Testosterone Replacement Therapy for Menopause
Testosterone Replacement Therapy (TRT) is a treatment designed to alleviate symptoms caused by low testosterone levels in women going through menopause.
Although testosterone is commonly viewed as a male hormone, it is also naturally produced by women in smaller amounts in the ovaries and adrenal glands.
Why Testosterone?
Testosterone levels in your body gradually decrease as you age, particularly around the menopause due to decreased hormone production in the ovaries. Some women can be sensitive to these changes and may benefit from additional testosterone. Younger women who undergo surgical menopause (removal of ovaries) may notice the drop in testosterone more, likely due to their younger age and the sudden nature of the decrease. The current recommended use of testosterone is for women with persistent low sex drive, also known as Hypoactive Sexual Desire Disorder (HSDD), after other possible factors, including taking adequate oestrogen, have been addressed. Currently, there is not enough evidence to support its use to increase energy levels or manage brain fog.
Can I use Testosterone?
Most healthy women can use Testosterone. Testosterone is usually only recommended for women already using Hormone Replacement Therapy (HRT), as sometimes ensuring good levels of oestrogen is enough to alleviate symptoms. Testosterone is not as effective for women using oral oestrogen as this can affect the way testosterone therapy is used by the body.
In the UK, testosterone is not currently licensed for use by women, so it is prescribed 'off licence'. Off-licence prescribing is when a medication is prescribed for a condition or in a manner not specified in the official product licence. This happens with lots of different medicines and is generally done when a clinician feels the medication would be beneficial and there is enough evidence to support its safe use.
How long does it take to work?
It can sometimes take a few months for the full effects of testosterone to be seen and a 3-6 month trial is often recommended.
Are there side effects?
Most women do not experience side effects when using testosterone at the recommended dose. However, higher doses may lead to unwanted effects such as acne and hair growth. In rare cases women could experience male pattern hair loss or deepening of voice.
Testosterone should only be started when the potential benefits of treatment outweigh the risk of experiencing side effects. Blood monitoring tests before and during treatment help to minimise the risk of side effects. There is a lack of long-term data for women using testosterone, but data up to five years shows no adverse effect in healthy women after menopause.
Blood Tests
Blood tests are not able to diagnose whether or not you need testosterone but are used to ensure you are not getting too much on top of your own natural levels. A blood test is required before prescribing, and then 3 months after commencing following by 6monthly blood tests.
Blood tests can be scheduled here
Consultations
An initial consultation is required followed by a 3month review after commencing treatment then annual reviews are required moving forward.
Appointments can be scheduled online
New patients can schedule an appointments here
Existing patients who have been seen within the last 12months can schedule an appointments here
How is Testosterone Given?
Testosterone is usually given as a gel or cream, which you rub onto your skin. It can come as a gel in a small sachet, a tube, or pump dispenser. It can be rubbed onto your lower abdomen, bikini line or behind the knee.
Is it Available on the NHS?
Testosterone can be prescribed on the NHS if the prescriber is familiar with it and is willing to prescribe. In some areas there are prescribing restrictions which mean it cannot be started by your GP. Privately, you may be prescribed a type of testosterone specifically manufactured for women called AndroFeme. This has been licensed for Testosterone Replacement Therapy in Australia but is not currently available on the NHS.