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[Sfifties]

Hello everyone,
after the hardest couple of years of my life since going through the menopause , suffering without help then finally managing to get hrt and having bleeding for ages with consequent hospital checks and exams , i thought i could finally breathe.
I am 50, i have been told from my gp after a blood  test and no periods for over 2 years that i have “gone” through the menopause already so i guess i am post menopausal.
Initially was on 2 pumps of oestrogel and utrogestan, my levels were still quite low for estrogen so went up to 4 pumps which stopped hot flushes, sweats and palpitations .
My moods have never really recovered and i am still anxious generally and have very low moods but was very relieved about the stopping of main symptoms .
My testosterone level last year was 0.5 had no libido and no energy at all.
As i mostly wanted to save my marriage i asked for testosterone, i was prescribed testogel 40.5 and have been using one sachet to last 8 days , if occasionally I squeezed a bit too much i would then avoid application for the next night .
After a few months my testosterone levels were 1.3 and i felt better , and i have been continuing with the same dosage.
I am now in need of a new prescription and i was asked to do another blood test , which now shows my testosterone level 5.5 nmol/L.
How is that possible?
I have no symptoms apart from some hair growth on the application area, but nothing else apart from the good symptoms, more energy and libido back.
I have now been told to stop using it and will not get another prescription.
And possibly to do another test in a few days to see if levels go down to a safe , female range.
I have read posts that explain that what i need to have is also measurements of SHBG but my Gp hasn’t mentioned it , is it not something that has ever been included in my blood test reading , do i have to ask for it and would that make a difference?
I would love is someone can give me some advice ,i cannot find much info on high testosterone causes in menopause it seems not to be a common occurrence.
I am unsure of how to approach next blood test : i am so shocked about this 5.5 reading that if on one side i think i should stop straight away on the other i was thinking of using one more sachet  maybe making it last 10 days and then repeat the blood test as cannot think that something has gone wrong in that result.
Would it be wise to stop for a few days and then restarting it ?
I do not want to “mess up “ my body but really struggling to make a decision, Gp wasn’t helpful as only approach from her is to stop and that’s it.
Also i had applied testosterone the night before and had the blood test the following morning , should i have stopped using it for a day before the blood test , desperately trying to get why this reading is so high and if there’s anything that could have contributed to it .
Thank you in advance for any advice .

[meno-mel]

I'm sorry you are being taken off testosterone suddenly, I can't imagine that is the right way to do it, surely you should be weaned off it slowly or given a reduced dose if you are absorbing too much?
Even hot weather can increase absorption I believe.
I googled it and read two articles on how eating grapefruit produces a substance which converts testosterone to oestrogen, thereby raising oestrogen levels while reducing testosterone!
So eat a bucketful of grapefruit in the days before your next blood test, if there isn't a reason not to. Be aware grapefruit can interfere with other meds you might be taking, so check the info in any pill boxes.
I wish I could be more help, I'm going to ask for testosterone at my hrt appointment next week, I've never had a blood test for hormones, is it always done to check testosterone do you know?

[Sfifties]

Hi meno-mel ,
thanks for replying.
Interesting about grapefruit, didn’t know that.
Yes i believe that once you have a discussion about symptoms to start with , ex with low testosterone no energy , lack of libido and more the way to know if one will benefit from taking it is via a blood test that can tell you the levels in your blood and see if you are on the low side of it .
I don’t think that testosterone gets tested automatically every time oestrogen levels are checked , it is added by your gp should you need to know your levels .
Generally gp then prescribe it when they have confirmation with blood test.
Hope this help

[Hurdity]

Hi there - don't know about grapefruit - do you have a link to the study meno-mel? I know it contains something that reacts with some meds - my husband can't eat it now as it reacts with his BP meds.

However - re the T levels. It's a bit drastic to say come off it completely!  My personal view about the prescribed T doses for women is that they err on the high side and I have never taken 5 mg per day. I would always want to start lower for a few months, see how one gets on, get retested and then increase if necessary.

