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[Hurdity]

I have been tested for testosterone and SHBG (normal) privately for the last 5 years and testosterone levels are pretty much 0 since then. I think I do have Hypoactive Sexual Desired Disorder. Could I have testosterone without taking oestrogen and prog for HSDD?

BeaR.

As I said before below bear,  T tests are not accurate because T in women is in lower end of range so not sensitive enough to detect significant differences in women although once T replacement commences then T monitoring is a good idea - especially to see if levels have risen above physiological range for women (also taking into account SHBG).

There are quite a few studies around easily found with searches. Personally though, if at least 2 years post-menopause i would not want to replace T without firstly replacing OE for the reasons I have given before ie greater potential for androgenic effects (even if libido and/or response is improved) at a stage in our lives when these can become more dominant.

Hurdity x

[Hurdity]

Hi Hurdity,
Thank you for your reply. I'm currently using a Mirena coil and 75 Estrodot. I've had a blood test at Gp to check Thyroid etc and all seems to be ok. My Oestrogen level is within a good range, my testosterone level was <0.1 nmol/L very low and SHGB normal at 39/gl
So after researching low T symptoms I felt that this is what is effecting me, low sex drive, low energy etc
I have paid privately to get T as my GP will not prescribe. I only used a pea sized blob and it gave me the unpleasant effects I wrote above.
I have contacted the doctor who prescribed and she said it was very unusual to have this effect after such a small amount and to try again with a small as possible blob and gradually build up.
I have tried the smallest amount possible this morning but it has given the same effect, maybe slightly less. I think I may be put off  T now as i wanted to feel less anxiety not more ! maybe the 2% is too strong for me....I have a feeling it may be a costly mistake 😬

There may be some interaction involving the levonorgestrel released from the Mirena coil, together with SHBG and testosterone as well as androgen receptors. it is all very complex involving various interactions not fully understood when you replace one of the hormones exogenously ( ie from outside not produced in the body). Like Perinowpost I use a tiny amount daily and it may well be the Tostran is too strong for you and you would be better off with the 1 % Testogel sachets and using a tiny petit-pois blob every alternate day to start with? What's your body size/height/weight? If you are small, thin etc then it will be more concentrated in your bloodstream....

The units of measurement don't seem quite right for your T and SHBG - trying to work out your Free Androgen Index. They are normally measured in the same units?

Also - how long have you had the Mirena - could this be the cause of your feelings ie the continuous progestogen released from the coil affecting you?

Hurdity x

[karenc1900]

Hi Hurdity,
Thank you so much for your reply...
As you say maybe it's not that simple, I had high hopes for T but have had more unpleasant side effects today with no more use..anxiety, palpitations, headache.
Like you say maybe the 2% was too strong for me, I'm slim about 10st5 5ft9 maybe the 1% would have been better but I'm rather put off it now !! I'm going to stick with Oestrogen, at least I know where I am with that ! Hopefully in the not too distant future we will have T for women available on the NHS..in the meantime I've got a whole tube of Tostran to dispose off 😬. Karen x

[karenc1900]

Also Hurdity I'm 53 and have had my mirena 10 months, although this is my 5th one. They seem to have suited me so far....

[bear]

As I said before below bear,  T tests are not accurate because T in women is in lower end of range so not sensitive enough to detect significant differences in women although once T replacement commences then T monitoring is a good idea - especially to see if levels have risen above physiological range for women (also taking into account SHBG).

There are quite a few studies around easily found with searches. Personally though, if at least 2 years post-menopause i would not want to replace T without firstly replacing OE for the reasons I have given before ie greater potential for androgenic effects (even if libido and/or response is improved) at a stage in our lives when these can become more dominant.

Hurdity x

Thank you, I think hat my test results are not the norm, although I get that the test sensitivity for low readings is poor. The lab has repeated the tests precisely because some were below the test sensitivity and this is not usual, according to them. My Gynaecologist is not confident about prescribing testosterone alone, but I can't take oestrogen/progesterone because they have brought back bad migraine and asthma attacks. Perhaps I have a specific testosterone production issue? I have other symptoms of low testosterone since my 20's, so this is not down to menopause (low energy, poor muscle strength,low libido, orgasm pain).

BeaR.

[Hurdity]

Is your gynae one of the recognised ones on the BMS List? If not go here https://thebms.org.uk/find-a-menopause-specialist/ and look for meno specialists - the closest to you and then look on their website to see their views on T or ring them up Good luck.

Hurdity x

[Ljp]

I have just been given a private prescription for tostran too! I've been on oestrogel 3 pumps, was 2 until beginning of this year, I have mirena coil and use estring for VA, been using all for 3.5 years.

