Hi friends,
Would you like to join a growing community of heart-led, creative women writing and making in the gaps of our busy lives?
Upgrade to paid for early morning writing sessions, live ideas salon calls, seasonal sessions & more (for a round up of all I’ll be sharing over the summer head to the link at the end of this post1)
OK amigas, let’s begin.
Last summer I wrote a post about my starting to take HRT; oestrogen to be specific, and about how I was feeling quite cross about it. It remains by far my most popular post and sparked so many conversations, including a series of live calls with
, and discussing our menopausal selves (link to my original article and to our menopause chats in footnotes for you)2.I’m now about ten months into taking oestrogen daily and I do think the benefits have been noticeable. I get far less aching joints, my energy levels are better (although still not fabulous), most of the time I don’t wake up feeling like I’ve been run over by a bus. I feel more stable emotionally, I’ve been able to maintain an exercise regime for 6 months (regime is a terrible word, I’ve actually LOVED my new reformer pilates classes and being able to maintain exercise consistently is something I haven’t been able to do for years). So overall, I am glad I made the choice to start slapping on that clear gel every morning.
For context for anyone curious I’m a 46 year old white woman, who has had a hysterectomy and also only has one ovary after an ectopic pregnancy a number of years ago. Menopause has been shown to begin on average two years earlier for women with hysterectomies and the fact I only have one ovary can’t be helping with hormone production levels either. I take 50mcg of oestradiol as a gel rubbed onto my inner arm or leg daily.
I’m still no wiser, really, about how long I’m to take the HRT for or what’ll happen when I stop. Some menopause specialists, including Dr Louise Newson, say you can take it for life, which confuses me because surely nature has some reason for the reduction of oestrogen as we age and whatever about supporting system as the levels plummet / while I sort myself out a little more in this transition phase, I’m nervous about taking forever with little to no clinical evidence as to any potential side effects When I asked this question of my doctor she said, ‘well, if you want to come off it, we just sort of feel into it’, whatever that means?
I’m also still unclear quite how it works in my system if naturally my levels would rise and fall in a month but I’m taking the same dose of either oestradiol or testosterone daily? And I’m still quite cross that the best solution we can come up with is simply replacing / boosting our hormones, with no acknowledgement of what living in this bat-shit crazy, capitalist, patriarchal world does to our bodies.
I’m still certain that what I need to do (and am doing) to transition into this new phase of my life (a phase, based on my Human Design chart, is where I’m told I come in to my own) is to do a lot of deep inner work, heal a shed load of childhood trauma and shake off lots of old patterns, listen more to my heart not my head, slow the fuck down, start saying YES more and NO more, get out from under that patriarchal yoke. That’s where all the transformation happens. But, for me, all of that is going to be a million times easier, if simply just possible at all, when I am feeling in some way ok in my body. I have decided, in short, to cut myself some slack.
Which brings me to testosterone. I had my bloods tested recently and the results showed that my testosterone levels were very low. Which didn’t surprise me; I’d asked for the test because I had a sense they were. I had next to no libido, energy still very low despite living, eating, sleeping well, cognitive fog3. Some of these symptoms can also be tied to oestrogen levels, but taking more oestrogen than I currently am isn’t advised for me. I have a histamine intolerance and overly high levels of oestrogen can impact that. The doctor did suggest taking an oestrogen pessary, which I tried for about a week and hated on every level. TMI warning here – my normally clockwork poops went on strike and I also found the level of plastic waste sort of astounding. Which is another thing I’m a bit cross about – to take a prescribed medicine I also have to make myself complicit in wasteful plastic production ... So, in short, due to the poops and the plastic, the oestrogen pessaries were a no-go for me.
But I also had a sense that my testosterone levels might be very low for another reason. I have had a sense for some time (not much science here) that I am not able to manifest myself in the world in a direct way. That back bone strength and powering forward that a masculine energy brings has felt hard to access. And testosterone felt like an important component of that. (I didn’t mention this to my menopause doctor because I know how she would look at me!).
But taking the testosterone still made me uncomfortable. Despite knowing that male and female bodies need testosterone - females for muscle mass, bone health, libido and more – it still somehow freaked me out. Side effects, I was informed, can include acne, weight gain and growth of coarse dark hair at site of application, none of which I was loving the idea of. More than that, there is no licensed female product available here in Ireland (or anywhere else in the world bar Australia as far as I can work out).
