Testosterone is often thought of as a male hormone, but it’s crucial for women as well. According to the NHS, women produce three times more testosterone than oestrogen before menopause. Despite its importance, accessing testosterone as part of hormone replacement therapy (HRT) remains challenging for many women.
Women typically need a referral to an NHS menopause clinic or must opt for private healthcare to access testosterone HRT. Both options often come with long waiting lists, leaving many women to endure symptoms without relief. GPs are usually hesitant to prescribe male formulations off-label, and even if they do, these are not covered by the HRT pre-payment certificate.
NICE guidelines suggest considering testosterone supplementation for menopausal women with low sexual desire when HRT alone is ineffective. However, the use of testosterone for women remains off-label in the UK. This means that women are often prescribed testosterone formulations designed for men, which are not ideal. For instance, male testosterone gels come in single-dose sachets that are too potent for women, who only need about one-tenth of the dose. Dividing these sachets can lead to inaccurate dosing, posing risks of over- or underuse.
In contrast, Australia offers a female-approved testosterone preparation, making the process more efficient. In November 2020, the Australian Register of Therapeutic Goods approved AndroFeme® 1 for treating postmenopausal women with low sexual desire. This condition, known as hypoactive sexual desire dysfunction (HSDD), affects one in three Australian women aged 40-65. The figures are likely similar in the UK.
Michael Buckley, CEO of Lawley Pharmaceuticals (the makers of AndroFeme®), has expressed intentions to seek UK and European registration for the product. As of March 2024, Lawley Pharmaceuticals, through its UK partner Andro Pharmaceuticals Ltd, submitted a Marketing Authorisation Application for AndroFeme® cream to the MHRA. Although progress is slow and costly, this marks a step towards accessible and appropriate testosterone treatments for women in the UK.
Women face numerous debilitating symptoms during menopause. While some manage through lifestyle changes, others need medical intervention. More research is essential to understand female health better and to refine HRT dosages. Access to proven treatments like female-specific testosterone preparations must be prioritised. Our NHS, though overworked and underfunded, can benefit from governmental support to implement these changes for a healthier and more productive population.
Dr Louise Newson’s website and the Balance app offer valuable resources for tracking symptoms and managing hormone health, making it easier for doctors to provide accurate diagnoses and treatments. As always, consult a healthcare professional for personalised medical advice.
The Importance of Testosterone for Women
- Libido: Low testosterone can lead to HSDD, affecting sexual health and overall well-being. Testosterone supplementation has shown efficacy in addressing these issues.
- Cardiac Health: Research by Professor Susan Davis suggests that low testosterone levels in women over 70 double the risk of cardiac events, challenging the notion that testosterone is harmful to women’s hearts.
- Bone Health: Testosterone helps maintain bone density and strength, potentially reducing the risk of osteoporosis and fractures in later life.
- Muscle Mass and Strength: Testosterone supports muscle mass, which is crucial for maintaining strength and a healthy metabolism as women age.
- Neurological Benefits: Testosterone enhances cognitive function, mood stability, and overall energy levels, playing a role in mental sharpness and emotional well-being.
For further information about hormone replacement therapy, visit NHS – Hormone Replacement Therapy (HRT).
By addressing these challenges and making the necessary changes, we can hope for a future where women have better access to the treatments they need to lead healthier, happier lives.