I have residual issues with brain fog, low mood, libido and energy and overactive bladder.

My Mona Lisa gynae has prescribed the tostran, suggesting 1 pump daily for at least 2 months to see if it helps me.

I'm worried to use it, I feel that 1 pump a day is too much? Also worried I'll get hairgrowth on application site (where's best?), and hair loss on my head?

Since menopause, my hair and nails are so dry and brittle, I'm hoping the tostran might help that? ......thoughts please?

[bear]

Is your gynae one of the recognised ones on the BMS List? If not go here https://thebms.org.uk/find-a-menopause-specialist/ and look for meno specialists - the closest to you and then look on their website to see their views on T or ring them up Good luck.

Hurdity x

Hi Hurdity,

Yes, she is. Thank you.

BeaR.

[bear]

I have just been given a private prescription for tostran too! I've been on oestrogel 3 pumps, was 2 until beginning of this year, I have mirena coil and use estring for VA, been using all for 3.5 years.

I have residual issues with brain fog, low mood, libido and energy and overactive bladder.

My Mona Lisa gynae has prescribed the tostran, suggesting 1 pump daily for at least 2 months to see if it helps me.

I'm worried to use it, I feel that 1 pump a day is too much? Also worried I'll get hairgrowth on application site (where's best?), and hair loss on my head?

Since menopause, my hair and nails are so dry and brittle, I'm hoping the tostran might help that? ......thoughts please?

Hi Ljp,

Hair and nails are hugely influenced by thyroid hormones as well, have you been tested recently?

I'm sorry I can't help you regarding testosterone, I have never used it. One pump seems a lot, but if it's only for 2 months, maybe she will have your symptoms rechecked and if testosterone is helping she might decrease the amount? Just a thought.

BeaR.

[Ljp]

Yes I had blood tests done earlier this year

[Hurdity]

I have just been given a private prescription for tostran too! I've been on oestrogel 3 pumps, was 2 until beginning of this year, I have mirena coil and use estring for VA, been using all for 3.5 years.

I have residual issues with brain fog, low mood, libido and energy and overactive bladder.

My Mona Lisa gynae has prescribed the tostran, suggesting 1 pump daily for at least 2 months to see if it helps me.

I'm worried to use it, I feel that 1 pump a day is too much? Also worried I'll get hairgrowth on application site (where's best?), and hair loss on my head?

Since menopause, my hair and nails are so dry and brittle, I'm hoping the tostran might help that? ......thoughts please?

Hi there - One pump per dayof Tostran is higher than the recommended dose by the menopause experts - the Chelsea and Westminster recommends starting with 2 pumps per week. I don't know what 1 pump of Tostran looks like looks like but for example I use Testim which is half the strength of Tostran and apply a very small ( petit-pois sized) blob per day. Better to start low and slow.

Do have a look at the long-running thread on Testosterone in Private Lives section to read about others experiences or go to the home page and do a search re T and hair growth.

I apply to lower inner thighs next to knee, alternating between the two and yes I have hair growth on my thighs. T is tranpsorted through the skin not only into the bloodstream but laterally thought the skin. I gather there is genetic variation in how we respond to this and hair growth. Funnily enough I am someone with a thick head of hair on my head, but had sparse hair on my body ie arms legs and face - which may be due to some genetic difference in my endogenous (internally produced) testosterone - so maybe it has a more marked effect on my thighs than others.

My hair and nails are also dry and brittle - but then I'm getting on a bit 

I presume your oestrogen dose is high enough? Also interested to know how adding T will work with the progestogen from the Mirena which is testosterone derived. I have some info sonewhere on this I think although I think there is not enough research!

Good luck and do report back

Hurdity x

[Ljp]

Thanks Hurdity, I'm thinking to start with half a pump every other day maybe?
My oestrogen blood test was 565 in June this year and I was told it's good

[Hurdity]

Look - I'm not your gynae obvs but in your position I would start with a low dose from what I've read. Would be interested to see what half a pump looks like in terms of peas?! 

Could the Mirena coil be also contributing to brain fog and fatigue?

Hurdity x

[Ljp]

I'm just going to dispense a small blob lentil/ petite poi's I think, every other day mon,wed, fri and see if I notice anything.

Had mirena for nearly 4 years has worked well for me, brain fog not as bad as it was before HRT, and I guess fatigue is part of ageing, but if testosterone can improve my bladder and VA it will be worth it alone.

Gynae said if it works great, if it doesn't just come off it, so nothing to lose really, just don't want to dose too high

[Dotty]

https://thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/

This is recent information about testosterone written by Nick Panay. The recommended dose of Tostran is 1 pump every other day. X