So I would be prescribed three male-licensed sachets a month, and sort of guestimate my dose. The prescribing doctor asked did I know what a petit pois was and if so, just to squeeze that much out and divide the sachet that way. Which didn’t feel particularly precise as a way to prescribe a medicine - using a small vegetable as a dose chart). The doctor assured me what was in the sachet has been tested on women, but clinical trials do seem limited. The British Menopause society, in a leaflet4 for GPs and clinicians says:
More data are required for the long term effects on cardiovascular and breast outcomes but the short term data from a recent meta-analysis are reassuring.
Why is it not licensed for women except in one country?
Although there is a lack of long term safety data for cardiovascular and breast outcomes, an equally important factor is the reluctance of the pharmaceutical industry to finance further clinical studies thus far to achieve licensing of female androgenic products.
But I have decided to take the testosterone anyway. My levels are super low, and I’ve reasoned to myself that the side effects of weird patches of dark hair and spots would probably be more pronounced in someone who has higher levels to begin with (no science here either, just a hunch). I’ve made the decision because I’d like to have more sex-drive, I’d like to feel energised, or at least have enough energy, I’d like to think with a clearer head. But mostly, and again, there certainly ain’t no clinical trials on this, I wanted to start to try and move forward with more of a healthy masculine force.
As I see it, and as many of my teachers have taught, a healthy masculine energy emerges out of a healthy feminine energy – the feminine finds the truth, the masculine manifests that out in the big bad world. I’ve been doing A LOT of work over the last few years trying to shed lots of layers of shoulds, to find the kernel of who the fuck I am and what I’m here to do. I think that’s probably a life’s work, but I’m much, much clearer in that now that I have ever been. Now’s the time to start acting on that truth and bringing it into the world. And in my head, it feels quite challenging to do that with next to no testosterone in my system and energy that is still, often, on the floor.
I’ve been taking my Garden Pea of Testosterone daily now for a little over a month. The first week I felt nothing, then I felt quite speedy for a time in an unpleasant way (a bit like taking speed, actually, which I also never really enjoyed), and now I’m not quite sure whether I feel anything at all, maybe a bit more knackered than usual? But then again, the world has been a dark old place the last few months and that takes its toll, too. Advice seems to be to allow three to six months for it to settle in the system, so I’m remaining open and curious for now.
Again, I’m not expecting miracles. Again, it all feels a little bit of a shot in the dark. Again, I’m looking on this as a tool to support me in the bigger, deeper work. Again, if it’s not feeling good I’m going to drop it like a hot potato (like the oestrogen pessary - ugh). And again, I’m nervous about it, uncertain about the scientific evidence, aware it all seems like an experiment on us all (again). Aware it might be a sticking plaster.
Still taking it though, because I want to cut myself a little bit of slack.
What about you all? Are any of you taking it? Have you felt it’s been of benefit?
Are you feeling hornier, sprouting dark hairs or manifesting the bejaysus out of yourself now?
Are you also using a petit pois as a dosage chart?
I’d LOVE to hear all in the comments … go!
Le grá,
Layla
what's on this summer with beauty & bone
I absolutely love your written offerings Layla - the one thing I consistently read alongside only one or two other writers.
The British Menopause Society says that: “Randomised clinical trials of testosterone to date have not demonstrated the beneficial effects of testosterone therapy for cognition, mood, energy and musculoskeletal health.” But my doctor said that she finds women who are still suffering symptoms like these after trial of oestrogen HRT often benefit from testosterone supplementation. All seems a bit unclear to me…
https://thebms.org.uk/wp-content/uploads/2022/12/08-BMS-TfC-Testosterone-replacement-in-menopause-DEC2022-A.pdf
Thanks for talking so candidly about this. I've been taking HRT for a year now, and it has made an incredible difference in some areas, none in others, and some, like the bleeding, seem to have got worse. I'm 58, I shouldn't still be bleeding at all. Lack of energy and motivation, zero libido and brain fog are still awful. I'm wondering if testosterone could be the missing link. Like you though, I've held off, inexplicably, knowing the logic of testosterone as a female hormone. And found myself consulting an Ayurvedic practitioner instead. Why though in 2025 do women have to guesstimate a pea-sized amount of gel? It's shocking.
I am lucky to be in Australia with testosterone supplementation recognised and prescribed for women, and I have benefitted enormously from it. With a great GP and an open mind I have just let my body work out what it needed in the cacophony of menopause, and for me, it was some testosterone supplementation. I try hard not to second guess myself with it all 🤷♀️ Menopause is hard, let’s be kind to ourselves and each other in the reality of it all ❤️