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According to a consultant, some women in Wales have been resorting to posing as men to purchase testosterone from online pharmacies because they face difficulties obtaining NHS prescriptions. Dr Michelle Olver, a menopause specialist, highlighted a significant rise in NHS referrals for testosterone treatment among post-menopausal women, although access to the hormone varies across different health boards. She reported seeing patients who had taken testosterone at levels up to 12 times higher than the safe limit due to unsupervised online purchases, which can lead to lasting negative effects.
Dr Olver expressed a desire for a consistent, Wales-wide policy on testosterone prescribing to ensure equitable access. She emphasized that testosterone can help with symptoms such as low libido after menopause but stressed that careful monitoring and counselling are crucial. “We want to maintain women in female physiological range for testosterone. We don’t want them to have sky-high levels,” she explained, warning that persistently elevated testosterone can cause unwanted permanent side effects including baldness, a deepened voice, or enlargement of the clitoris.
Individuals with experience in testosterone treatment share nuanced views on its benefits and limitations. Emma Thomas, co-founder of a menopause support group in Cardiff and Vale, recalled how many women she knows have struggled to obtain testosterone from the NHS, with some GPs refusing to prescribe it. Thomas herself felt profoundly changed during menopause, describing a loss of joy and increased insecurity, which improved significantly after starting hormone replacement therapy (HRT) and later testosterone. “It was the final piece of the puzzle for me,” she said, adding that testosterone helped restore her energy and enthusiasm for life.
Despite positive experiences, neither specialists nor patients regard testosterone as a cure-all. Emma Jones, who noticed increased energy shortly after beginning testosterone but also experienced jitteriness, highlighted the importance of access to a range of HRT options to find what suits each individual. In one instance, a woman who had been prescribed testosterone by her NHS GP faced refusal when moving to another health board and resorted to buying testosterone online while pretending to be male to reduce costs. Dr Olver pointed out that inconsistencies in prescribing practices exist due to differences in policies across Wales’s seven health boards, with some restricting testosterone prescriptions to specialists. A licensed female testosterone product, Androfeme, available privately in the UK and licensed domestically but pending cost-effectiveness evaluation by NICE, further complicates availability. The Welsh government affirmed that all health boards should follow NICE guidelines and provide individualized care, including prescribing testosterone where appropriate
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