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Sarah Vine: should we be taking testosterone for menopause?

October 18th 2016 / Sarah Vine Google+ Sarah Vine

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A leading gynaecologist is calling for testosterone to be given to menopausal women; why not, if it boosts energy, libido and bone density - and combats middle-aged spread? Sarah Vine books an appointment

The menopause seems to be having a bit of a moment. I wouldn’t quite describe it as fashionable; but it’s not the taboo subject it used to be.

Why is not clear. Perhaps it’s a side-effect of feminism, in that more and more women of a certain age find themselves in positions of influence, and therefore the topic takes on a certain degree of heat.

After all, if young women like Amy Schumer can bang on endlessly about periods, it only seems fair that those of us at the other end of that particular biological conveyer belt should be allowed to discuss our stuff too.

Anyway, fact remains that last week the menopause got itself a two-day nutrition special in the Daily Mail before landing itself a bona fide news story in the shape of a comment made by Nicholas Panay, Britain’s most eminent gynaecologist and a specialist in this field.

Panay is THE man to see if you've got a bit of a hot flush going on. He’s also the man who recently captured the imagination of the nation’s headline writers when, earlier this month, he told a GP’s conference that adding testosterone to traditional HRT could help boost flagging libido in women.

The resulting coverage was excitable to say the least (one suspects that most national news editors are middle aged men with vested interests in this field). Which was somewhat surprising, since it wasn’t the first time Panay - or for that matter other experts in the field - has highlighted the positive effects of testosterone in dampening the effect of the menopause.

Testosterone is generally associated with hirsute, somewhat pungent, young men. In fact your average teenage girl produces almost as much as a boy - only in females an enzyme called aromatase converts it into oestrogen. When our hormone levels fall overall as a result of the menopause, testosterone drops off too - by roughly 50 per cent.

This contributes to the striking loss of energy and enthusiasm for life that many menopausal women experience, as well as a the aforementioned lack of interest in sex.

The most prominent advocate of taking testosterone is probably Jane Fonda, who credits supplements of the hormone with restoring her libido. And you can bet your bottom dollar that the likes of Sharon Stone and Madonna are on the stuff too.

But testosterone isn’t just about sex. It has been clinically proven to also help restore bone density and combat the dreaded middle-aged spread (after all, testosterone is the reason men’s muscles are larger and their bones denser and why men are far less likely to get osteoporosis).

It can even improve cognitive function: in 2013 a study found that post-menopausal women who were given a testosterone supplement showed improved memory function and greater verbal skills.

Oh, and one more advantage: it protect against cardiac disease and breast cancer. In fact - and this is important - when used in conjunction with conventional HRT, which carries a slightly elevated risk of triggering breast cancer, the addition of testosterone appears to cut that risk significantly.

Given all that, why did Panay’s comments come as such a surprise to the wider world? Why aren’t women already being given testosterone as part as their overall treatment during menopause? Surely an easily obtainable hormone with such clear beneficial effects should be provided as standard?

Well, that is the problem. No one prescribes it. The whole reason Panay mentioned testosterone in his speech to the GPs is because awareness of the benefits of testosterone in female HRT is very low; not only that, the only company providing patches for use in women ceased production for the UK market in 2012. Why? Not cost-effective enough. So even if you did manage to persuade your GP of the benefits, you wouldn't actually be able to get it.

If Panay is right, a sea-change in treatment policy would seem long overdue. As luck would have it, I have a long-awaited personal appointment with the man himself next Monday. I look forward to finding out more.

Read Sarah's menopause diary and her experience of HRT

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