Hormone replacement therapy aims to replace estrogen to control the effects, both short and long term, of estrogen deficiency. In addition, for women who still have their womb, some form of progestogen is given to protect the womb lining from being stimulated by the estrogen. Some women also benefit from the replacement of testosterone, particularly those who experience premature ovarian failure, or have surgical removal of their ovaries, since our ovaries produce about 50% of our testosterone, the rest being produced from the adrenal glands. The lack of testosterone in women can cause fatigue, low mood and low libido.
Previously, women could be given testosterone in the form of a twice weekly patch or a six monthly implant and many found these preparations very helpful. Unfortunately, the patch has now been withdrawn from the market, and implants of both estrogen and testosterone are not readily available in the UK, although some clinics have been able to purchase them from America.
This has caused much concern, reducing treatment options for some women and the British Menopause Society are trying very hard to provide pressure on relevant organisations to improve the situation. Meanwhile, for postmenopausal women, the HRT tablet tibolone provides a combination of estrogen, progestogen and testosterone and is a very useful option for postmenopausal women who wish to take HRT and for whom low libido is a symptom. For women who require to use a separate form of testosterone along with HRT, several brands of testosterone gel are available. While they are only licensed for use in men, they can be used for women “off-license” under specialist supervision.
For more information see www.menopausematters.co.uk/testosterone.php