TESTOSTERONE can be added for symptoms of low sex drive provided there is no other cause for low sex drive and it has not been helped with HRT.

Women should be treated for vaginal dryness and soreness with vaginal oestrogen first before adding testosterone as this can be a cause of painful sex and contribute to low sex drive.

Oral Estrogen increases level of a protein called Sex hormone binding globulin.

(SHBG) which binds to testosterone. This results in less amount of free testosterone which can reduce sex drive.

Before starting Testosterone ,women should have their HRT changed from oral therapy to patches/gel or spray to see if this improves sex drive.

Investigations

Before starting testosterone blood tests are done for testosterone levels to check levels are not high and this is repeated 3 months later and thereafter every 6-12 months to check levels are in the normal premenopausal range.

Testosterone preparations

Testosterone preparations in UK are unlicensed. Testosterone preparations such as Testim gel 1% ( tube) or Testogel sachets 1% used by men can be prescribed on the NHS in lower doses for women (unlicensed use).

AndroFeme 1 cream is licensed for use for women in Australia and is imported in UK therefore unlicensed. This can be prescribed on a private prescription. There is no extra charge for a private prescription if it is issued at the same time as the consultation, you only pay the pharmacy for the price of the medication.

There is anecdotal evidence that Testosterone also improves cognition, brain fog, fatigue, mood, bone density and muscle strength.

If sex drive has not improved in 3-6 months treatment should be stopped.

Side effects of Testosterone

These are uncommon : increase hair growth on face and acne is seen in 2% of cases . Testosterone replacement can cause weight gain in some. Other side effects such as male pattern hair loss and hoarseness of voice (irreversible side effect) are rare (5%). If you develop hair loss or hoarseness of voice treatment should be discontinued.

Safety of Testosterone

More data is required on long term effects of Testosterone, but short term data we have on bone , heart and breast so far is reassuring.

Further information on Testosterone can be accessed at Further information on Testosterone can be accessed at https://www.womens-health-concern.org/wp-content/uploads/2022/12/22-WHC-FACTSHEET-Testosterone-for-women-NOV2022-B.pdf