to some extent on the individual) it is more difficult to give a consistent amount if you didn't want to use a whole pumped dose - which I wouldnt for example (because I make a Testogel sachet last longer than 10 days so the equivalent with Tostran would be less than a pump).
Precision in these things, as always, is key!
Hope this helps and clarifies and good luck with it?!
Hurdity x
Hello Hurdity,
I have just collected my prescription of Testogel 16.2mg/g pump pack gel. The email from the consultant who prescribed it for me says 1 pump on alternate days but reading this thread makes me think that's rather a lot? I have put one full pump on just now but I'm wondering if using that amount every other day sounds like it's a bit too much?
Kind regards
Jo
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Hi JoClaireH
Wow that is a lot of T!! Is this consultant a meno specialist? No way would I ever want to use that much which is one quarter of the dose for men! The max recommended dose by the British Menopause Society is Tostran 3 x per week (alt days in essence) which is approxc 30-35 mg T per week. This would give you just over double that. I wonder if you were prescribed Tostran and dispensed Testogel pump pack? It is so important to get the dosage right for women but i am surprised if either the consultant or the pharmacist has made such an error.
I would say you really do not want to give yourself that much of a hit all at once anyway ie one pump which is 20 mg gel. I pretty much use this amount per week - well probably 25 mg as my sachet lasts approx two weeks I think.
If you have no ovaries then you could get away with a higher dose but I would want to start with a pea-sized blob depending on your age and circumstance. The testogel pump pack especially, is not designed for women.
Please question this and find out what exactly you were prescribed (eg was it just testosterone gel without a brand name being given or a concentration of T?). If it is the case that you have been prescribed this I would quote the BMS tools for clinicians info here: https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/ and ask on what basis have you been prescribed such a high dose and actually in your position I would disregard it and use much much less whatever they say!
Hurdity x
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Hi Hurdity.
Thanks for your reply. I read through the whole thread again closely yesterday. I did put one full pump on the first day I got the gel, so I now know exactly why that was a bad idea! My heart was racing and it took me ages to get to sleep that night.
The letter I got from the male consultant (which it took a month of chasing to get sent through, and then I received one copy a day for three days running) says "we can source some testosterone for Joanne which is in gel format and called Tosterone". I have searched everywhere for a testosterone gel called that - and I'm good at researching - and I cannot find it anywhere. This and the incorrect dose makes me think there's a problem with the prescribing process at the meno clinic I went to. However, I want the gel so I'm following the advice I've found here rather than his. I've measured one full pump into a plastic medical syringe to see what it looks like, because basically, I want to take half of that over two days. As my preference is for daily usage, I halved that again and guess what it looks like? You've guessed it.
A pea sized blob!
Thanks, Hurdity. Your advice is better than all the doctors and 'specialists' I've seen over the last two and half years put together. Thank you, and here's to peas!
Jo x
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Hi,
Does anybody know what the range is for testosterone? I've had a total hysterectomy and I'm on Testogel - 1 pump over 3 days for the last 2 years. I had a recent blood test and my testosterone level has come back as 13.6 nmol/L. I don? t know if the fact that I'd applied my gel about an hour before I had the blood test makes a difference. I've had a phone call from my GP's secretary today to say that it's too high and made me a telephone appointment with the GP on Friday. My GP surgery don't prescribe testosterone to women but because my private gynecologist asked them to they do it on a private prescription for me. I'm worried the GP will stop prescribing it for me due to this blood test result. I can't find any info on what the range should be.
Thanks
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Hi Hurdity.
Thanks for your reply. I read through the whole thread again closely yesterday. I did put one full pump on the first day I got the gel, so I now know exactly why that was a bad idea! My heart was racing and it took me ages to get to sleep that night.
The letter I got from the male consultant (which it took a month of chasing to get sent through, and then I received one copy a day for three days running) says "we can source some testosterone for Joanne which is in gel format and called Tosterone". I have searched everywhere for a testosterone gel called that - and I'm good at researching - and I cannot find it anywhere. This and the incorrect dose makes me think there's a problem with the prescribing process at the meno clinic I went to. However, I want the gel so I'm following the advice I've found here rather than his. I've measured one full pump into a plastic medical syringe to see what it looks like, because basically, I want to take half of that over two days. As my preference is for daily usage, I halved that again and guess what it looks like? You've guessed it.
A pea sized blob!
Thanks, Hurdity. Your advice is better than all the doctors and 'specialists' I've seen over the last two and half years put together. Thank you, and here's to peas!
