Hi sheila99
Testosterone testing is not always (necessary to be) carried out before prescribing T as doctors should go on symptoms - the most obvious being lack of libido (provided the woman is not taking other meds which can reduce this eg oral HRT or some ADs) coupled with lack of energy, muscle fatigue and general lethargy - other reasons having been ruled out eg vit/mineral deficiencies, underactive thyroid etc. I gather it is normal practice - or should be - to monitor T levels once T therapy is started just to check on over-dosing - especially as response time can be a matter of months.
The test for T in women is not sensitive, as I understand it is the same test as used for men and therefore less accurate at the bottom of the scale - which is where women will be.
@CLKD NICE allow for it to be prescribed to women, the link to the page is here: https://www.nice.org.uk/guidance/ng23/chapter/recommendations (Section 1.4.8 ). The prescription amount is much lower for women than men, but women who have not yet hit peri produce twice as much testosterone as estrogen. The amount should not affect your voice. Btw blood tests are not a reliable way to test as the levels fluctuate and it needs to be done by an expert as there is a formula to follow. I'll try to find it.
Also the usual measure I believe, is total testosterone which is not a reliable indicator oof bio-available T since much of it is bound to SHBG (google this!). A good doc should also measure SHBG and the formula I found on the web is for the Free Androgen Index (FAI) which is: Total testosterone x 100/SHBG (measured in the same units). Even so as you say, one test alone is not really indicative but as I said monitoring after starting T is important.
I did have a private consultation to obtain T but this was before the NICE Guidelines made provision for it to be prescribed off-licence. I am lucky to have a GP who will now prescribe it on NHS and I got my box of Testim today - should last me at least a year
![Roll Eyes ::)](https://www.menopausematters.co.uk/forum/Smileys/extended/rolleyes.gif)
. The inequitability of the system is appalling....ie some can and some can't access this treatment on NHS.
Hurdity x