Could wearing a testosterone patch reignite women’s sex drive when the menopause strikes?  

Trials are about to begin in the UK with a testosterone patch to boost the sex drive of menopausal women. Here, Rachel Ellis assesses how important this patch can be to women’s well-being.

What is the role of testosterone in women?

Many consider testosterone to be just a male sex hormone, but it is also very important for women.

It plays a role in maintaining a woman’s libido and energy levels, improves mood, sleep and keeps bones healthy. In women, testosterone is produced in the ovaries and adrenal glands (while in men it is produced in the testes).

Do women’s levels change over time?

“Levels peak in women in their mid-twenties and start to fall from the thirties,” says Dr Haitham Hamoda, gynecologist and menopause leader at King’s College Hospital, London, and former president of the British Menopause Society.

“Unless a woman is experiencing symptoms of a low sex drive that doesn’t improve with estrogen treatment, we wouldn’t check her testosterone levels.”

There is no “normal” testosterone level for women, but they generally have “about a tenth of the testosterone level that men have,” explains Dr. Hamoda.

What Effects Can Low Testosterone Have?

It can cause a low sex drive in some women – and this is a common symptom of menopause.

However, not all menopausal women experience this, and a low sex drive can be linked to other factors, including illness, medication, and relationship problems.

Testosterone is a treatment approved by the National Institute for Health and Care Excellence for women with low libido if HRT does not relieve the problem.

‘For a significant proportion of women going through menopause, testosterone has a beneficial effect on sex drive,’ says Dr Hamoda.

“However, we don’t yet know if testosterone also has a beneficial effect on energy levels, mood, sleep and bone health, and it’s not approved to treat these issues.” Further research is needed to evaluate this.’

Is it available to women on the NHS?

There is currently no licensed testosterone product specifically for women in the UK. There are three testosterone gels licensed for men: Tostran, Testim, and Testogel, which are rubbed on the skin daily. These can be prescribed to women with low libido – both on the NHS and privately – under the supervision of a specialist and prescribed by a GP.

However, access to the treatment can be sketchy as some NHS GPs feel uncomfortable or reluctant to prescribe it, possibly because it is approved for men, or because they are restricted by local prescribing guidelines.

‘Some NHS GPs don’t prescribe it until a specialist doctor has decided it’s the right treatment for the woman,’ says Dr Hamoda.

‘A testosterone patch for women would be a welcome addition in the UK. A preparation specially made for them would be more reassuring.’

It is not known how many women are currently on testosterone therapy in the UK.

Is it available privately and what is the cost?

Testosterone gel is available on the NHS and privately for around £80 for a six month supply. To get it private, you have to pay for a consultation with a private doctor who can do a blood test to check your testosterone levels.

Can men have the same treatment?

Yes, the three testosterone gels currently available for women in this country are made for use by men. This can make it difficult for women to estimate the dose they need (for example, women will need to take a small portion of a sachet as advised by their doctor).

‘Doses are normally around 5mg per day for women – ten times lower than the typical 50mg per day for men,’ says Dr Hamoda.

Testosterone deficiency in men is referred to by some as “male menopause,” but it’s a controversial topic, with some experts saying it’s a big deal while others question its existence.

Yet Superdrug Online Doctor, for example, has seen a consistent increase in demand for its male testosterone testing and treatment service, which launched in 2019. In the last 12 months, the number of orders for this service has increased by 190 percent.

What is the benefit of the new patch?

The new patch will do the same job as the gels currently available. However, since it’s formulated for women, you don’t have to worry about how much gel to apply. ‘The patch is also a convenient way to get testosterone, like estrogen patches often used with HRT,’ says Dr Hamoda.

Is it the first testosterone patch for women?

No, another testosterone patch for women called Intrinsa was developed and made available on the NHS in 2007.

However, this was withdrawn about ten years ago for commercial reasons. In the US it was never approved due to insufficient data.

A new female testosterone cream, AndroFeme, was recently licensed in Australia but is not currently approved in the UK, although it can be imported for private use under a special license from the drug regulator, the Medicines and Healthcare products Regulatory Authority (MHRA).

When could the new patch be available?

The new testosterone patch for women with ‘low libido and diminished enjoyment of life due to menopause’ is being developed by a company affiliated with the University of Warwick. David Haddleton, a chemistry professor who is leading the research, says trials of the new patch will begin in the fall (2023).

He said: ‘The work we do is not just theoretical, but focuses on a problem that women face, which can drastically affect their daily lives and work.

“This could produce a product that is much needed and simply not available.” But even if the trials are successful, it will likely be several years before the patches are widely available.

Are there any side effects to taking testosterone?

‘In general, testosterone treatment is very safe and side effects in women are rare,’ says Dr Hamoda.

“However, as with all androgen (male sex hormone) treatments, there are potential side effects, including acne, excessive hair growth, and thinning hair, but these tend to occur when taking higher doses of testosterone.

“You would have to take a lot over a long period of time to experience this one.” Taking slightly more than the recommended dose is not likely to cause any problems.”

My libido returned – but my husband said it made me irritable

Writer Louise Atkinson, 58, lives in Oxfordshire with husband Jon, 59, and has three children in their 20s. She says:

When I started taking Testosterone I felt the benefits almost overnight. My mood swings, anxiety, and brain fog disappeared and I felt like I had the energy and strength I had ten years ago again.

Admittedly, I started taking the testosterone gel alongside estrogen and progesterone as part of an HRT pack when my menopause started to hit in my late 40s.

At the time, GPs were reluctant to offer HRT because of fears of an increased risk of breast cancer, which was subsequently debunked. The private gynecologist I consulted handed me the same three-for-one pre-printed prescription he gave to all his mid-life patients, insisting that testosterone was an important part of the hormone mix and that it would improve my focus, drive and flags libido.

The combination left me feeling refreshed, and friends (particularly those not on HRT) were jealous of my testosterone boost.

The problem was getting it. When the NICE guidelines changed in 2015, my GP was happy to honor the estrogen and progesterone parts of my HRT prescription, but refused to add testosterone. She told me it wasn’t properly tested on women and made me feel like I was asking for illegal party drugs.

I had to come back for a private consultation (£350) and another blood test (£350) to secure a six-month supply of testosterone gel, which cost around £50 at the time.

After about five years I stopped renewing the prescription – I didn’t feel I could justify the cost – and noticed my personality softening (my husband thought I was more fun to be around. He said that testosterone made me irritable at times).

Interestingly, I lost all desire to keep up with the extreme yoga and handstand classes I’d been sticking to each week.

I also got lazier and got a middle-aged belly. But about two years ago the lack of energy and drive, and libido, sent me looking for another private GP who was willing to give me a private testosterone prescription (£150 for the consultation) on the condition that I have regular blood tests cared about my levels. The six month prescription costs around £80.

I did notice that my energy levels and libido came back up quickly, but testosterone gel is formulated for men, in amounts far greater than women need, so you have to squeeze a small dot out of a sachet and put it into the skin every second or third day to rub . It’s really clunky and imprecise. Eventually I let my supply dwindle.

As I get closer to 60 I enjoy a more leisurely pace of life and I’m not sure if the energy and easily accessible libido testosterone is best for marital harmony when your partner’s natural levels of the hormone decline.

That said, I would be interested in a low-dose patch if it could steadily release a small amount of this important hormone. But only if my husband could have one too!