Menopause Matters Forum
Menopause Discussion => Personal Experiences => Topic started by: AngelaH on July 14, 2023, 11:58:29 AM
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Just wondering ::)
Ladies, who think they need testosterone to be added to their HRT, may I ask you ::) why do you think your body needs it? What kind of signs your body is sending to you? Any symptoms? I believe probably I need it as well. ::)
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Absent libido and muscle weakness
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Sheila99 would absent libido be an indicator on its own, or would it have to include muscle weakness? I have the former but not the latter and really wamt my libido back!
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Am interested in this answer too.... My libido has plummeted and I just took the option of an AD that had possible side affects of Wight gain over another that was likely to crash libido even further. My to never seems interested when I mention my extremely low sex drive.
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Zero libido, fatigue, brain fog, feeling flat/loss of drive/zest etc, but in a different way to depression.
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Sheila99 would absent libido be an indicator on its own, or would it have to include muscle weakness? I have the former but not the latter and really wamt my libido back!
Not everyone has muscle weakness but I'm fairly sure everyone has low/no libido. It's the only symptom the nhs are interested it, you often can't get it for anything else.
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Why don't gps listen when we mention this? Is it because it is simpler for them to work on other symptoms?
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Thanks Sheila99, so worth me mentioning to the GP then. I hadn't realised testosterone was good for that.
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Hello ladies.
Many ladies on the forum have found that the only way to have testosterone prescribed is by complaining about low libido, other benefits are not recognised by GPs it seems.
I am not sure about other private clinics but I am with Newson Health and they were happy to add in testosterone. However my oestrogen levels needed to be raised first otherwise the body converts testosterone into oestrogen and the added value is lost.
I must say that I gave up on testosterone a while ago but I was very post meno when I began HRT so perhaps that is why it wasn't effective for me.
Take care ladies.
K.
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My view is that a declining libido and specifically the desired response ( ::) ) would be the first sign of decreasing testosterone, and the more it decreases, the other symptoms would come into play - though don't think I have read evdiecne for that, but is logical.
That being said, if you take certain anti-depressants ( SSRI's I think but would need to check which), or take oral HRT then this can also cause decreased libido/response for various reasons, and of course I am sure other meds may have similar effect as well as psychological factors. But if you're ruled out all of those, and libido has gone or is going out of the window and your tissues are nicely plumped to avoid dryness and discomfort - then chances are you will benefit from testosterone.
Blood tests are inaccurate for women though might be good to get a baseline especially of the compound SHBG before you start.
If you've got a great libido but muscle weakness then I would look for another cause.
Kathleen - I am interested in your comment "However my oestrogen levels needed to be raised first otherwise the body converts testosterone into oestrogen and the added value is lost." because others have said this, but I've not found any evidence for it so would be great if you could point me to a study or something? I'm a bit out of date with the literature so mostly only going by what's in my head that over read over the years! It is on the same metabolic pathway but it's the evidence of what actually happens in the body in practice under these circumstances (ie addition of T when oestrogen is low) that I'm interested in.
Hurdity x
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Hello again ladies.
Hurdity - Sadly I don't have any research papers to point you towards but I was told about the testosterone/oestrogen interaction by a doctor from Newson Health. The doctor explained that the conversion from testosterone to oestrogen was the reason why oestrogen levels needed to reach a certain level before T could be added.
I am not science minded but I wondered if some women don't need to supplement with oestrogen during the menopause because they are efficient at converting their natural testosterone instead? There are likely many reasons that some women suffer so much more than others and this mechanism may be one of the differences that explains it.
Sorry I can't be more helpful but perhaps one of the Menopause clinics could tell you where this information came from.
Wishing you well and take.
K.
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I am interested in your comment "However my oestrogen levels needed to be raised first otherwise the body converts testosterone into oestrogen and the added value is lost." because others have said this, but I've not found any evidence for it so would be great if you could point me to a study or something? I
testosterone is indeed present in women, produced primarily in their ovaries and adrenal glands. Although testosterone can be converted to estradiol, the reverse does not happen. Testosterone, however, is not the main androgen (hormones that promote male characteristics) in women. Instead, dehydroepiandrosterone-sulfate (DHEA-S), dehydroepiandrosterone (DHEA), and androstenedione are the more common androgens in women
https://www.americanscientist.org/article/testosterone-in-women
And here as well:
All estrogenic steroids are synthesized in vivo from testosterone or related androgens in a reaction catalyzed by aromatase. Aromatase expressing cells in the brain convert circulating testosterone into estrogen, and it is this local estrogen that is thought to control dimorphic behaviors in males
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851224/#:~:text=Male%20behaviors%20require%20both%20testosterone,estrogen%20to%20the%20male%20brain.
Is this what are you looking for? :)
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That's very interesting re DHEA. Would we be better off taking DHEA then, as well as Testosterone do you think?
