As a GP with a particular interest in the menopause, I spend a considerable amount of time each week talking to women about HRT and also about testosterone. Testosterone is one of the sex hormones that women produce. Many people think of it as the "male" hormone which is correct, but women need to have testosterone too. In fact, women produce three times as much testosterone than oestrogen before the menopause.
Levels of testosterone in your body gradually reduce as you become older and reduce very abruptly in those women who have had an oophorectomy (an operation in which their ovaries are removed).
Even a very small amount of testosterone can really help with a woman's emotions and energy. Testosterone is really beneficial at improving general wellbeing, mood, energy, concentration and also sex drive (or libido). It can also provide benefits to the skin and hair. Testosterone is usually given as a gel to rub into the skin.
When women's levels of testosterone decrease, women may find that they desire sex less often and when they do have sex, it is not as pleasurable as it used to be, even though they still desire their partner.
I experienced menopausal symptoms several months ago, despite only being 45 (the average age of the menopause in the UK is 51 years) so I started taking HRT which has really helped to improve my symptoms.
After I had been taking HRT for a few months I decided to have my testosterone levels done and was not totally surprised to find that my levels were low. However, I was surprised at my initial apprehension of using testosterone myself. One of the reasons for this uneasiness is that testosterone gel is currently not licensed in women in the UK. However, it is prescribed by many menopause experts (including me) as it has proven benefits in many clinical trials. It is also very safe.
So on opening the packaging, the leaflet was all about using testosterone gel in men. I always heavily reassure my patients to ignore this leaflet, but clearly I could not take my own advice. So after reading it, I felt even more worried.
There are usually no side effects with testosterone treatment because it is given to replace the testosterone that women are otherwise lacking. Very occasionally women notice some increased hair growth in the area in which they have rubbed the gel. As the dose is so low, testosterone used in this way does not increase a woman's risk of developing facial hair.
So it is now four months since I started using testosterone and I can honestly say I have not felt this good for years. My energy has returned to higher levels than I thought possible, my concentration is better and I do not need as much sleep. The sleep I do have is a lovely, deep uninterrupted sleep that I have not experienced for decades. Even my yoga practice flows better and feels smoother.
It is hard to be frank and open about my relationship with my husband but I must admit that having sex is even more pleasurable!
Testosterone is not this effective for everyone, but it really can make a huge difference to many women's quality of life. Its effects should not be underestimated and clearly more work needs to be undertaken for testosterone to have a licence for its use in women. I certainly would not function nearly as well without it!
Dr Louise R. NewsonBSc(Hons) MRChB(Hons) MRCP FRCGP is a GP and menopause expert, based in Solihull, West Midlands, UK.
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