Testosterone is a useful and increasingly popular treatment as part of hormone replacement therapy (HRT). It is available as either testosterone gel or testosterone cream – both work well and have their advantages.
Find what you need quickly
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When to use testosterone during menopause
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Which kinds of testosterone are available for women?
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Should you choose testosterone gel or testosterone cream for menopause?
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How to use testosterone gel and cream
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Where should you apply testosterone gel or cream?
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How long does it take for testosterone gel or cream to work?
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Final word
When to use testosterone during menopause
Testosterone can be a really useful addition to your HRT treatment. It’s been proven to help those with hypoactive sexual desire disorder (HSDD), also known as low libido. A 2017 paper found that women with HSDD who took testosterone had greater satisfaction with sex, more orgasms and a higher sex drive. Sounds good, right?
But sexuality is a complex subject and can be affected by many different factors. For this reason, your doctor will explore all of the different possible causes of your symptoms before starting testosterone. These can include depression and relationship difficulties as well as physical problems like incontinence, vaginal prolapse or other vaginal discomfort (including GSM).
They may then recommend a trial of testosterone. This usually happens after you have been on conventional HRT – containing oestrogen and sometimes progesterone too – for at least three months.
Which kinds of testosterone are available for women?
Testosterone for women can be prescribed in a number of different forms, all of which involve applying the product to your skin. The testosterone is then absorbed directly into your bloodstream. Be aware that different products come with different concentrations of testosterone, so you need to follow your doctor’s instructions carefully to ensure the right dose.
Testosterone implants are also available, but are used much less often. These are little pellets that sit under your skin for six months and slowly release testosterone over this time.
Testosterone gel for women
Testosterone gel is used as part of HRT to treat low libido. Brands available include Tostran and Testogel. In the UK, these are commonly prescribed on the NHS and are also available privately.
These products are all used off-label for menopause and low libido. This means that although they may have been officially approved to treat certain groups of patients or conditions, they are not currently licensed to treat menopause symptoms. This is common practice in medicine, and happens in most specialties. It simply means that a doctor needs to have sufficient knowledge and training to be able to recommend the off-label treatment.
In this case, the testosterone gels prescribed for women are actually intended for use by men with low testosterone levels.
What does off-label mean?
It’s important to follow your doctor’s instructions when something is prescribed off-label as the dose is likely to be different to that listed on the product information sheet. For instance, women using testosterone gel will generally need to take a much lower dose than men who have been prescribed the same medication.
Testosterone cream for women
Androfeme is a testosterone cream designed specifically for women during menopause. It has a lower concentration of testosterone compared with the testosterone gels currently available.
Androfeme is currently licensed in Australia, but not in the UK. This means that it needs to be imported under a special regulatory license and then prescribed privately. It is not available on the NHS.
Should you choose testosterone gel or testosterone cream for menopause?
Testosterone gel and cream both work in the same way, and many women are happy with both medications. Read on for things to consider…
Application
Testosterone gel can be more awkward to apply, as you need to gradually use one sachet over the course of a week. Androfeme cream is more convenient as it comes with an applicator designed to help you apply doses appropriate for women.
Availability
Androfeme is imported and you might find it more difficult to obtain in your local area. Testosterone gel is generally easy to find.
Price
Testosterone gel is available on the NHS and costs the standard prescription charge. You may also be eligible for free prescriptions, or be able to take advantage of a prepayment certificate. Androfeme is only available privately and costs around £90 per tube.
Allergies
If you have any specific allergies, you should also check the ingredients of each product. Androfeme contains almond oil so is not suitable for those with an almond allergy.
If you still aren’t sure what to choose, ask your doctor for their advice.
How to use testosterone gel and cream
Follow your doctor’s instructions on how much product to apply. In general:
- Gently rub the product onto clean, dry skin
- Wait until the product is dry before getting dressed – this usually takes about 30 seconds
- Wash your hands afterwards
- Wait at least 30 minutes before getting your skin wet
- Don’t use any moisturisers, perfumes or body care products on the area where you apply your testosterone
For more details, check your pack leaflet.
Where should you apply testosterone gel or cream?
To apply your testosterone gel or cream:
- Choose a hairless area of skin – usually your buttocks or upper outer thighs
- Regularly change the place where you apply the gel or cream
- Avoid damaged areas of skin – for example, if you have skin conditions like eczema or psoriasis
How long does it take for testosterone gel or cream to work?
It can take several months for the benefits of testosterone to really kick in, just like with other forms of HRT. The British Menopause Society advises that it can take three to six months to tell how well you are responding to treatment.
If things aren’t improving by this point, it’s worth checking in with your doctor. They may advise:
- Increasing your dose
- Changing your HRT, such as switching from a pill to a patch
- Re-evaluating your symptoms or looking for an alternative cause
Find out more about what to do if your HRT is not working for you.
Final word
Testosterone gel and cream are both useful treatment options for women in menopause who are struggling with low libido and other sexual difficulties.
We offer testosterone as part of our clinical services. Email hello@onstella.com if you want to find out more.
Find out more about menopause on our blog or in our symptoms library.
- Achilli C, Pundir J, Ramanathan P, Sabatini L, Hamoda H, Panay N. 2017 Feb Efficacy and safety of transdermal testosterone in postmenopausal women with hypoactive sexual desire disorder: a systematic review and meta-analysis. Vol. 107, no. 2, pp. 475-482.
- Bolour, S., Braunstein, G. 2005 Testosterone therapy in women: a review. Int J Impot Res Vol. 17, pp. 399–408
- British Menopause Society, 2022 Testosterone replacement in menopause.
- National Institute for Health and Care Excellence 2019 Menopause: diagnosis and management (NICE Guideline 23).
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