Menopause Matters Forum

Menopause Discussion => All things menopause => Topic started by: Hurdity on March 03, 2019, 07:40:00 PM

Title: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Hurdity on March 03, 2019, 07:40:00 PM
The British Menopause Society has produced some up-to-date guidance on testosterone replacement in women including information about the products currently available and suggested dose. At last we have some guidance to give to our GPs if necessary and should hopefully avoid some of the blunders that have been made by GPs (as reported on this forum) prescribing totally inappropriate doses to women.

https://thebms.org.uk/wp-content/uploads/2019/02/08-BMS-ToolforClinician-Testosterone-replacement-in-menopause-02C.pdf

The BMS intends to keep the information about specific products updated as brands and doses etc become available or are withdrawn.

It was written by Nick Panay.

Hope this is helpful!

Hurdity x

Edit - the above link no longer works as the location of thie information has moved. it is now here:

https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Perinowpost on March 03, 2019, 07:56:54 PM
That's really informative, thanks for posting x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Taz2 on March 03, 2019, 09:12:42 PM
This is great news Hurdity. Thanks so much for posting!

Taz xx
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Autumn27 on March 03, 2019, 10:05:22 PM
Thank you very much for this information, it is a higher dose than was prescribed to me by the dispensing pharmacist at Nick Panay's NHS Menopause clinic. Maybe now they'll all be on the same wavelength!
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Ladybt28 on March 04, 2019, 12:59:21 AM
Yaba daba doo!! Wo hoo about flaming time!!  Written by a leading Meno consultant as well  Good old Nick!  Now all my cynical brain has to say is......how do we get GP's to actually read all the up to date stuff and ditch their "know it all - you know nothing" attitude.  :-X My GP visibly flinched once when I asked her to read something  :(
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Lanzalover on March 04, 2019, 06:58:20 AM
Good morning Hurdity

Many thanks for taking the time to post the link.

Lanzalover x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Joaniepat on March 04, 2019, 08:59:50 AM
Many thanks for posting this, Hurdity.

I had to see my GP this morning to ask for Testogel sachets, as I have nearly run out of the original prescription given at the Chelsea & Westminster in January 2018. He didn't bat an eyelid and has even put it on my repeats. It's not that he knows anything much about HRT, just willing to go along with what the meno clinic prescribes.

JP x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Tc on March 04, 2019, 10:49:41 AM
Thank you for sharing this.

Upon reading it I notice the testogel dose is stated re sachets. My pharmacist told me the sachets are no longer available so I have the pump pack.

I'm about to start a thread because I have not bee  told how to take it by my consultant.

Thank goodness for the sharing of information on here.
Due to reading that today I discovered the BMS have a sister site for patients womens health concern. I have emailed them to ask about converting the sachet dose to pump.
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Rosie63 on March 04, 2019, 04:53:07 PM
Thanks for sharing the info., Hurdity.

Rosiex
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: rosie17 on March 04, 2019, 06:40:35 PM
Very interesting reading, Hurdity. The paper states:

"Note 2: Although the NICE NG23 guideline recommends that systemic HRT should be prescribed before a trial of testosterone, there are trial data in women with HSDD which indicate that testosterone used without systemic estrogen, is equally effective and safe."

This seems to contradict the belief (theory or proven scientific fact?) that estrogen levels must be raised/adequate before testosterone is introduced to avoid androgenic effects. If this is true (will they change their minds tomorrow?), I'm overjoyed! Estrogen has never done much for me, but if I use testosterone, I can feel it kick in almost immediately - more motivation/energy, less muscle pain, lighter mood, etc. But maybe that's just me.
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Hurdity on March 04, 2019, 07:53:22 PM
Thanks yes rosie17 I noticed that too but can't find any data on this - maybe it's as yet unpublished. The trials on the Intrinsa patch were as far as I recall carried out with women also using oestrogen but would need to check.... Also what does safe mean? The Intrinsa patch studes only lasted I think 2 years ( maybe 3) - nothing long term. Also what does effective mean - it might increase sexual desire, orgasm etc but be associated with more adverse androgenic side effects. However I presume a statement like that wouldn't be made unless it had substiantial info backing it up. Maybe someone in touch with him or attending his clinic can ask Nick himself!

Personally I would worry about testosterone dominance through using on its own in post-menopause anyway - even if it did improve my energy levels etc.

