Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: karenc1900 on August 30, 2019, 04:01:29 PM
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I have managed to get a private prescription for Testosterone and was prescribed Tostran. The dosage was 1 pump 3 times a week, I decided that I would go much less and probably used pea size ? I applied it at about 4pm, at about 10pm I went to bed but could not sleep due to heart pounding and felt very anxious or kind of like I had had lots of strong coffee ! not very nice feeling at all, I did manage to get to sleep but still felt ‘wired' in the morning. My dilemma is do I try a tiny, tiny dose and maybe apply in the morning or do I ask for Testim the lower strength ? I paid £40 for the Tostran 😳 any advice welcome..
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Well, why were you prescribed it?
For me, it makes me stronger as I was very weepy and scared, and felt awful with is as before meno I was fearless...
When my meno dr was giving it to me first time she said to observe and if I felt like punching anyone, to decrease the dose.
I took Testim, and it did wonders. But it is no longer produced. Now, I am on Testogel which I am observing but.. I preferred Testim..
I apply it after shower... each day at different times.
Try to take it earlier, perhaps..? Take smaller doses but each day..? If it is new to you, you may be getting used to it. Give it a time!..?
Hope it helps,
Best!
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Thank you for your reply Orllia, I was prescribed it for fatigue, low energy etc. I have been on HRT for a year and it has helped with lots of symptoms but I just can't shake this sluggishness feeling. Was hoping that t would be the answer but I have kinda been put off after my first attempt ! when I feel braver I think I may try again with the smallest amount possible...
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I started using androfeme about 18 months ago. I apply it in the morning after I shower and don't experience any side effects. It made so much difference to me, I. A positive way. I would give it another go applying in the morning with a smaller dose and see if you feel the same. Good luck!
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Hi, again!
I get mental benefits from it, as I said. I feel stronger and cope better with people on it. Better for me, not for them ;) but have energy levels of a dead cat for some time now, after decrease of oestrogen dose, which they insisted on cutting because I am 64 now.. I have reached a stage of passively going along with whatever.
In past, I tried almost every product. None brought me back to what was before. I understood that that can't be done. I think best is to take one and get used to functioning on it. I asked for most popular, used by largest number of women, so am now on Evorel Conti plus Testogel 50mg/week.
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Hi guys I know this is about testosterone can I just ask what you're estrogen levels were before you could have testosterone as I have been on estrogel pump 2 pumps daily and was obsorbing well in the beginning and in a 3 month period my estrogel level was 195 and T was 0.8 however roll on 4 months and my estrogel has dropped to 104 and T 0.6
Menopause have told me that my levels need to be 250/300 to have testosterone however I said but what if my levels never get to that I'm not going to keep suffering with low energy fatigue and lack of sex drive!
I've had ovaries removed 5 yrs ago but it only had menopause symptoms in last year mainly VA which I take ovestin for and have been on that 8 months however the last few days have had soaked knickers and this milky frothy discharge which is around my vulva and vagina and I have this burning sensation to could the ovestin no longer be working ? I have tried vagifem first however 5 weeks into taking it I shed lots of hair and hair has been falling out since driving me crazy all this . Any help would be much appreciated
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Hi Sammiejane,
I have the same question. I'm not on HRT, my oestrogen levels are not flat low, but my testosterone levels are 0. I'd like to know if I could start with a small dose of testosterone, without taking oestrogen and progesterone. Does anyone know if that's possible?
IMHO you are entitled to have testosterone asap, because of oophorectomy. It's amazing how doctors still treat surgical menopause like natural menopause. It's completely different, it's a medical condition that needs to be addressed immediately after surgery. If they deny it until your oestrogen levels are 250/300, you can try DHEA pessaries, or prasterone, brand name INTRAROSA, if I'm not mistaken.
BeaR.
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Hi karenc1900
Testim has been discontinued 18 months ago or more but Testogel sachets are at the 1% strength. So you are using a pea-sized blob 3 x per week? That sounds about right to start with. I use a pea-sized blob of Testim (just have a few tubes left now!) daily and my levels are just above the range although as my SHBG is high my Free Androgen Index is still low so I'm fine with that.
Do you have low libido as well - this would be the first indication that tesosterone is low, and if you are not on oral oestrogen nor anti-depressants - both of which can lower libido. Which HRT are you on?
Thank you for your reply Orllia, I was prescribed it for fatigue, low energy etc. I have been on HRT for a year and it has helped with lots of symptoms but I just can't shake this sluggishness feeling. Was hoping that t would be the answer but I have kinda been put off after my first attempt ! when I feel braver I think I may try again with the smallest amount possible...
