Before I entered my early 40s, I wouldn’t have described myself as an anxious person. My outlook was almost always positive and I could easily rationalise the few worries I did have.
But then I hit perimenopause and the clouds began to descend. I started to overthink things and catastrophise.
The person who hadn’t replied to my text wasn’t simply busy, but horribly upset with me because I’d done something wrong. My husband wasn’t late because he was held up at the office, he’d been in a car accident. You get the picture.
I had palpitations, felt breathless and was so fearful of developing a heart condition, like my late mum, I had an echocardiogram to check it.
It couldn’t go on, and at 43 I was advised to start hormone replacement therapy (HRT). It helped clear the cloud of low mood, but it didn’t do much for the brain fog.
As a mum of three, the to-do list is as long as my arm, and I was forgetting half of it. I still wasn’t sleeping well and, having been very sociable, I was cancelling and making excuses not to see people. My usually healthy libido took a nosedive, too.
Meanwhile, all around me women were singing the praises of traditional HRT and an added element that, they said, could blast away my midlife malaise.
We think of testosterone as a ‘male hormone’, but women have plenty of it, too – at least until they hit middle age and it starts a precipitous decline.
Between 8,000-10,000 women are prescribed testosterone on the NHS, an increase since 2015 but still a tiny proportion of the 14 million over 50.
I hit perimenopause and the clouds began to descend. I started to overthink things and catastrophise, writes Georgina Fuller
Under NICE guidelines, it can only be considered for menopausal women with low libido – and that’s essentially the only condition GPs will prescribe it for. So, like many, I registered at a private clinic, Newson Health in Stratford-upon-Avon run by menopause expert Dr Louise Newson.
After filling in a questionnaire about my symptoms, I had a blood test which found my testosterone levels were slap bang in the middle of normal but could stand to be boosted. The average for a woman my age – I’m now 48 – are 0.5 to 2.4 nmol/L and mine was 1.26 nmol/L.
After a consultation, I walked out of the clinic with a prescription for Testogel, which is technically meant for men and given to them on the NHS but is prescribed to women privately at much lower doses.
I also discussed Androfeme, a body-identical testosterone cream designed for women, recently approved for UK use by the Medicines and Healthcare products Regulatory Agency but only available privately.
I opted for the Testogel, mostly because it was a bit cheaper than the Androfeme (just under £37 for 12 weeks compared with £115 for 12 weeks). I’m told the only other differences are the texture (Androfeme is a cream) and that you can measure the dosage more accurately with Androfeme, which comes with a small syringe.
I was instructed to take 0.5 mg daily alongside my normal HRT (oestrogel, a transdermal oestrogen gel, plus progesterone tablets), but I found it tricky to measure out the ‘pea size’ dose since the gel is translucent and comes in a fiddly foil sachet that you apply to your thigh.
She registered at a private clinic, Newson Health in Stratford-upon-Avon, run by menopause expert Dr Louise Newson
After a consultation, Georgina tried Testogel, which is technically meant for men and given to them on the NHS but is prescribed to women privately at much lower doses
While Testogel gave me an immediate boost (my skin looked and felt better and less prone to the rosacea that flared up during perimenopause), I had some concerns. A few months after I started it, when I went to have my brows done, I was asked if I wanted my top lip hair removed, too.
I’ve never had any facial hair before but – horror – there they were, a few stray hairs by my mouth. Had I been using too much? I also put on a few pounds during that time, less than half a stone.
After losing confidence and stopping and starting Testogel over a period of about 12 months, I decided to switch to Androfeme (at the same dose, which you can calibrate far more easily than with Testogel), and this time it’s been truly life enhancing. The biggest difference has been the reduction in those ‘what did I come into this room for?’ moments.
Before Androfeme, I would often lose my train of thought mid-conversation or forget my words. To be honest, I was starting to lose confidence in myself and my cognitive abilities. But within a few months, my mind and memory snapped back to their sharpness.
I managed my home logistics better than ever and my sleep improved. I find it easier to wind down at the end of the day – I’m taking magnesium, too – and nod off quicker. That’s not to say I don’t still wake up in the middle of the night with my mind racing, but overall things are much better.
She then decided to switch to Androfeme (at the same dose, which can be calibrated far more easily than with Testogel), which she says has been truly life enhancing
The other matter is my libido. I’m not going to go into that too much because my husband, Dom, is more private than me, but let’s just say things have improved on that score, too.
It’s also reignited my latent, er, admiration for attractive blokes, much to my children’s dismay. Watching The Summer I Turned Pretty, I couldn’t help but swoon over the young, floppy-haired Conrad and don’t get me started on Jacob Elordi in Wuthering Heights.
The burning desire for Heathcliff wasn’t just coming from Cathy. Yes, I know I am old enough to be his mum but I can still admire from afar, can’t I?
Historically, of course, the problem with testosterone for women has been the undesirable side-effects it’s been thought to cause with anything other than very low doses (weight gain, hair loss, facial hair, deepening voice). I can understand why the idea of it scares some.
The British Menopause Society said in 2024: ‘The only current evidence-based factual indication for the addition of testosterone to standard HRT, is for persistent low libido in postmenopausal women, after all other contributory factors have been addressed. There is no evidence to support claims that testosterone will help with other symptoms associated with menopause or prevent bone loss or dementia.’
But Dr Newson, who attracted controversy for prescribing high dose HRT, points out it’s been available to women since the 1940s for heavy or painful periods, premenstrual symptoms and the menopause, and that it ‘helps the mitochondria, the powerhouse of all our cells’. ‘It can also help reduce inflammation, which is linked to a list of neurodegenerative diseases, including dementia, Parkinson’s, depression and schizophrenia,’ she says. It has other, less known benefits, too, such as improvements in tinnitus symptoms, recurrent urinary tract infections and pelvic pain.
I tell her I’ve had an improvement in the dry eyes I’ve had over the last five years or so as a result of staring at a screen all day. By the end of the working day, my eyes would usually be itchy and sore. I’ve tried eye drops and got a new pair of glasses but nothing helped until I started testosterone. Could the improvement be down to that? Apparently so.
‘We’ve got testosterone receptors in our eyes, including the lacrimal gland that produces tears. The testosterone acts as a sort of lubricant so the cornea and the lens feel less dry.’
So while Androfeme is more expensive than Testogel, it has been a worthwhile investment. Whether you’re head of a multi-million-pound corporation or an incredibly busy mum of three (or both), women shouldn’t assume testosterone isn’t for them.
You can’t put a price on improving your abilities in both the boardroom and the bedroom, after all.