Jo x
Clearly either a consultant in a hurry or an ignorant one, unless he dictated the e-mail and it was misheard! Absolutely right there is no product of that name. Given the dosage instructions he did of course mean Tostran which as you can see from my first post in this thread, delivers a much smaller amount of T in one pump even though it is more concentrated at 2 %. Of course it is better to use the lower conc preparations like Testogel 1% sachets as there is less leeway for inccuracies when used by women.
So - your pea-sized blob will give you a bit more T than mine (half as much again) but is still within the paramteres recommended for women!
I despair at such errors. Heaven knows what would have happened if you carried on using it like that and what about other women who are blissfully ignorant and use that amount? Their bliss won't last long. Scary....
Please do report back to the meno cinic so that other women are not given the same high dose.
Thanks for kind words. Obviously mostly on here we advise women to be guided by their own doctors especially specialists even if standard guidelines re dosing are varied and individualised, and we are offering suggestions and advice based on what we've read of the science and medicine, as well as our own experience, but when it is a matter of drastically contradicting BMS recommendations in this and some other instances, some of us on here do know more than some of the medical professionals prescribing, so it unfortunately seems.
Good luck with the peas!
Hurdity x
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Hi,
Does anybody know what the range is for testosterone? I've had a total hysterectomy and I'm on Testogel - 1 pump over 3 days for the last 2 years. I had a recent blood test and my testosterone level has come back as 13.6 nmol/L. I don? t know if the fact that I'd applied my gel about an hour before I had the blood test makes a difference. I've had a phone call from my GP's secretary today to say that it's too high and made me a telephone appointment with the GP on Friday. My GP surgery don't prescribe testosterone to women but because my private gynecologist asked them to they do it on a private prescription for me. I'm worried the GP will stop prescribing it for me due to this blood test result. I can't find any info on what the range should be.
Thanks
Yes that is high but yes also having the test just after you applied it is not a good idea. If you apply it daily then the test should be approx in mid range I would say so if in the morning then have the test as late as possible in the afternon. Also SHBG should be measured which gives a proxy for free T known as the Free Androgen Index. I am presuming it was total T that was measured as free T is rarely measured directly?
Did you keep your ovaries when you had your total hysterectomy?
The ref range should have been given on your lab result. Can you view these online? If not ask for them but I expect that will still come out as high even without the SHBG. Here is an example of a test re range:
https://www.southtees.nhs.uk/services/pathology/tests/testosterone/
Male: 10 ? 30 nmol/L
Female: 0.7 ? 2.8 nmol/L
Although most of free T is bound by SHBG I'm not sure even with high SHBG if your total T levels are still high they should still ideally be within range. I don't think enough is known about what happens to the T in women if large qwuantities are bound up. This is probably because there is insufficient research on T replacement as there are no currently licensed products for women and those that were, were only researched for a short time.
I would ask for a repeat test, to include SHBG and make sure it is a long while after your T application and blood taken from a different place on the body.
GtG so apols for typos!
Hurdity x
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Hi I was doing OK on tostran but after several mo tbs felt it was making me more combative and irritated. This was on every other day so reduced to every 3 days which was better however my specialist is keen to move me to testogel and daily routine. Struggle with the peasize blob and faffing with the sachet but have tried and notice my mood level has dropped off, and more tired. Why can't we have an easier way to have more measured doses. Should I persevere with the sachet will its effects increase and improve my energy levels again. :(
Hi Hurdity.
Thanks for your reply. I read through the whole thread again closely yesterday. I did put one full pump on the first day I got the gel, so I now know exactly why that was a bad idea! My heart was racing and it took me ages to get to sleep that night.
The letter I got from the male consultant (which it took a month of chasing to get sent through, and then I received one copy a day for three days running) says "we can source some testosterone for Joanne which is in gel format and called Tosterone". I have searched everywhere for a testosterone gel called that - and I'm good at researching - and I cannot find it anywhere. This and the incorrect dose makes me think there's a problem with the prescribing process at the meno clinic I went to. However, I want the gel so I'm following the advice I've found here rather than his. I've measured one full pump into a plastic medical syringe to see what it looks like, because basically, I want to take half of that over two days. As my preference is for daily usage, I halved that again and guess what it looks like? You've guessed it.
A pea sized blob!
Thanks, Hurdity. Your advice is better than all the doctors and 'specialists' I've seen over the last two and half years put together. Thank you, and here's to peas!
Jo x
Clearly either a consultant in a hurry or an ignorant one, unless he dictated the e-mail and it was misheard! Absolutely right there is no product of that name. Given the dosage instructions he did of course mean Tostran which as you can see from my first post in this thread, delivers a much smaller amount of T in one pump even though it is more concentrated at 2 %. Of course it is better to use the lower conc preparations like Testogel 1% sachets as there is less leeway for inccuracies when used by women.