Also has the doc looked for other reasons for your feeling sluggish, fatigued etc - it may be that you do not need tesosterone replacement?
Hurdity x
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Sammiejane - tests are not especially accurate although if you've had two that are both low then could be a reflection of your approx levels at that time. Were they blood tests taken at a clinic? It looks like you do need more oestrogen and depending on your age. Can you increase you dose? Are you still suffering from flushes and sweats? It is important to get oestrogen to an adequate level because actually a decent level of oestrogen can also help with these symptoms and only after increased oestrogen does not work is it worth trying testosterone (as I understand).
The BMS has produced some guidance on T replacement here: https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/ but clearly your menopause clinic sounds like they know what they're talking about. This BMS information refers to that NICE Guidelines saying that women should be prescribed systemic HRT before a trial of testosterone, although it (T) has been used alone to treat cases of HSDD (Hypoactive Sexual Desire Disorder).
Bear I hope this answers your question too? T testing at low levels is notoriously inaccurate because the test is designed for T levels in men who have much hgiher levels so not sensitivie enough at the low end of the range> There are various threads on tesosterone - one in private lives ("Testosterone Here We Go") and one I did on dosage and different products available too which I can bump if you want.
Intrarosa is designed for VA but not yet widely prescribed (if at all) although it is licensed.
Hurdity x
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Hi hurdity
I increased the gel last night to 2.5 pumps but immediately I'm hit with aniexty which is horrible I feel like I can't breath and this is why I'm wondering if I add progesterone is will counter act some of estrogen side effects one being hairloss due to an imbalance I'm post menopause and surgically induced into it 5 yrs ago but have only had symtoms that were bothersome last year and have been on estrogel for 8 months.
Menopause specialist said I'm not obsorbing the gel very well and to increase to 3 pumps but can't cope with that level - is this because it's unopposed ? I know aniexty is caused by low testosterone so can hair loss but when ovaries are removed you loose 3 sex hormones and I feel maybe my body needs all 3 I never suffered on the pill which was combined pill but this I think is because it contained both estrogen and progesterone. I've been to doctors who said try a 50 mg patch estradot and 100 mg utrogestan daily but I'm scared with swapping to a patch whether this will work aswell for VA symtoms as I know the gel is designed for menopause and also moderate to severe vaginal atrophy ? Also doctor says my exessive sweating could be due to imbalance of hormones but I have also stopped taking the magnesium I was on for month and a bit now so maybe this was helping sweats and flushes too.
Do I have any personal experience on the patch and VA symtoms and if you take or took estrogel and utrogestan any hairloss or any hairloss when swapping to a patch ?
Thank you
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Hi Hurdity,
Thank you for your reply. I'm currently using a Mirena coil and 75 Estrodot. I've had a blood test at Gp to check Thyroid etc and all seems to be ok. My Oestrogen level is within a good range, my testosterone level was <0.1 nmol/L very low and SHGB normal at 39/gl
So after researching low T symptoms I felt that this is what is effecting me, low sex drive, low energy etc
I have paid privately to get T as my GP will not prescribe. I only used a pea sized blob and it gave me the unpleasant effects I wrote above.
I have contacted the doctor who prescribed and she said it was very unusual to have this effect after such a small amount and to try again with a small as possible blob and gradually build up.
I have tried the smallest amount possible this morning but it has given the same effect, maybe slightly less. I think I may be put off T now as i wanted to feel less anxiety not more ! maybe the 2% is too strong for me....I have a feeling it may be a costly mistake 😬
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I don't agree that it's very unusual to have those side effects that you describe Karenc1900, it is possible. I had a reaction to testogel, I tried several times and every time I tried it it never went away. Someone on here suggested I try testim and that was better - although even then I have to ration the dose to 3 x petit pois blobs per week as my body can't cope with anymore. Unfortunately they don't make testim any more, I've still got about 10 tubes left as I use it so slowly. I think your reaction all depends on how sensitive your receptors are.
I would say don't give up and try something else. It really is worth it. I'm waiting to try androfemme as it's made specifically for women so hopefully side effects will be less x
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Thank you Perinowpost.
It is a shame there is no licenced T for women, I have done some research and as you say it seems it is not unusual to have these side effects.
I don't think the doctor that prescribed it has a lot of experience of prescribing it, maybe that was my mistake in my research of who to go to ?
It has put me off a bit but like you may be I need to get my hands on some Androfemme..how are you going to source it ?
