The short answer is: sometimes. Some people can access testosterone through the NHS, but it often depends on local prescribing rules, whether specialist advice is needed, and whether the GP practice is able to prescribe and monitor it under local arrangements.
That can be frustrating, especially if you have read that testosterone may help low sexual desire associated with menopause. But NHS access and clinical suitability are not exactly the same thing. A lack of local access does not automatically mean testosterone is wrong for you, and private access does not automatically mean it is right for you.
Important
Testosterone should not be treated as a quick online purchase or a general treatment for tiredness, brain fog or low mood. It should sit within a clinical menopause pathway, with assessment, monitoring and review.
What do NICE and BMS say?
NICE recommends that testosterone supplementation can be considered for people with low sexual desire associated with menopause if HRT alone is not effective.
BMS takes a similarly careful approach. Testosterone should usually be considered only after a wider assessment has looked at other causes of low desire, such as relationship factors, psychological factors, medication effects, vaginal symptoms and whether HRT has been tried or optimised where appropriate.
This matters because low libido can have more than one cause. Painful sex, vaginal dryness, poor sleep, stress, low mood, antidepressants, relationship strain and confidence changes can all reduce desire. For some people, testosterone may be part of the plan. For others, a different step may be more helpful first.
Why can NHS access vary?
Even when a treatment is mentioned in guidance, how it is accessed can vary across the NHS. Testosterone prescribing for menopause-related low sexual desire may be affected by:
- Local formulary decisions — some areas have clearer prescribing policies than others.
- Specialist initiation rules — some GP practices may prescribe only after advice from a menopause clinic, gynaecology service or specialist clinician.
- Shared-care arrangements — some areas allow ongoing prescribing in primary care after specialist initiation, while others do not.
- Product availability — NHS options may differ from private options, and local pathways may specify particular preparations.
- Monitoring requirements — clinicians need a safe way to arrange, interpret and act on blood tests and symptom reviews.
- Practice experience and resources — not every GP practice will feel able to start or continue testosterone prescribing without specialist support.
This means two people with similar symptoms may have different NHS experiences depending on where they live and how local services are set up.
What can I reasonably ask my GP or NHS menopause service?
You can ask for a review of low sexual desire in the context of perimenopause or menopause. It may help to be clear that you are not asking for testosterone as a first step, but for an assessment of what might be contributing and whether testosterone is appropriate under local guidance.
You might ask:
- Could my HRT need reviewing or optimising first?
- Could vaginal dryness, painful sex or urinary symptoms be contributing?
- Could any of my medicines be affecting libido?
- Is testosterone available in this area for menopause-related low sexual desire?
- Does local policy require specialist initiation or referral?
- If testosterone is started, who would arrange monitoring and repeat prescriptions?
- If the GP practice cannot prescribe it, can I be referred to an NHS menopause clinic or gynaecology service?
If you are already using private care, you can also ask whether your NHS team is willing to review your care plan, consider shared care, or continue prescribing after specialist advice. They may or may not be able to do this.
If my GP says no, does that mean I am not suitable?
Not necessarily. There are different reasons someone may be told testosterone is not available or cannot be prescribed through their GP practice.
Sometimes the issue is clinical: testosterone may not be appropriate because another cause needs treating first, blood results are already high, side effects are present, there is a complex medical history, or the main concern is not low sexual desire.
Sometimes the issue is access: the practice may not be allowed to start treatment under local formulary rules, may need specialist advice first, or may not have a shared-care route in place.
A refusal or delay does not automatically answer the clinical question. It may mean that another review, referral or treatment route is needed.
NHS and private pathways: what is the difference?