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Thank you very much to everyone, who replied to me. So it is absent/low libido is the main sing of low testosterone and the main reason to make a decision for GP to prescribe it to a woman . Well, to be honest I see HRT as a treatment for “pathological” menopause, because “nonpathological” menopause (which most of women have) is natural thing and doesn’t require HRT at all. It is natural to have absent/low libido, when woman reaches certain age and sex hormones don’t play the main role in her life any more, so why it should be treated?
My HRT doesn’t work for me and I am trying to think why. Just pump oestrogen to my body makes me much worse than without pumping it. I was born as a hairy girl, I mean all my life I have to fight with my hair over my whole body, even in parts, where ladies normally don’t have hair at all. ::) But apart from that I never had problems, my periods were normal, I didn’t have a problem to conceive and give a birth, I am a normal lady, just more hairy, than others 8). But now I have noticed that my usual hair on my lags, for example, started growing more slowly than before, in some parts of my body it disappeared at all. Now I look like a normal lady :o But I feel rubbish :'( This is why I think now about testosterone, I think I was born with much higher level of it, than lady needs and the problem is now really low level of testosterone as well in my body? ???
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That's very interesting re DHEA. Would we be better off taking DHEA then, as well as Testosterone do you think?
Who knows, probably we will have an answer in the next century. 8)
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Gah!
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Hi Angela H
Thank-you kindly for posting those links. Yes these are accounts of the endogenous (inside the body) conversion of testosterone to oestrogen - which is what I meant when I said that they are on the same metabolic pathway. It;s called "steroidogenesis", You can see it diagrammatically here: https://commons.wikimedia.org/wiki/File:Steroidogenesis.svg
All of these processes take place in certain tissues in the body, are controlled by enzymes (as per the diagram) and subject to feeback loops etc - all very complex, in terms of regulation.
What I am looking for though, is trials showing that when you add testosterone exogenously (ie from outside the body) as part of HRT, it is converted to oestrogen up to a certain level. To my knowledge (limited!) this has not been done. However the reason I question it is because I read the product monograph ( a type of summary research paper about a pharmaceutical product before it gets approved) some years ago for the testosterone patch "Intrinsa" which used to be marketed, and as far as I recall (some time ago) the addition of the T patch did NOT cause an increase in oestrogen levels in the women studied. Now I can't remember if they were also taking oestrogen as part of HRT - but that has stuck in my mind and I remember it every time someone mentions this.
So in a nutshell - just because testosterone is ONE of the precursors on the metabolic pathway of estradiol synthesis, doesn't necessarily mean that if you ADD testosterone it WILL convert to oestrogen. That's what I'm trying to find out!
(You didn't ask for that did you?!)
Incidentally you will see DHEA in that same diagram - full name DeHydroEpiAndrosterone.
Gnatty - the whole DHEA thing is very interesting and the same argument occurs - if you take DHEA - you cant control what it will convert to. There has been some research and one of the vaginal products contains DHEA. Unfortunately there is insufficient research into dosage and efficacy - because you can buy it OTC but who knows how much to take and whether you could be causing an increase in womb lining etc if it converts to oestrogen and your'e not taking prog (or get too hairy if it converts to T!). I did buy some once - and took a weak dose for a couple of months or so but noticed not one jot of difference in anything!
Hurdity x
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I read the product monograph ( a type of summary research paper about a pharmaceutical product before it gets approved) some years ago for the testosterone patch "Intrinsa" which used to be marketed, and as far as I recall (some time ago) the addition of the T patch did NOT cause an increase in oestrogen levels in the women studied. Now I can't remember if they were also taking oestrogen
Hello Hurdity :)
Of course they were talking oestrogen because Intrinsa was supposed to be prescribed for women, who had surgical menopause. Is it right?
https://www.ema.europa.eu/en/documents/scientific-discussion/intrinsa-epar-scientific-discussion_en.pdf
Be honest I don’t know much about testosterone, never been interested before, so I feel I do need to do more research, probably it will help me to find out what is going wrong with me.
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I went to Newson Health for Testosterone because after being on Evorel 50 for 8 months I was still struggling with extreme brain fog, lack of interest in anything, exhaustion, no libido and lots more.
I told the Dr I wanted testosterone to try and give me myself back, my vavavoom, I also told her I didn't care about libido, which was why I went private as opposed to NHS.
She gave me testogel.
After a few weeks my libido was back, after 9 weeks my brain for started to lift and I began feeling like my old self again.
After 11 weeks, I began getting night sweats and muscle pain again.
I went back to my GP who liaised with Newson. I am staying with testogel but have now switched from patches to oestrogel and utrogestan so I can tweak my oestrogen levels as and when needed.
I hope this will be the last tweak I need for a little while.
Testosterone has definitely helped me, a lot.
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Testo made me more like myself, from before Meno, which turned me, from bold, never scared of anything, get up and go woman into scared, crying, apologetic, worried jelly with daily anxieties. Even my washing machine scared me!
