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A daily dab of testosterone has banished my anxiety and given me a new zest for life - and my husband! BRYONY GORDON
Monday, 8.15am. I am crammed on the Overground train, making my way to a boring work meeting when I am suddenly overcome by the desire to rip my husband’s clothes off.
This is unfortunate, because he is on the other side of London in his own boring work meeting, and I am not going to see him for at least another 12 hours.
As the train trundles through decidedly unsexy suburban London — Peckham, Wapping, Shadwell — I try to think about decidedly unsexy things: the U.S. presidential race, tax returns, the squashed banana in the bottom of my handbag.
But it is no good. My entire body has been hijacked by lustful thoughts that are not appropriate for the 8:07am from Clapham Junction, and no matter how hard I try, I can’t rid myself of them.
An appointment with a menopause specialist revealed that Bryony's oestrogen levels were low
All day, I engage in a vigorous battle between my brain and my . . . well, there’s no other way to put this, my loins.
I stride around like a woman possessed, trying not to dwell too long on what I plan to do to my husband when I get home. I find the only thing for it is . . . no, not that.
It’s going to the gym, where I discover relief under a barbell loaded down with an ever-increasing amount of weights.
I deadlift, I bench press, I back squat, I power clean, and when all of this is done I stand under the shower and think: gosh, this must be what it’s like to be a man.
Let me explain. For the past three months, I have been taking testosterone. Yes, you read that correctly: testosterone, the so-called ‘male’ hormone usually associated with gym bros and bodybuilders.
Every evening, I dab a pea-sized amount of Testogel on my inner thigh, careful to rotate locations so I don’t end up with excess hair in funny places.
Though to be frank, the gel’s effects on me have been so incredible that I’ll happily put up with an unruly bikini line in exchange for its many benefits: a much higher sex drive and more motivation for exercise, yes, but most importantly, to me, a joie de vivre that has been largely absent ever since I began going through a quite early menopause two and a half years ago.
I was 41 when I found myself slipping back into one of the episodes of mental illness that have plagued me on and off since childhood.
I have had crippling Obsessive Compulsive Disorder (OCD) and subsequent depression since the age of about 12; my way of dealing with it was alcohol and, later, drugs. But in the early months of 2022 I had been clean and sober for almost five years, with a solid programme behind me that meant life was stable.
It was a shock, then, when the darkness of OCD began to creep back in. Many people laugh off OCD and use it as a shorthand for cleanliness and tidiness, when in fact it is a debilitating mental illness that ruins lives.
I describe it as your brain refusing to acknowledge what your eyes can see — that your hands are clean, or the iron is off, or the bump you just drove over was a speed bump and not a child.
It is known as the ‘doubting disease’, characterised by a paralysing succession of ‘what ifs?’: ‘what if I left the oven on and the house is burning down; what if my hands contain deadly bacteria that might kill me and everyone around me; what if that intrusive thought I had is a sign I’m evil?’
Sufferers engage in a series of compulsions — hand-washing, rumination, checking — to try to ease the obsessions, but they only make them worse.
And yet despite knowing all of this, I felt powerless to stop the intrusive thoughts that began to bombard me again in January 2022. Very quickly, I became really, really unwell, unable to leave the house or work or parent my 11-year-old daughter.
It was a bleak time, almost as terrible as the very first episode of OCD I encountered at the age 12, when I would wash my hands until they bled and repeat phrases in the hope of keeping my family alive.
I confided in a friend who mentioned that I might be peri-menopausal. I shrugged off her suggestion — surely I was too young? Furthermore, I didn’t think the darkness in my mind could be explained away by hormones.
But I was also desperate to feel better, so I booked an appointment with a menopause specialist and discovered that my oestrogen levels were low. It turned out that both my mother and grandmother had stopped having periods in their early 40s, so the doctor suggested I start taking a small amount of HRT.
I was told that it could take up to three months before I really felt a difference, but within three days I was springing around the house like a Disney princess, the volume on the intrusive thoughts turned down to a more tolerable level.
I was astounded by the difference the oestrogen made.
Two weeks later, however, I began taking progesterone (if you have a womb, you have to take progesterone as it keeps the womb lining healthy) and within days I was plunged back into a deep depression, sobbing and suicidal.
It turned out I was one of the estimated 10 per cent of women who have an intolerance to certain types of progesterone, which caused my mood to plummet.
It was a lightbulb moment: my whole life, I had been highly sensitive to something made by my own body. And while I wouldn’t blame all my problems on hormones — I believe I have always been predisposed to mental illness — I could also see that they made dealing with those problems that much harder.
But Dr Paula Briggs, who is also a consultant in sexual and reproductive health at Liverpool Women’s hospital, warns: ‘We have no idea what long-term testosterone supplementation does to women’
For a year we wrestled with getting different types of progesterone into me.
My mood went up and down like a roller coaster. It was awful. I genuinely considered having a hysterectomy, which would have removed the need for it.
Eventually, I was fitted with the Mirena coil, which sees a low level of progesterone released directly into the womb — doctors have found it often has less of an effect on mood than tablets — and, incredibly, it worked.