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Apparently there are plans to make it more mainstream underway (checkout Louise Newson website). If however, it isn't available before I run out of testim I'll go private and pay for it x
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The BMS has produced some guidance on T replacement here: https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/ but clearly your menopause clinic sounds like they know what they're talking about. This BMS information refers to that NICE Guidelines saying that women should be prescribed systemic HRT before a trial of testosterone, although it (T) has been used alone to treat cases of HSDD (Hypoactive Sexual Desire Disorder).
Bear I hope this answers your question too? T testing at low levels is notoriously inaccurate because the test is designed for T levels in men who have much hgiher levels so not sensitivie enough at the low end of the range> There are various threads on tesosterone - one in private lives ("Testosterone Here We Go") and one I did on dosage and different products available too which I can bump if you want.
Intrarosa is designed for VA but not yet widely prescribed (if at all) although it is licensed.
Hurdity x
Thank you Hurdity. The link you provided is for clinicians. Is there a similar one for patients?
I'd like you to bump those threads, thank you.
I have been tested for testosterone and SHBG (normal) privately for the last 5 years and testosterone levels are pretty much 0 since then. I think I do have Hypoactive Sexual Desired Disorder. Could I have testosterone without taking oestrogen and prog for HSDD?
BeaR.
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I have been tested for testosterone and SHBG (normal) privately for the last 5 years and testosterone levels are pretty much 0 since then. I think I do have Hypoactive Sexual Desired Disorder. Could I have testosterone without taking oestrogen and prog for HSDD?
BeaR.
As I said before below bear, T tests are not accurate because T in women is in lower end of range so not sensitive enough to detect significant differences in women although once T replacement commences then T monitoring is a good idea - especially to see if levels have risen above physiological range for women (also taking into account SHBG).
There are quite a few studies around easily found with searches. Personally though, if at least 2 years post-menopause i would not want to replace T without firstly replacing OE for the reasons I have given before ie greater potential for androgenic effects (even if libido and/or response is improved) at a stage in our lives when these can become more dominant.
Hurdity x
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Hi Hurdity,
Thank you for your reply. I'm currently using a Mirena coil and 75 Estrodot. I've had a blood test at Gp to check Thyroid etc and all seems to be ok. My Oestrogen level is within a good range, my testosterone level was <0.1 nmol/L very low and SHGB normal at 39/gl
So after researching low T symptoms I felt that this is what is effecting me, low sex drive, low energy etc
I have paid privately to get T as my GP will not prescribe. I only used a pea sized blob and it gave me the unpleasant effects I wrote above.
I have contacted the doctor who prescribed and she said it was very unusual to have this effect after such a small amount and to try again with a small as possible blob and gradually build up.
I have tried the smallest amount possible this morning but it has given the same effect, maybe slightly less. I think I may be put off T now as i wanted to feel less anxiety not more ! maybe the 2% is too strong for me....I have a feeling it may be a costly mistake 😬
There may be some interaction involving the levonorgestrel released from the Mirena coil, together with SHBG and testosterone as well as androgen receptors. it is all very complex involving various interactions not fully understood when you replace one of the hormones exogenously ( ie from outside not produced in the body). Like Perinowpost I use a tiny amount daily and it may well be the Tostran is too strong for you and you would be better off with the 1 % Testogel sachets and using a tiny petit-pois blob every alternate day to start with? What's your body size/height/weight? If you are small, thin etc then it will be more concentrated in your bloodstream....
The units of measurement don't seem quite right for your T and SHBG - trying to work out your Free Androgen Index. They are normally measured in the same units?
Also - how long have you had the Mirena - could this be the cause of your feelings ie the continuous progestogen released from the coil affecting you?
Hurdity x
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Hi Hurdity,
Thank you so much for your reply...
As you say maybe it's not that simple, I had high hopes for T but have had more unpleasant side effects today with no more use..anxiety, palpitations, headache.
Like you say maybe the 2% was too strong for me, I'm slim about 10st5 5ft9 maybe the 1% would have been better but I'm rather put off it now !! I'm going to stick with Oestrogen, at least I know where I am with that ! Hopefully in the not too distant future we will have T for women available on the NHS..in the meantime I've got a whole tube of Tostran to dispose off 😬. Karen x
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Also Hurdity I'm 53 and have had my mirena 10 months, although this is my 5th one. They seem to have suited me so far....
