Testosterone Quick Start Consultation

Minter et Al is pleased to offer testosterone quick start appointments for those patients who are already prescribed HRT. Read more about these consultations below and book your consultation. 

Book your Consultation

Testosterone for Women

Testosterone is a female hormone which is produced in the ovaries and adrenal glands. Testosterone plays a significant role in sexual function and can also improve self esteem, energy, mood and emotions with its application in women (Source: Lawley 2020). It also helps maintain muscle and bone strength. 

The National Institute for Health and Care Excellence (NICE) guidelines support prescribing of testosterone in women with low libido (sex drive) if HRT alone is not helping.

Testosterone replacement can be applied as a cream or transdermal gel (through the skin into the blood). Prescribing testosterone within the the NHS is classified as ‘off licence’ as Testogel and Testim are both male formula which have been adapted for use with women.  It comes in 50mg sachets (women need a 1/10 of this dose) therefore it can be fiddly and inexact to apply via this regimen.  

The female formula we prescribe comes in a tube with an applicator, which makes it easy to apply a more accurate dose. The tube lasts 100 days. Androfeme (female testosterone formula) is made and licensed in Australia for women. It cannot be prescribed by the NHS but can be prescribed privately. It is imported under MHRA permit for unmet clinical need.

We find in clinical practice when checking our patients symptom checker survey scores, that some women report their symptoms have improved with the addition of testosterone to their HRT regime. Anecdotally some women find it is the missing piece of the puzzle. Equally, for some women, they may do a six-month trial and find no benefit and therefore stop taking testosterone. 

Women who have had a surgically induced menopause (removal of uterus and ovaries) will experience a sudden drop in all hormone levels, including testosterone, so could be more sensitive to changes in testosterone levels. Also women with premature ovarian insufficiency may notice the symptoms of testosterone deficiency more acutely. 

Baseline blood tests should be taken prior to starting testosterone replacement treatment to register their baseline, then again in three months to maintain the physiological concentration for women.  Follow-up reviews for repeat prescriptions will be conducted with blood tests (testosterone and SHBG) after month three and six of treatment. It is important that monitoring continues every 6 – 12 months to ensure that levels remain within the female physiological range.  Total testosterone and sex hormone binding globulin (SHBG) together can be used to calculate free androgen index. 

Pharmaceutical testosterone is produced using soya or wild yam substrates. 

This consultation is only suitable for women currently taking hormone replacement therapy. 

If you are not on HRT already please book a consultation here: Booking A Consultation.  

We can discuss and initiate HRT and testosterone can be prescribed at your follow up consultation if indicated. 

​The current NICE guidelines stipulate testosterone can only be prescribed in conjunction with HRT. 

  • Initial consultation Fee: £115 for 30 mins consultation if already on established HRT 
  • Blood test for testosterone and SHBG: £135
  • ​Follow up appointments: £115

We highly recommend that you have your thyroid and B12 checked with blood tests in the last year as there can be very similar symptoms.  You can see your GP for this if you wish.  For those experiencing tiredness and fatigue this would be an indication for your GP to check your routine blood tests full blood count, urea and electrolytes, liver function tests, HBA1c and include thyroid and B12.  You can ask your GP to check your testosterone and SHBG as well.  They may decline this, as some clinicians understandably, will not request blood tests that they do not know how to interpret. 

If you have any issues with getting blood tests we can organise them for you after your consultation.  We have a nurse at home service that can organise blood tests anywhere in the country within a few weeks of our request.

The full profile that checks full blood count, urea and electrolytes, liver function tests, HBA1c and include thyroid, B12, Oestradiol, testosterone, SHBG and Vitamin D costs £285.  For more information see our Tests

If you ask your GP to check your routine blood tests and we need to check your testosterone and SHBG the home visit nurse service is £135. ​

The usual starting dose is 0.5 mL of cream by measured applicator per day.  Always apply Androfeme directly onto clean, dry, healthy skin of either the lower torso or the upper outer thigh.  Massage the cream into the area until absorbed.Typically this takes about 30 seconds. No perfume, deodorant or moisturising creams / gels should be used on the area because this may interfere with Androfeme from being absorbed.  Never apply the cream to broken or damaged skin.

Androfeme cream should be applied at approximately the same time each day.  It is recommended that patients do not swim or shower until at least one hour after application of Androfeme  cream. Close skin contact with the area of application within an hour of application, by a partner or children should be avoided. This may result in the partner or child absorbing some testosterone through the skin contact. Cover the application area with clothing once applied.

Rinse the applicator in hot water after use and replace in box with Androfeme cream ready for the next day’s application.  Wash your hands thoroughly with soap and water after applying the cream.

If you forget to apply your cream, you should apply it as soon as you remember provided this is within 9 hours of your usual time of application.  Otherwise do not apply the cream until the next application Is due. Missing a dose will not create an undue disruption to your treatment.

Because of the way Androfeme is used, an unintentional overdose is unlikely. If you think that you or anyone else may have used too much Androfeme immediately telephone your clinician or the local Poisons Information Centre for advice or call 111.

Keep the tube in a cool dry place where the temperature stays below 25°C.

Using the Androfeme syringe to apply testosterone PDF booklet

Balance menopause PDF testosterone Layout 1 (balance-menopause.com)

Balance menopause : how to apply androfeme cream How to apply Androfeme testosterone cream – YouTube

  • Low libido
  • Weight gain
  • Loss of focus
  • Anxiety
  • Depression
  • Muscle pain
  • Memory loss
  • Migraine headaches
  • Sugar cravings
  • Fatigue
  • Belly fat

Source: Angela De Rosa – European Menopause Society Conference 2023

Current Guidance 

The British Menopause Society current guidance is that testosterone supplementation should only be considered in women who complain of low sexual desire after a biopsychosocial approach has excluded other causes such as relationship, psychological and medication related HSDD (Hypoactive Sexual Desire Dysfunction) e.g. medications like SSRIs/SNRIs.

The World Health Organisation International Classification of Disease (ICD-11) definition for HSDD (updated in 2018) states:  Hypoactive Sexual Desire Dysfunction is characterised by absence of marked reduction in desire of motivation to engage in sexual activity as marked reduction in desire of motivation to engage in sexual activity as manifested by any of the following: manifested by any of the following:​

  1. reduced or absent spontaneous desire (sexual thoughts  or fantasies)
  2. reduced or absent responsive desire to erotic cues and stimulations: or stimulations: or
  3. inability to sustain desire or interest in sexual activity once initiated. initiated.

The pattern of diminished or absent spontaneous or responsive desire or inability to sustain desire or interest in sexual activity has occurred episodically or persistently over a period at least several month and is associated with clinically significant distress.

Results can be discussed with your health care provider.

Each question is answered Yes or No.

  1. In the past, was your level of sexual desire or interest good and satisfying to you? Yes/ No
  2. Has there been a decrease in your level of sexual desire or interest? Yes/ No
  3. Are you bothered by your decreased level of sexual desire or interest? Yes/ No
  4. Would you like your level of sexual desire or interest to increase? Yes/ No
  5. Please mark all the factors that you feel may be contributing to your current decrease in sexual desire or interest:
    • An operation, depression, injuries, or other medical condition Yes/ No
    • Medications, drugs, or alcohol you are currently taking Yes/ No
    • Pregnancy, recent childbirth, or menopausal symptoms Yes/ No
    • Other sexual issues you may be having (pain, decreased arousal, or orgasm) Yes/ No
    • Your partner’s sexual problems Yes/ No
    • Dissatisfaction with your relationship or partner Yes/ No
    • Stress or fatigue Yes/ No