I was a late starter to working out but, in 2004 at the age of 48, feeling fat and frumpy, decided to do something about it, beginning a regime of regular exercise and healthy eating that continues to this day. The excess pounds fell away, and I felt great, but a few years ago a chance remark from my son made me question everything I’d been doing. He was worried I ‘might break’ - a sentiment backed by my two daughters. It seemed that while I pictured myself as a Davina McCall-type figure (slim and energetic), my kids saw Mary Berry (sorry Mary).

Strangely I’d had a niggling feeling for the last six years or so about my inability to build muscle. I was definitely slimmer, but not toned or athletic. Friends would tell me I should push myself harder so I did. But even after running 30 miles in one week, I still couldn’t see a calf muscle. In fact, despite my best efforts, I was looking sort of puny. It was most noticeable around my shoulders and arms. If I was to avoid becoming The Incredible Shrinking Woman, I needed to sort this out.

Luckily, a bone mineral density scan came to the rescue. After the scan, my GP dropped the bombshell that I had osteoporosis, a progressive skeletal disorder that weakens bones, making them prone to fracture. According to the NHS, women can lose up to 20% of their bone density in the five to seven years after the menopause due to the falling levels of the hormone oestrogen. Who knew?

I was prescribed alendronic acid - a once-a-week pill, that I would take for the next five years, to build bone. But it wasn’t oestrogen, and as oestrogen is so important to bone health, I had a big problem. Post-menopause I hadn’t been prescribed HRT due to its links with an increased risk of breast cancer (I’d had the disease twice), but nor had I been advised about the probability of thinning bones if I did nothing.

Around that time, I also realised I wasn’t feeling as ‘up’ as I normally do. My cup is usually half full, but I found myself feeling sad, fatigued, low. I didn’t want to carry on like that, and in 2018, did the one thing I advise others never to do. I Googled. It took a matter of minutes to find the link between loss of muscle mass, thinning bones and low mood with a low level of testosterone. In the past I’d only associated the hormone with men who wanted to bulk up, and celebrities who wanted their libido back, but it was clear it could also help women like me.

“On average, women produce three times more testosterone than oestrogen every day. Testosterone deficiency mostly affects women following natural or medically induced menopause. Young women who have to undergo surgical removal of ovaries or treatments such as chemotherapy or pelvic radiotherapy are most severely affected,” says professor Vikram Sinai Talaulikar MBBS MD FRCOG PhD MICOG, a specialist in women’s health and reproductive medicine at University College London Hospital NHS Foundation Trust and University College London. “Symptoms of deficiency include low sex drive, irregular periods, loss of bone density, loss of muscle mass, low energy/stamina, depression and vaginal dryness. Women who experience such symptoms should seek help from their GPs or other health professionals.”

Well, you can seek help, but you won’t necessarily get it. My GP sent me for a blood test, and when the results came back, it was official, I had an abnormally low level. Ahah!

“Can I have a prescription?” I asked.

“No, I don’t have the authority to prescribe it because it’s off-licence,” was the answer.

I was referred to an endocrinologist who could prescribe it, but refused, telling me my level wasn’t low, I didn’t need testosterone, but I could try HRT...although he didn’t think I needed that either. In a subsequent letter to my GP, he said testosterone could be prescribed only if I had HRT first. Well, that made no sense at all, but I didn’t give up hope as I had someone else to turn to, the doctors at the North Thames Clinical Genetics Unit. They have been looking after me (on the NHS) since my BRCA1 diagnosis, and immediately referred me to the Menopause Clinic at UCLH. That changed my life.

They listened, they questioned and explained there was no research on the long-term effects of testosterone on women, but together we would all learn from this. I finally had my NHS prescription for Tostran 2% gel. I was to rub a pea-sized amount onto my inner thighs daily. I was now on a clinical trial of one! Over the course of the next 12 months professor Talaulikar monitored everything.

My weight, height, blood pressure, testosterone levels, muscle mass, bone density and mood, altering the testosterone dose accordingly. “Increased awareness about the role of testosterone in female reproductive physiology and access to off-licence testosterone prescriptions have led to an increasing number of women being identified and treated for this condition,” he explained. “The preservation of bone density and muscle mass is so important for women as they age and live longer and, by monitoring Sharon’s progress, we are learning how testosterone can contribute to combatting a growing problem.”

I appreciate that I’ve been lucky in having a clinician like professor Talaulikar to consult. Not everyone does, and the intransigence I experienced earlier could have been the end of the story. Happily, it’s not. Four years on I’m building muscle, I’m building bone density (my latest bone scan shows I no longer have osteoporosis), and I’m feeling much brighter, more me. I need to keep exercising and eating healthily, but I could not have achieved the strength and shape without testosterone, and I’d been trying for years. There has been a lift in my libido too, which is a bonus; feeling like a woman not a mum, is quite wonderful. I’d almost forgotten.

The only downside to this happy ending is that I cannot undo the damage to my bone health from having no replacement to the oestrogen I began losing in 2004, when chemotherapy pushed me into menopause, but I have stopped it getting worse.


If you’d like to explore the many ways in which you can live your best life as you age, check out Sharon’s Age Inappropriate YouTube channel.