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As I said before below bear, T tests are not accurate because T in women is in lower end of range so not sensitive enough to detect significant differences in women although once T replacement commences then T monitoring is a good idea - especially to see if levels have risen above physiological range for women (also taking into account SHBG).
There are quite a few studies around easily found with searches. Personally though, if at least 2 years post-menopause i would not want to replace T without firstly replacing OE for the reasons I have given before ie greater potential for androgenic effects (even if libido and/or response is improved) at a stage in our lives when these can become more dominant.
Hurdity x
Thank you, I think hat my test results are not the norm, although I get that the test sensitivity for low readings is poor. The lab has repeated the tests precisely because some were below the test sensitivity and this is not usual, according to them. My Gynaecologist is not confident about prescribing testosterone alone, but I can't take oestrogen/progesterone because they have brought back bad migraine and asthma attacks. Perhaps I have a specific testosterone production issue? I have other symptoms of low testosterone since my 20's, so this is not down to menopause (low energy, poor muscle strength,low libido, orgasm pain).
BeaR.
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Is your gynae one of the recognised ones on the BMS List? If not go here https://thebms.org.uk/find-a-menopause-specialist/ and look for meno specialists - the closest to you and then look on their website to see their views on T or ring them up Good luck.
Hurdity x
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I have just been given a private prescription for tostran too! I've been on oestrogel 3 pumps, was 2 until beginning of this year, I have mirena coil and use estring for VA, been using all for 3.5 years.
I have residual issues with brain fog, low mood, libido and energy and overactive bladder.
My Mona Lisa gynae has prescribed the tostran, suggesting 1 pump daily for at least 2 months to see if it helps me.
I'm worried to use it, I feel that 1 pump a day is too much? Also worried I'll get hairgrowth on application site (where's best?), and hair loss on my head?
Since menopause, my hair and nails are so dry and brittle, I'm hoping the tostran might help that? ......thoughts please?
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Is your gynae one of the recognised ones on the BMS List? If not go here https://thebms.org.uk/find-a-menopause-specialist/ and look for meno specialists - the closest to you and then look on their website to see their views on T or ring them up Good luck.
Hurdity x
Hi Hurdity,
Yes, she is. Thank you.
BeaR.
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I have just been given a private prescription for tostran too! I've been on oestrogel 3 pumps, was 2 until beginning of this year, I have mirena coil and use estring for VA, been using all for 3.5 years.
I have residual issues with brain fog, low mood, libido and energy and overactive bladder.
My Mona Lisa gynae has prescribed the tostran, suggesting 1 pump daily for at least 2 months to see if it helps me.
I'm worried to use it, I feel that 1 pump a day is too much? Also worried I'll get hairgrowth on application site (where's best?), and hair loss on my head?
Since menopause, my hair and nails are so dry and brittle, I'm hoping the tostran might help that? ......thoughts please?
Hi Ljp,
Hair and nails are hugely influenced by thyroid hormones as well, have you been tested recently?
I'm sorry I can't help you regarding testosterone, I have never used it. One pump seems a lot, but if it's only for 2 months, maybe she will have your symptoms rechecked and if testosterone is helping she might decrease the amount? Just a thought.
BeaR.
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Yes I had blood tests done earlier this year
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I have just been given a private prescription for tostran too! I've been on oestrogel 3 pumps, was 2 until beginning of this year, I have mirena coil and use estring for VA, been using all for 3.5 years.
I have residual issues with brain fog, low mood, libido and energy and overactive bladder.
My Mona Lisa gynae has prescribed the tostran, suggesting 1 pump daily for at least 2 months to see if it helps me.
I'm worried to use it, I feel that 1 pump a day is too much? Also worried I'll get hairgrowth on application site (where's best?), and hair loss on my head?
Since menopause, my hair and nails are so dry and brittle, I'm hoping the tostran might help that? ......thoughts please?
Hi there - One pump per dayof Tostran is higher than the recommended dose by the menopause experts - the Chelsea and Westminster recommends starting with 2 pumps per week. I don't know what 1 pump of Tostran looks like looks like but for example I use Testim which is half the strength of Tostran and apply a very small ( petit-pois sized) blob per day. Better to start low and slow.
Do have a look at the long-running thread on Testosterone in Private Lives section to read about others experiences or go to the home page and do a search re T and hair growth.
I apply to lower inner thighs next to knee, alternating between the two and yes I have hair growth on my thighs. T is tranpsorted through the skin not only into the bloodstream but laterally thought the skin. I gather there is genetic variation in how we respond to this and hair growth. Funnily enough I am someone with a thick head of hair on my head, but had sparse hair on my body ie arms legs and face - which may be due to some genetic difference in my endogenous (internally produced) testosterone - so maybe it has a more marked effect on my thighs than others.
