A Saga Magazine reader asks Dr Mark whether they should be prescribed testosterone in addition to HRT.
Q. Why would a menopausal woman be prescribed testosterone in addition to conventional HRT? I understand the rationale of adding back in missing female hormones, but why a male one?
The reason I ask is because I have met a few women who are taking it and they have all said that they feel so much better.
Am I missing out?
Testosterone is not widely used in HRT. Women also produce the male hormone, albeit at much lower levels than men and, as happens in both sexes, levels tend to drop as they get older.
Conventional HRT, taken by the majority of women, is based on replacing the missing female hormone oestrogen (along with progesterone-type additives to protect the womb where required) as this is typically all that is needed. However, low dose testosterone may be added in for some women complaining of a low sex drive (libido) despite taking normal oestrogen-based HRT.
Testosterone should boost libido, and many women report other benefits too, such as extra energy and improved mood, but these are less clear cut in published research.
And testosterone supplementation needs to be prescribed with care as side effects can include weight gain, acne and excess hair growth (such as on the face).
As with all types of HRT, it is all about tailoring the regime to the needs of the individual – something that often requires a GP/specialist with a particular interest in the menopause.
Or, to put it another way, think of HRT regimes like dresses – what looks great on one woman may not suit another.
For more information on the use of testosterone replacement in the menopause, visit thebms.org.uk
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