I wish I was offered it much earlier and had not have to go through all that, for years, as I seem to be high on testo before. Contrary to most experiences, my libido was extra high in Meno so I did not need that for that.
I need it for functioning! Now that they cut my dose in half, from last Dec, I flopped, lost interest, my muscles gone soft, spine collapse, and my bits went into sort of Prolapse.
For last two weeks I increased my dosage by quarter, by myself, to check, and already am more active and done lots in my flat.
So, it seems to make me more energetic, my body stronger, and I cope better on it with life!
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Hi I used for about a year but had to try other things first. My libido was not the problem but no energy, fatigue and it really helped with that.
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My HRT doesn’t work for me and I am trying to think why. Just pump oestrogen to my body makes me much worse than without pumping it. I was born as a hairy girl, I mean all my life I have to fight with my hair over my whole body, even in parts, where ladies normally don’t have hair at all. ::) But apart from that I never had problems, my periods were normal, I didn’t have a problem to conceive and give a birth, I am a normal lady, just more hairy, than others 8). But now I have noticed that my usual hair on my lags, for example, started growing more slowly than before, in some parts of my body it disappeared at all. Now I look like a normal lady :o But I feel rubbish :'( This is why I think now about testosterone, I think I was born with much higher level of it, than lady needs and the problem is now really low level of testosterone as well in my body? ???
Hi, do you suffer with PCOS at all? I’m peri and have had excess hair, but regular periods all my life. Scans showed PCOS, although blood tests were normal. I also have darker skin on my neck and groin, another symptom of PCOS. Also being overweight. Anyway, the doctor at Newsons said women who’ve had higher than average testosterone levels in younger life (as those of us with PCOS do) suffer more with low testosterone in peri, when t begins to decline - we really feel it, often more than the decline in oestrogen. I only fancy sex one week a month, and my energy and muscle tone has declined sharply. Also the brain fog…. Argh! Sure enough, my free androgen index was really low. I’ve just started testosterone gel and am hoping for the best. Im on a very low dose of oestrogen and that seems enough for me. I believe people in peri with PCOS have even more of a hormonal rollercoaster than normal!
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Interested in this thread as I have just started on Tostran a few days ago. After reading posts on here I have started on a v small amount (prob the 'petit pois' size that I have read on here) daily. I am interested in how much other women are using (of Tostran) as wondering if 1 pump every other day (or twice a week) would be better (and easier to measure accurately.
orrla, which brand of testosterone are you using and what is your dose, if you don't mind me asking?
Other than libido my main hope from it is improved energy, motivation and muscle mass, I do a lot of sports and def find it more tiring than I used to. Just a bit impatient so don't want to start on too low a dose!
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Hi, do you suffer with PCOS at all? I’m peri and have had excess hair, but regular periods all my life. Scans showed PCOS, although blood tests were normal. I also have darker skin on my neck and groin, another symptom of PCOS. Also being overweight. Anyway, the doctor at Newsons said women who’ve had higher than average testosterone levels in younger life (as those of us with PCOS do) suffer more with low testosterone in peri, when t begins to decline - we really feel it, often more than the decline in oestrogen. I only fancy sex one week a month, and my energy and muscle tone has declined sharply. Also the brain fog…. Argh! Sure enough, my free androgen index was really low. I’ve just started testosterone gel and am hoping for the best. Im on a very low dose of oestrogen and that seems enough for me. I believe people in peri with PCOS have even more of a hormonal rollercoaster than normal!
Hello WishIdknowsooner :)
Thank you so much for sharing your experience. I don’t think I had PCOS when I was in my reproductive age, excess hair is probably the only one symptom which I had, but I never been checked by Dr and never been tested, so there is possibility I had it, just didn’t know about it. I remember I had a friend, she was diagnosed with PCOS in her early 30th, as far as I remember all the symptoms which she had where nothing like mine, apart from excess hair. My peri was a nightmare, I don’t know if I am still there or have moved to the next stage - meno or even post because of Mirena coil. All my peri symptoms were successfully treated with a small dose of progesterone (Mirena) 4 years ago, but now some symptoms have returned back I also have a new one - cold flashes. GP thinks my estrogen level has dropped and prescribed me Oestrogel, the problem is my body is definitely not happy with pumping estrogen in it, so I don’t think my GP is right. It is more likely that my old problem from peri is returning back (due to the end of Mirena life) and I still need progesterone more than estrogen. I have managed to make an appointment with GP only in October to discuss it. Question about testosterone still open for me as well.
Good luck with your treatment, I hope it will help you. It means a lot when you know what exactly is going wrong in your body, so it makes easier for you to find right treatment to fix it.
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Thanks to all lovely Ladies who posted their experience on here. What I can see that all 3 sex hormones have very similar symptoms if level of them drops. It really makes hard to understand which hormone needs to be lifted up.