Both NHS and private care should be safe, evidence-informed and monitored. The main differences are usually around access, cost, communication and how quickly appointments, blood tests and reviews can be arranged.
| Part of care | NHS route | Private route with LIVVE |
|---|---|---|
| Initial assessment | Usually starts with GP review. Referral to a menopause or gynaecology service may be needed depending on local policy. | Book directly for a menopause/testosterone assessment. The clinician reviews symptoms, HRT, medicines, vaginal symptoms, blood tests and suitability. |
| Blood tests | May be arranged through NHS services if locally supported and clinically indicated. | Arranged privately through LIVVE or via an accepted external accredited provider, depending on the pathway. |
| Medicine choice | May be limited by local formulary and prescribing policy. | Options may include Androfeme, Tostran or Testogel where clinically appropriate and available. |
| Cost | NHS prescription charges may apply unless exempt. Appointments and blood tests are usually NHS-funded where available. | Consultation, medicine, blood tests and reviews are paid for privately unless included in a care plan. |
| Reviews and repeats | Follow local NHS process. Repeat prescribing may depend on GP agreement and monitoring arrangements. | Repeat prescribing depends on clinical review, monitoring, response, side effects and completion of any required steps. |
| Communication | Usually through GP surgery or NHS service routes. | Through LIVVE’s patient pathway and support channel, according to the response times shown at booking. |
Can I move safely between private and NHS care?
Sometimes, but it cannot be guaranteed. Some patients use private care to start treatment and then ask their NHS GP whether prescribing or monitoring can be continued locally. Others stay fully private because their area does not offer shared care or because their GP practice is not able to take over prescribing.
If you want to explore transfer or shared care, it is helpful to keep clear records of:
- your diagnosis or reason for treatment
- current HRT and vaginal treatments
- testosterone product and current prescribed instructions
- baseline and follow-up blood results, including reference ranges
- side effects, response and review notes
- the monitoring plan recommended by your prescriber
LIVVE can provide information to support continuity of care where appropriate, but your NHS clinician decides whether they can prescribe or monitor under their local policy.
Monitoring is needed whichever route you use
Testosterone treatment should be monitored whether it is prescribed privately or through the NHS. Monitoring is not just about a number on a blood test. It helps your clinician consider:
- whether sexual desire or distress has meaningfully improved
- whether side effects have developed, such as acne, increased hair growth, scalp hair thinning, voice change or irritation
- whether total testosterone remains within the female physiological range
- whether HRT, vaginal symptoms, medicines, stress, sleep or relationship factors need further review
- whether treatment should continue, change, pause or stop
Do not change your dose based only on the numerical result, and do not continue indefinitely if there is no meaningful benefit after an appropriate monitored trial.
What to take to an NHS appointment
If you are going to speak to your GP or NHS menopause service, preparation can make the appointment more productive.
Practical checklist
- A short description of the problem: when low desire started, whether it is persistent or has changed suddenly, and whether it causes personal distress.
- Your menopause stage if known, period pattern, hysterectomy or surgical menopause history.
- Your current HRT, vaginal oestrogen, Intrarosa, lubricants or moisturisers, including how long you have used them.
- Any painful sex, vaginal dryness, irritation, burning, bleeding, urinary symptoms or recurrent infections.
- A current medicine list, including antidepressants, contraception, pain medicines and any private prescriptions.
- Relevant blood-test results, including total testosterone and SHBG if already tested.
- Any previous testosterone use, side effects, product name and prescribed instructions.
- What you are asking for: HRT review, vaginal symptom review, NHS menopause referral, testosterone suitability review or shared-care discussion.
Where LIVVE fits
LIVVE offers a private pathway for women seeking specialist menopause and testosterone assessment, with transparent pricing, access to blood testing, prescribing where clinically appropriate and ongoing monitoring.
Where appropriate, we can also support shared care with your GP. Following your consultation, we will write to your GP with details of your assessment, treatment plan and prescribing recommendations, and may ask whether they are willing to support ongoing blood-test monitoring or prescribing. Shared care is always at the discretion of your GP practice and local NHS policies, so availability varies between practices and regions.
If testosterone is suitable, LIVVE may discuss options such as Androfeme, Tostran or Testogel, helping you choose the most appropriate treatment for your individual needs. These options are explained in more detail in our treatment comparison guide and product pages.
If testosterone is not the right next step, we may instead recommend optimising HRT, treating vaginal symptoms, reviewing medicines that may affect libido, considering wider health assessments, or exploring psychosexual or relationship support where appropriate.
Understand your testosterone treatment route
If you are unsure whether to speak to your GP, seek NHS referral or use LIVVE’s private pathway, we can help you understand your symptoms, treatment history and what a safe next step may look like.
