I’ve just taken my first dose of testosterone. Not because I want to change my gender or take up body-building, but because I would like to feel like a normal woman again.
Back in August I wrote about my menopausal journey so far and my experience with synthetic HRT, namely Prempak-C. After two months of persistent weight gain I decided to stop taking Prempak-C and returned to my GP to ask if she could prescribe bio-identical HRT.
Not being a fan of bio-identical HRT, she referred me to the Gynae Endocrine Clinic at King’s College Hospital in South East London. After a two month wait, I finally saw a Consultant Gynaecologist last week.
It wasn’t a moment too soon as I was feeling pretty frazzled. The calming effects of having a little oestrogen in my body for a couple of months had worn off and I was back to having hot flushes, night sweats and getting either extremely stressed or irritable over the slightest thing. The other menopausal symptoms that hadn’t been helped by Prempak-C were still persisting, so I was not a happy camper.
I was pretty tense before the appointment, afraid that I would be prescribed synthetic HRT again and have to argue the case for bio-identical HRT, but my worries proved to be unfounded. From the friendly nurse, who took a detailed medical history, to the calm and reassuring Consultant, my experience at the clinic was extremely positive.
Premature Ovarian Failure
Five minutes into my consultation the Consultant diagnosed Premature Ovarian Failure. Suddenly it all made sense. Years ago, in my early thirties, I was diagnosed with premature menopause, but later that diagnosis was changed to PMT with depression. All these years that I’ve been feeling half the woman I’m meant to be are not because of something in my head, it’s because of my poor shrivelling ovaries.
Without prompting, the Consultant prescribed bio-identical HRT in the form of Oestrogen (Evorel 50 patches), Progesterone (Utrogestan 200 mg) and Testosterone (Intrinsa Patches). Fantastic! And just what I was hoping for.
The Role of Testosterone in Women
Now, you may be wondering why I have been prescribed testosterone and why I seem so keen to get my hands on the stuff. When I had my hormone levels checked back in June, my testosterone levels showed up as very low at 0.5 ng/dL. From what I’ve been able to ascertain normal levels for women are between 10 and 70 ng/dL, so it’s no wonder my sense of well-being isn’t all it should be.
Testosterone is produced in the ovaries and adrenal glands of women and plays a crucial role in a woman’s libido and overall experience of sexual pleasure. Not only that, testosterone is important in improving bone mineral density and the development of lean muscle mass and strength. It also contributes to an overall sense of well-being and energy levels, can improve mood and outlook and increase feelings of confidence and assertiveness.
Looking at the list of all the roles testosterone plays it seems to me that testosterone could actually play an important role in shaping personality and behaviour. Could my lack of assertiveness and general low mood and low energy be down to my pitifully low testosterone levels, I wonder?
The Battle to get hold of Testosterone
Unfortunately, since then, I have been involved in a bit of battle to try and get hold of the testosterone.
My pharmacist said that he had tried ringing other pharmacies in the area, gone on the internet, but had been unable to get hold of the Intrinsa Patches. Apparently, the marketing authorisation holder for the patches, Warner Chilcott UK Ltd, has voluntarily withdrawn the marketing authorisation for commercial reasons.
Testosterone for Women
Until it was recently discontinued in the UK, Intrinsa was the only form of testosterone that was specifically developed for treating women.It was only licensed on the NHS for women who have had an early surgically-induced menopause, and who are already receiving oestrogen therapy but it was also prescribed privately for women with low libido, or hypoactive sexual desire disorder (HSDD). It came in the form of patches that were easy to apply and supplied a measured dosage over a period of days.
After tracking down my Consultant and asking him for the name of a testosterone alternative I headed back to my GP and asked her to prescribe testosterone gel. Armed with my new prescription I headed off to the pharmacy only to be told there was none in stock so they had to order it in.
When I returned the following day I was told that they had been unable to source it, were still trying, and I needed to come back again the next day. I don’t know if this is just because not many people in South London need extra testosterone or whether it’s a nationwide problem. Still, I applaud my local pharmacy for their persistence.
Today, I finally received my tubes of Testim gel. The only problem is that the only testosterone available to women is that which has been developed for men and it is not licenced for use in women.
The instructions for men is to apply one sachet of gel or one tube of cream daily. Simple. For women, the advice given by doctors is to apply one eighth of a sachet or tube daily or one quarter every second day.
There is nothing to measure a standard dose, so women just have to guess the correct measurement. It all seems a bit hit and miss and it annoys me that women aren’t better catered for by the pharmaceutical industry when it comes to testosterone.
But for now I am grateful that I finally have all the HRT I need to start my treatment. I have no idea if this particular combination of hormones is going to work or if I will have unpleasant side-effects. My body feels like a bit of an experiment at the moment and I am curious to monitor any changes, good and bad. Hopefully I won’t grow a moustache and develop acne and a deep voice.
But I am hoping, that one day soon, I will start to feel more alive and energised, and be able to enjoy my body and this particular time of life rather than feel a victim of my hormones.
I’ll keep you posted.
Part 1: HRT and Me: The Story So Far