Menopausal women posing as men to buy testosterone amid NHS access issues

Menopausal women in Wales are posing as men to buy testosterone online amid difficulties accessing NHS prescriptions, a consultant has said.

Access to testosterone for postmenopausal women varies between Welsh health boards despite a “very sharp increase” in referrals, according to menopause specialist Dr Michelle Olver.

Olver said she had seen women with testosterone levels up to 12 times the safe level after they bought the hormone online, putting them at risk of permanent side effects.

She said it was “incredibly sad” to see women lying to obtain the drug online because they were being “denied access to something they need”, but said proper counselling and monitoring were needed.

Olver, a consultant in sexual and reproductive health, said: “We want to maintain women in female physiological range for testosterone. We don’t want them to have sky-high levels.

“When you persistently have very high testosterone levels you can get undesirable permanent side effects.

“Nobody wants to have baldness, deepening of the voice or enlargement of the clitoris.”

Testosterone occurs naturally in women, but levels decline with age.

It is prescribed after menopause to help with reduced libido, while research is under way in Wales into whether reported effects on cognition and energy can be scientifically supported.

Women are advised to have a baseline blood test and regular tests afterwards to ensure levels remain within the female range.

Emma Thomas, co-founder of menopause support group Menopals Cardiff and Vale, said members had reported difficulties accessing testosterone through the NHS.

She said: “We hear a lot of women saying their GP thinks there’s no need for it or their surgery won’t prescribe it.”

Prescribing arrangements differ across Wales’ seven health boards, which use a traffic light system. In some areas testosterone is classified as red, meaning only specialists can prescribe it.

There are two amber options.

One involves a GP seeking support or agreement from a hospital specialist that testosterone is appropriate for a patient.

The other requires a hospital specialist to start and monitor treatment under a shared care agreement, with GPs continuing to prescribe it.

The Welsh government said: “All health boards are expected to adhere to the NICE guidelines on identification and management of menopause including providing individualised care when prescribing HRT.

“We are aware this may include some practitioners prescribing testosterone for some women.

“We expect all health boards to conform to any recommendation made by NICE in relation to prescribing testosterone when its guidance is published.”