© 2023 Willow Health
Testosterone plays an important role when it comes to menopause symptoms. Although not licensed in the UK (yet), it is commonly prescribed by menopause specialists due to evidence of benefit with lack of libido.
Androgens, such as Testosterone play a vital role in sexual desire and sexual response.
In women, we have a natural gradual decline in testosterone from our 30s, when our ovarian function declines. However, in those that have had a sudden menopause, due to the ovaries being removed or chemotherapy for example, testosterone will sharply decline.
This fall in testosterone can lead to reduced libido (sex drive), reduced sexual responsiveness and ability to orgasm. Some women also notice reduced energy and brain fog.
Not all women with low testosterone will have symptoms.
HSSD is when you have a complete lack of interest in sex for > 6 months, that is affecting your relationship or your own wellbeing.
It often has multiple factors contributing, which is why it is so important to have an in-depth discussion with your specialist about sex.
There is good evidence showing that testosterone replacement is effective in women with low libido. The studies to date (randomised clinical trials) have not shown a beneficial effect for testosterone replacement for cognition, mood, energy and musculoskeletal health. However, some women report an improvement in these symptoms.
More studies are required to look at the long term effects on our cardiovascular and breast health, however the short term data we have is reassuring.
Side effects of testosterone replacement in women is uncommon, if the blood levels are maintained within the right level for a female. This is why we would need to offer a blood test to check testosterone levels before treatment and at 3 months, 6 months and annually, if you continue with replacement.
The commonest side effects include excess hair growth (on the skin where testosterone applied), acne and weight gain. These usually are reversible with reducing the dose or stopping the testosterone.
There are rare side effects of testosterone replacement which include alopecia (hair falling out), deepening of voice and enlargement of the clitoris.
The current UK guidance recommend testosterone replacement if you have severely reduced libido (Hypoactive Sexual Desire Disorder). NICE guidance and the British Menopause Society (BMS) recommend that a trial of conventional HRT is given prior to considering testosterone replacement.
we follow BMS guidance and prescribe testosterone replacement for reduced libido, for our patients already on HRT. It is quite common to need some tweaking of your HRT prior to trialling testosterone.
In our testosterone consultations, we explore all aspects impacting libido and come up with a personalised plan, including a prescription and lifestyle plan.
30 min consultation (face to face or virtual)
£150, including prescription fee
30 min consultation face to face, including blood taking (phlebotomy)
£100, including prescription and phlebotomy fee
15 min virtual consultation
£75, including prescription fee
Testosterone replacement requires regular blood monitoring at 3 month, 12 months and then annually thereafter. This will be a requirement for ongoing prescriptions from Willow. Blood tests can be carried out at the time of your face to face appointment, or we can arrange for you to visit your nearest Nationwide Pathology phlebotomy clinic where there will be a phlebotomy fee of around £30.
© 2023 Willow Health