Endocrine Abstracts

Objective: To determine tertiary care practice of prescribing testosterone to women attending menopause clinic and to assess its tolerability and side effects.

Methods: Retrospective electronic notes review of patients attending the University College London Hospital (UCLH) menopause clinic between 2019-2023 and Whipps Cross Hospital (WCH) menopause clinic between Jan 2021-July 2023. Patients prescribed testosterone were identified and included.

Results: Between 2019-2023, 1099 women attended the menopause clinic at UCLH. Of these, 179 women were started on testosterone. There was an average length of 5.7 years between their last menstrual period and receiving testosterone. The majority (64.8%) were started on testosterone at their first appointment with the most common indication being sexual dysfunction (50.3%), other indications included fatigue and brain fog. Testogel was the most frequently prescribed preparation (67.6%). At the time of starting testosterone, 83.8% were on oestrogen replacement therapy, with 16.2% not on oestrogen replacement due to contraindications. Within the study period, 107 (59.8%) of the women started on testosterone treatment attended follow-up; 13.1% reported side effects (including heavy legs and breast tenderness) whilst 29.9% reported benefits (most frequently being generalised improvement in symptoms and increased libido). Comparing UCLH prescribing practise to WCH, over a 2.5 year period, 28 women were initiated on testosterone. Of these, 46.4% were started on testosterone at their first appointment. Similarly to UCLH, 17.9% discontinued treatment and 7.1% discontinued due to reported side effects.

Conclusion: This data provides useful real-world experience regarding testosterone prescribing. Across two menopause clinics, 16.3% and 7.7% of all women were prescribed testosterone therapy. Testosterone is generally well tolerated with less than 10% discontinuing treatment due to side effects. Interestingly, women reported improvements beyond improved libido, despite this being the only licensed indication. Further prospective data is required to determine clinical utility of testosterone in women experiencing the menopause.