So - your pea-sized blob will give you a bit more T than mine (half as much again) but is still within the paramteres recommended for women!
I despair at such errors. Heaven knows what would have happened if you carried on using it like that and what about other women who are blissfully ignorant and use that amount? Their bliss won't last long. Scary....
Please do report back to the meno cinic so that other women are not given the same high dose.
Thanks for kind words. Obviously mostly on here we advise women to be guided by their own doctors especially specialists even if standard guidelines re dosing are varied and individualised, and we are offering suggestions and advice based on what we've read of the science and medicine, as well as our own experience, but when it is a matter of drastically contradicting BMS recommendations in this and some other instances, some of us on here do know more than some of the medical professionals prescribing, so it unfortunately seems.
Good luck with the peas!
Hurdity x
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Bump for Julia Dizzy
Hurdity x
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Bump for Mintea
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hello! I've just been prescribed tostran and was wondering how many mls of gel 1 pump will be? (I guess I can put a pump into a measuring spoon once I pick it up, but was wondering if anyone knew). thanks!
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Hi there - all the information is at the beginning of this thread. If the pumps are the same as they used to be then 1 pump of Tostran is 0.5 g gel (not ml) which looks like a tiny amount! Why do you need to know?
Hurdity x
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Bump for nicky_boo
Hurdity x
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Anyone had good results from testim?, I'm a newbie to this and on day 9 today. I'm so fatigued all the time (peri, age 41) xx
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I use Testim. I used to make one tube last a fortnight, then 10days. Latest blood tests showed Free Androgen Index still low at 1.1 so now upped to one tube per week. Will be interesting to see next lot of blood tests. You need to be patient (again!!) as it takes a few weeks to kick in.
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Hi gnattry- yes patience isn't my best asset lol. Thank you so much for your reply xxx
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Bump but probably a bit out of date now - Testogel 1 % sachets no longer available but the more concentrated Testogel is available in smaller sachets of 2.5 g gel each containing 40.5 mg testosterone.
Dosage compared with the 1 % gel:
Some specialists suggested making a 5g tube of 1% testogel/testim containing 50 mg testosterone last 10 days which gives 5 mg per day.
That being the case the new sachets should last 8 days.
I continue to use a small pea-sized blob of 1 % gel.
Hurdity x
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Hi Hurdity
I have just been prescribed the Testogel 2.5 g gel sachets.
Only used it this morning for the first time however I also apply sandrena gel on a morning. Just wondering if you or any ladies know if I am ok applying both sandrena gel and Testogel on a morning at same time but obv at different areas of the body. This is what I did this morning but just dawned on me now whether I shouldn't have done this.
Didnt cross my mind to ask meno specialist this question yesterday
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Hi, I've been taking testosteone in the morning with my Sandrena (previously oestrogel) for a year. It workd well for me.
Menopause specialist said Oestrogen in the morning, Testosterone in the eve. I used Testosterone ONCE at night. Never again! I was wired all night.
Good luck with it and keep us posted
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I think I said before in a reply to Banjo, that I realise testosterone works better for me in the morning. When I took a bit much I felt too jittery so night time would not work for me.
I use oestrogen patches on my belly, changed twice a week and alternating sides and positions. So I ' reserve ' those areas purely for the patches.
I change the patches in the mornings, and add the testosterone thinly on my inner thighs about halfway down also in the morning.
Others on here and my gp suggest other body areas which don't usually have hair, such as behind knees, wrists, buttocks, inner elbows and some use soles of feet. So there does seem to be a choice at body areas if you don't want to overload on area with both sandrena and testogel.
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Hi, I've been taking testosteone in the morning with my Sandrena (previously oestrogel) for a year. It workd well for me.
Menopause specialist said Oestrogen in the morning, Testosterone in the eve. I used Testosterone ONCE at night. Never again! I was wired all night.
Good luck with it and keep us posted
Thank you. Pleased it has worked well for you. I've only tried it in the morning. I take Utrogestan on a night. So think I will stick with mornings
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I think I said before in a reply to Banjo, that I realise testosterone works better for me in the morning. When I took a bit much I felt too jittery so night time would not work for me.
I use oestrogen patches on my belly, changed twice a week and alternating sides and positions. So I ' reserve ' those areas purely for the patches.
I change the patches in the mornings, and add the testosterone thinly on my inner thighs about halfway down also in the morning.
Others on here and my gp suggest other body areas which don't usually have hair, such as behind knees, wrists, buttocks, inner elbows and some use soles of feet. So there does seem to be a choice at body areas if you don't want to overload on area with both sandrena and testogel.
That's good to know. I will try other areas for application. Thanks