Unfortunately the new Testogel is approx 1 1/2 times as concentrated than the discontinued one meaning it is less easy to judge how much to use. I now use Testim which is 1 % and use a smal pea-sized blob and my libido, or should I say response, is as good as it ever was when I was young  .

The SHBG issue is interesting. Thinking seems to have changed on this as more information becomes available. I see from the BMS Tools for Clinicians now says that total T is the important parameter to measure and only to measure SHBG in certain circumstances - including if your SHBG is particualrly high or low. Of course you;re not going to know this unless it is measured, so it should be.

Do have a look at the BMS Tools for Clinicians. It's here - about half way down the list:

https://thebms.org.uk/publications/tools-for-clinicians/

The most sensible approach from your GP would have been to say reduce the amount you are using and we will retest after 3 months for example use a very tiny petit-pois sized blob and see how long the sachet lasts, or use an 1/8th of sachet every other day ( tapering off gradually).

If you can let your GP have this information so that you are both clued up, hopefully you can move forward. It is tricky though since it is prescribed off licence but the fact that yuou were prescribed it in the first place is a good sign.

Sorry I haven't time to peruse and summarise the BMS info at the moment - it has definitely changed from the previous version I had!

You're right that T is not tested automatically but should be tested periodically if you are taking it as part of hRT _ though mine hasnt been tested since way before covid - not even when they changed my prescription to Testim when I last requested the T (it lasts months) - I'm just on repeat!

Hope this helps and do ask if you need more help.

Hurdity x

[orrla]

Something is going on aboutctgese Testosterone prescriptions. I am reading here, each of you get different disage... I used it since 2015, no tests, one sachet per week..

Suddenly, soon after all these TV programmes, it was decreased to half if not less (confused by all shortages, different makes, etc.(.

It was doing me good. I felt best after many years, ..now I have energy similar to a dead cat..

For some reason, someone does not want women to feel good, or is trying to impose some standard, it's my conclusion..!?

[Sfifties]

Thanks for your reply Hurdity and Orria.
Hurdity may i ask if you know how long testosterone stays in your body?
So if my levels were 5.5 nmol with blood test taken last Thursday if i change my dosage would blood test shows a different reading already say in 2 weeks?

I have since i was first prescribed it moved abroad and so this is a different Gp and she has admitted that she’s not experienced in hrt but i am surprised as the advice she gave to stop immediately and have a blood test again next week was given to her from and endocrinologist (she called the hospital when saw reading so high).

My thinking is that as you suggested maybe do a blood test in 3 months but i do not have 3 months of gel left .
So to reassure her and myself , although she has said she will not prescribe it any more and i will have to see a specialist, i am trying to think when should i do a blood test that will show a decrease , do u think that using 2 sachets making them last say 24  days would give a different reading in as little as over 3 weeks?
I am really  in an awkward position as i do not know how to make her understand that stopping so suddenly might not be a good idea , but then when i get the next results i will have to admit that I haven’t stopped all together using the gel and that will be in my file and might go against me if future gp read that i continued using it against her advice .
Are you aware if there’s  any argument that supports not stopping suddenly testosterone ?
 i do not want to do a blood test too quickly in a few days if the body needs time ( not sure how long ) to adjust to the new dosage and that will be reflected in new blood test results.
Obviously i am very anxious now about possible effects i might get from having  had such a high amount in my blood , as mentioned earlier i got only the good symptoms from it ( libido back and more physical energy to exercise) bit i am extremely worried that my hair now might fall or i will start having some unpleasant effects .
I have stopped applying testosterone as was quite in a panic when she called   and if i start back on monday i would have had a 3 days break .
it’s so uncommon to have high readings like 5.5 in menopause that i am not finding much info at all.
Lastly should one not to apply any hrt in the 24 before a blood test?
In order to have any chances to be able to have it prescribed again by a specialist i need to make sure that the next blood test shows normal readings
hence all the questions and confusion in my head …

You have always been an incredible support and source of backed up and personal advice in this forum , so i thank you for  your advice as i am feeling a bit lost at the moment .