My hair and nails are also dry and brittle - but then I'm getting on a bit ::)
I presume your oestrogen dose is high enough? Also interested to know how adding T will work with the progestogen from the Mirena which is testosterone derived. I have some info sonewhere on this I think although I think there is not enough research!
Good luck and do report back :)
Hurdity x
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Thanks Hurdity, I'm thinking to start with half a pump every other day maybe?
My oestrogen blood test was 565 in June this year and I was told it's good
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Look - I'm not your gynae obvs but in your position I would start with a low dose from what I've read. Would be interested to see what half a pump looks like in terms of peas?! ::)
Could the Mirena coil be also contributing to brain fog and fatigue?
Hurdity x
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I'm just going to dispense a small blob lentil/ petite poi's I think, every other day mon,wed, fri and see if I notice anything.
Had mirena for nearly 4 years has worked well for me, brain fog not as bad as it was before HRT, and I guess fatigue is part of ageing, but if testosterone can improve my bladder and VA it will be worth it alone.
Gynae said if it works great, if it doesn't just come off it, so nothing to lose really, just don't want to dose too high
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https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/
This is recent information about testosterone written by Nick Panay. The recommended dose of Tostran is 1 pump every other day. X
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Thank you Dotty
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Ljp....I use 1 pump of Tostran 4 times a week....Mon, Wed, Fri, Sat. X
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Has it helped you Dotty? What effect has it had? Where do you apply it?
How long have you been using it? And how long did it take to notice any changes?
Sorry for all the questions 🤭
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Hi Ljp I've been using testosterone for about 19 months now. I started it at the same time as I started oestrogel and utrogestan. I put it on my inner forearm and rub it in with my other inner forearm so none is wasted.
I was very ill both mentally and physically when i started this combination. I'd already been on hrt tablets for 4 months and they'd had no effect! I began to get better within a month but I can't tell you whether it's the oestrogen or the testosterone or both. All I can say is I will be eternally grateful for the wonderful doctor who prescribed them all for me . X
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So pleased it's working for you 😊
I've had a reply from my gynae, she suggests I use one pump of tostran daily for first two weeks, then reduce to 3 times a week, but she said I may need more.
Any change is scary and triggers anxiety I find 😩
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Hi dotty
On your regime of estrogel utrogestan and testosterone have you had hair thinning .
I've been told I can't have testosterone till my estrogen levels higher but you were perscribed all 3 together ?
My gynocologist seems to think I should have all 3 hormones for balance even though I have no uterus or ovaries and I'm wondering it because of hairloss and how I'm feeling
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https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/
This is recent information about testosterone written by Nick Panay. The recommended dose of Tostran is 1 pump every other day. X
Thanks Dotty - I've posted this link myself too! I was just wanting to err on the side of caution re the lower starting dose of the C and W!! I wonder why they differ? Also I think it's because I use a very low dose and get a good response (and T level) and I do worry about overdosing hence my urge to start low and slow! Have you had your T and SHBG levels monitored - would be interested to know if so?
Sammiejane I presume you are having regular blood tests if the docs have suggested you need to get your oestrogen levels higher before introducing T? I am sure you would benefit if you have no ovaries and it could be the missing link. However if your oestrogen levels are too low addition of T could tip the balance in favour of too much T to OE and hence more androgenic side effects potentially. As you are in surgical menopause your situation is a bit different and it does seem from what I read on here that it can be more tricky to get the right balance - and dose of oestrogen.
Hurdity x
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Hi hurdity
Why does there need to be a balance between estrogen and testosterone yet another major female sex hormone we have as progesterone is never mentioned in hysterectomy women unless they suffered endometriosis!
I personally think I will take all 3 hormones to get a steady balance
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You don't really need extra progesterone as it is still produced in very small quantities by the body after menopause (via the adrenals). It is only needed in really large quantities for pregnancy which is why it is produced in the ovaries. Oestrogen and testosterone are the two that are needed more for normal functioning and in decent quantities. If you haven't tried T then I do recommend you pursuing this avenue with your doc.
Hurdity x
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Hi hurdity
If you have small levels of progesterone produced by the adrenals would that not then create an imbalance with estrogen if you take estrogen hrt as this is also produced by the adrenals and in fat in our bodies but if then take hrt without progesterone your create an imbalance surely ?
Thanks
Sam