Hurdity x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Ladybt28 on March 04, 2019, 08:03:44 PM
Its great to hear...I will volunteer as a guinea pig for any HRT trials of anything... (hey nick choose me if you want a study!) Personally I have felt absolutely beyond ill for so long through this whole meno thing (if I were a dog I would have been put down!) that I really don't care...I will give anything a go, if it helped me or someone else for that matter.  I can always shave off my beard, or become a bricklayer in retirement at least those are more useful than all this c..p! ;D ;D
Oh yes I now have a very cavalier attitude to my health!
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Perinowpost on March 04, 2019, 08:16:56 PM
I was on Intrinsa patches (as previously mentioned) and remember I had to be on oestrogen for 3 months before I could have them. I didn't have any androgenic side effects apart from the odd pimple. That said they were far superior to anything we have now - I do miss them x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Yorkshire Girl on March 04, 2019, 08:27:29 PM
Thanks Hurdity, have just read through it, good timing as I have my appointment with a gynaecologist for testosterone in a couple of weeks.
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Tc on March 04, 2019, 09:50:16 PM
I was told the same as you perin. My doc said my E had to be raised before starting T. She didnt mention androgenic dominance as the reason she said if you dont have enough E your body will convert the testosterone to eastrogen.
I'm not sure about that to be honest. I know there are steroid hormones with very long names  which can convert T to E but dont know if its low E which triggers that in the body.

Anyway that seemed to go out the window because my E hasn't raised in 6 months and she still gave me T anyway.

 I am happy to be starting it  She did go on about growing a beard and voice dropping  as she wrote the prescription but shes a bit of an alarmist as you will see from my other posts
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: rosie17 on March 05, 2019, 12:56:32 AM
Nobody has been able to explain to me why estrogen is the go-to hormone for women if, as the paper says, we produce 3-4 times more testosterone than estrogen when we're young and healthy. Wouldn't it be lovely if all we need is a sprinkling of testosterone, and that some of the testosterone would convert into all the estrogen our bodies need to stay balanced? Hmmm.
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: pepperminty on March 05, 2019, 07:33:24 AM
Great info thanks Hurdity.

Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Ladybt28 on March 05, 2019, 03:43:06 PM
Rosie - if it were true ref the paper - would it be that we would only need T and Progestrone (to keep womb lining thin) and only a little oestrogen would need to be there as a pre-cursor to trigger the T to produce more ….hum that's interesting.

I wish there were more studies on all this stuff!
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: rosie17 on March 06, 2019, 12:42:29 AM
Well, Ladybt28, in a perfect world we wouldn't need extra progesterone as either the T or the E, or our adrenals or fat cells or whichever organ wants to volunteer, would spit out just the right amount of progesterone to keep the lining thin. I guess we can dream, can't we?

I read a book called "Testosterone: Strong Enough for a Man, Made for a Woman: P.S. We Had It Wrong" by Dr. Charles Mok, published in 2017. The description on Amazon states "Clinical studies show that testosterone therapy reduces the risk of breast cancer by 50 to 75 percent and relieves virtually all symptoms of menopause with no adverse effects.
You read that correctly. The benefits of implementing testosterone into hormone replacement therapy are virtually unprecedented, and yet the larger medical community continues to ignore the facts. In order to repair the standard of care, Dr. Charles Mok confronts medical professionals for their slow integration of testosterone.
With support from a wealth of peer-reviewed studies, he shows how this therapy can help women facing menopause maintain their weight, enjoy sex again, and reduce the health risks associated with aging. Discover the true treatment for menopause and take back control of your body!" (I'm assuming it's okay to mention books, authors and descriptions on this forum? I guess I'll find out!)

As I was reading the book, I thought "What an outlandish idea! If it's true, why don't more doctors know this?"
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Tc on March 06, 2019, 09:39:25 AM
I have got to read that book rosie
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Joaniepat on March 16, 2019, 07:54:04 AM
The British Menopause Society has produced some up-to-date guidance on testosterone replacement in women including information about the products currently available and suggested dose. At last we have some guidance to give to our GPs if necessary and should hopefully avoid some of the blunders that have been made by GPs (as reported on this forum) prescribing totally inappropriate doses to women.

https://thebms.org.uk/wp-content/uploads/2019/02/08-BMS-ToolforClinician-Testosterone-replacement-in-menopause-02C.pdf

The BMS intends to keep the information about specific products updated as brands and doses etc become available or are withdrawn.

It was written by Nick Panay.

Hope this is helpful!

Hurdity x

Bumped for Anaïs and Jaylou
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Dotty on March 16, 2019, 08:08:54 AM
https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/

I've just tried the previous link and it didn't work so I've posted the new one above x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Dotty on March 16, 2019, 08:10:11 AM
https://thebms.org.uk/wp-content/uploads/2019/03/08-BMS-ToolforClinician-Testosterone-replacement-in-menopause-02D.pdf
 
This is the pdf version x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Joaniepat on March 16, 2019, 08:55:17 AM
Thanks Dotty. I should have tested it!

JP x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Hurdity on March 16, 2019, 09:07:19 AM
Thanks Dotty - they moved the page! I will edit it also in the main post.

Hurdity x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Dotty on March 16, 2019, 09:15:49 AM
Hi no problems. I only found the page had moved by accident 😄 x
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Butterfly22 on March 17, 2019, 01:59:21 PM
Interesting, I've never been offered this or tested for it as far as I know xx
Title: Re: British Menopause Society-Testosterone Replacement in Menopause: New Guidance
Post by: Hurdity on January 19, 2021, 08:43:10 AM
bump for Julia Dizzy

Hurdity x