Life ticked along on an even keel again, and though I didn’t feel brilliant, I was no longer experiencing the awful lows that had become such a normal part of my life. It was a crash course in just how much hormones had affected my mental health. I wondered how different things could have been had doctors taken women’s health a little more seriously when I was younger.
Even so, I was unprepared for the difference a small dab of testosterone could make to both my mood and my energy levels.
The doctor suggested I add it into my HRT regime earlier this year, when I sustained a stress fracture while training for a marathon. There is some evidence that testosterone can help with bone density and muscle mass, which decreases in women the older we get.
I was sceptical: wasn’t testosterone for blokes? But it turns out the hormone is also produced in our bodies, in both our ovaries and our adrenal glands, and that it has an important role in female sexual function.
'Testosterone has felt like the missing link for me,' says Bryony. 'My physical strength feels much better, and the brain fog that had started to cloud my afternoons has also dissipated'
My doctor said that there was also some anecdotal evidence that women’s moods and energy levels were improved by it, and that while many women felt no difference, it was worth trying.
I was told the side-effects — which include excess hair, acne and a deepening of the voice — only happened if you took too much, and that they were all reversible.
I took delivery of my little sachets of Testogel, and was told to make one last for around ten days, which was the equivalent of a pea-sized amount a day on my inner thigh.
I began dabbing — and washing my hands furiously afterwards so as not to transfer it to my husband or daughter — and waited for something to happen. For a few weeks, nothing. Then I became intensely moody for a few days.
Pretty soon, this subsided and I felt the opposite — instead of everything inducing rage in me, I became completely chilled out.
Things that would have normally left me spiralling into a whirling mass of overthinking and obsession instead left me curiously unbothered.
It wasn’t that I didn’t care about things, more that I had stopped caring about the small, petty things that could previously leave me a gibbering paranoid wreck — a barbed comment at work, for example, or an unanswered text from a friend.
Then there was the re-emergence of my libido, which I had long assumed had been buried under the weight of middle age, marriage and family life. Suddenly, it was there again, in a way I hadn’t known since my early 20s. In short, my energy for everything other than overthinking was completely replenished.
Testosterone has felt like the missing link for me. My physical strength feels much better, and the brain fog that had started to cloud my afternoons has also dissipated.
But as with everything menopause-related, the subject is highly contentious, splitting the community right down the middle. Earlier this month, the former chair of the British Menopause Society warned that testosterone prescribing was ‘completely out of control in the UK’.
Dr Paula Briggs, who is also a consultant in sexual and reproductive health at Liverpool Women’s hospital, continued: ‘People are being led to believe that they must have this.
‘But we have no idea what long-term testosterone supplementation does to women.’
Currently, the National Institute for Health and Care Excellence (NICE) says that doctors can consider testosterone supplementation for menopausal women with low libido if conventional HRT (oestrogen and progesterone) is not effective. NHS prescriptions for testosterone rose by 15 per cent between 2021 and 2022, but there is no product licensed for women in the UK, meaning that you have to ‘dose by eye’, which can lead to confusion and those unwanted side-effects, in people accidentally giving themselves too much.
‘There are huge problems with testosterone in terms of professionals not agreeing,’ says Dr Naomi Potter, who runs a women’s health clinic and co-wrote the bestselling Menopausing with Davina McCall.
‘Recent analysis of research does not show clear evidence that testosterone improves anything other than libido, but many patients report otherwise.
‘In my clinical experience, some women report it improves other symptoms such as mental function and get up and go.’
Dr Potter says that there are known downsides from overdose, including cardiovascular risk, but this exemplifies why prescribing needs to be undertaken by sufficiently qualified doctors.
But as with most things to do with the menopause, ‘there’s not been enough research, not enough money invested, it’s not been deemed as important enough. Female sexual health is way down the list, far further than male sexual health. This area of medicine comes with a lot of baggage. Everyone feels they have a right to an opinion on it.’
Dr Louise Newson is one of the menopause specialists who is evangelical about the effects of testosterone — as long as it is prescribed at a low dose, and monitored. ‘We’re just talking about natural hormones that reduce in some women,’ she says.
The gel’s effects have been so incredible that Bryony says she'll happily put up with an unruly bikini line in exchange for its many benefits
Dr Newson believes that people who dismiss testosterone as ‘only’ boosting female libido are also dismissing how important that can be to many women.
‘If a man has a low libido, they can easily go and buy Viagra. But Freud’s definition of libido was not just about sex — it was about being happy and joyful.
‘We also see that in women with ADHD and OCD it can really help with that monkey chatter. How do you tease that out in a clinical trial? I have no idea, but I have seen it happen in many of my patients.’
When I mention the lack of evidence linking testosterone to improved health outcomes in menopausal women, Dr Newson points out there is no evidence showing that antidepressants help menopausal women, but that doesn’t stop GPs prescribing these drugs for exactly that purpose.
For me, the change has been an entirely positive one, and a blessed relief after feeling so low for so long. My husband’s pretty impressed by it, too.
But no two menopausal women are the same. As Dr Potter says: ‘Do I think everybody needs to be on it? No. For some women, testosterone makes no difference whatsoever. But I do believe it’s for a lot more people than currently have access to it.’