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METERED-DOSE TESTOSTERONE GEL FOR MENOPAUSE-RELATED LOW LIBIDO
A concentrated 2% testosterone gel supplied in a metered-dose pump. At LIVVE, Tostran may be prescribed at very low doses, where clinically appropriate, to treat persistent low sexual desire associated with menopause, in line with current specialist guidance.
Tostran is a prescription-only testosterone gel that may be prescribed for women by specialist menopause clinicians where clinically appropriate. It is used at much lower doses than those used in men and is prescribed off-label for women in line with national menopause guidance. Your clinician will explain why Tostran has been recommended for you and will monitor your treatment with regular reviews and blood tests.
Menopause-focused assessment
Clear pump-measuring instructions
Baseline and follow-up blood tests
Realistic expectations and safety checks
Step-by-step support after prescribing
Quick product facts
Here are the key product details, with more information below on suitability, safety, application and monitoring.
Medicine type
Testosterone transdermal gel
Regulatory Status
Off-label in women
Presentation
Metered-dose pump
Concentration
2% testosterone gel
Female use
Very low prescribed dose
PRESCRIPTION NEEDED?
Yes
Monitoring
Baseline and follow-up blood tests
Review
Regular clinical reviews
Tostran is prescribed off-label for women by specialist menopause clinicians where clinically appropriate. It is used at substantially lower doses than those used in men, in line with current British Menopause Society guidance. Your clinician will explain why Tostran is the most appropriate option for you and will monitor your treatment with regular reviews and blood tests.
Application video guide
Watch this short pharmacist-led video to learn how to dispense and apply Tostran safely. It explains the prescribed dose, where to apply the gel, how long to allow it to dry and how to reduce the risk of transfer to other people.
Wash and dry your hands before starting.
Press the pump down fully and use only the number of pump depressions prescribed by your LIVVE clinician.
Apply the gel to clean, dry, unbroken skin on the lower abdomen or inner thighs, following your clinician’s instructions.
Gently spread the gel with one finger until dry. Allow the area to dry fully, then cover it with clothing.
Wash your hands thoroughly with soap and water after application.
Avoid skin-to-skin transfer to children, partners or pets.
Do not use additional pumps, change how often you apply Tostran or use a different application area without speaking to your LIVVE clinician.
Symptoms and suitability
Low libido in midlife is often multifactorial. Before prescribing testosterone, a clinician should consider oestrogen levels, vaginal or bladder symptoms, relationship factors, stress, sleep, mood, pain, medicines and other health conditions.
Persistent low sexual desire
Reduced sexual interest that is ongoing and distressing to you.
Low arousal or pleasure
Reduced response, sensation or satisfaction that has changed from your normal.
Symptoms despite HRT
Low desire that continues after oestrogen/HRT has been optimised where appropriate.
Distress or relationship impact
Symptoms that affect confidence, intimacy or wellbeing.
After surgical menopause
Symptoms may be more noticeable after removal of both ovaries.
Other causes ruled out
Fatigue, mood and medication factors should be considered too.
What is Tostran?
A concentrated 2% testosterone gel supplied in a metered-dose pump. At LIVVE, Tostran may be prescribed at very low doses, where clinically appropriate, to treat persistent low sexual desire associated with menopause, in line with current specialist guidance.
Tostran is a prescription-only testosterone gel that may be prescribed for women by specialist menopause clinicians where clinically appropriate. It is used at much lower doses than those used in men and is prescribed off-label for women in line with national menopause guidance. Your clinician will explain why Tostran has been recommended for you and will monitor your treatment with regular reviews and blood tests.
Where Tostran fits
Some patients may have heard of different testosterone options being used in menopause care. Tostran is one option your clinician may discuss with you. The right choice depends on your symptoms, medical history, blood results and treatment goals.
Tostran: A testosterone gel that may be prescribed for women at a lower dose where clinically appropriate.
Androfeme: A female-specific testosterone cream prescribed where clinically appropriate.
Testogel: A testosterone gel that may be prescribed for women at a lower dose where clinically appropriate.
Realistic expectations
Testosterone is not an instant libido switch. The first few months are about correct application, tolerability, symptom tracking and blood-test monitoring.
You may not notice much change yet. Focus on applying the correct amount consistently and watching for early side effects such as oily skin, spots or irritation.
Some people begin to notice changes in sexual desire, arousal, confidence or response. Others need longer.
This is the key review point. Your LIVVE clinician will look at symptoms, side effects and blood-test results before deciding whether to continue, adjust or stop.
If there has been no meaningful improvement despite correct use and safe blood levels, testosterone may not be the right treatment for you.
Your LIVVE pathway
We keep the process clear from the start, so you understand each step before treatment is prescribed.
We review symptoms, libido changes, menopause stage, medication, medical history and treatment goals.
Your clinician considers whether oestrogen, vaginal symptoms, mood, sleep, pain or other factors should be addressed first.
Baseline blood testing is completed within 3 months before starting treatment. Total testosterone is checked, and SHBG may provide additional information in selected cases.
If suitable, you receive dose instructions, application advice, side-effect guidance and planned follow-up testing.
PUMP SCHEDULE AND DOSE
There is currently no testosterone product licensed specifically for women in the UK. Tostran may be prescribed off-label at a substantially lower dose by specialist menopause clinicians where clinically appropriate. Following your prescribed pump schedule and attending regular blood-test monitoring are essential to ensure treatment remains safe and effective.
Do not change the pump schedule yourself. Tostran is a concentrated 2% gel. Use only the number of pumps and frequency prescribed by your LIVVE clinician.
| ITEM | WHAT IT MEANS | |
|---|---|---|
| Product | 2% testosterone gel supplied in a metered-dose pump | |
| Female use | Off-label at a much lower dose where clinically appropriate | |
| Dosing | Follow your individual prescribed pump schedule | |
| Monitoring | Regular reviews and blood tests are required |
This table explains the product pathway only. It is not a dose instruction.
HOW TO USE TOSTRAN
Your LIVVE clinician will explain how often to use a full pump and where to apply it. Because Tostran is a concentrated 2% gel, the schedule used in menopause care is much lower than the licensed male pathway.
Apply only as prescribed.
Use clean, dry, intact skin at the site advised by your clinician.
Let the gel dry fully before dressing.
Wash your hands thoroughly with soap and water after application.
Cover the dry application area with clothing.
Avoid transfer to partners, children, pets and anyone pregnant or who could become pregnant.
Do not increase the frequency or number of pumps without clinical review.
Suitability and safety
Your clinician will check whether testosterone is appropriate for you and whether other causes of low libido need addressing first. You should mention pregnancy possibility, breastfeeding, cancer history, liver disease, severe acne, hair loss, unwanted hair growth, voice changes, clot/cardiovascular history and all medicines or supplements you take.
Side effects
Most people tolerate carefully dosed testosterone well, but side effects are more likely if testosterone levels rise too high. This is why LIVVE includes blood-test monitoring as part of the pathway.
| Possible side effect | What to do |
|---|---|
| Oily skin or mild acne | Mention this at review, especially if it is worsening or new for you. |
| Increased facial or body hair | Tell your clinician; your level or dose may need checking. |
| Mood changes or irritability | Track when it started and discuss with LIVVE, especially if it feels out of character. |
| Headaches | Seek advice if new, persistent, severe or different from your usual pattern. |
| Scalp hair thinning | Contact your clinician promptly rather than increasing or stopping the dose yourself. |
| Voice deepening | Rare, but seek medical advice quickly as this can be serious and may not fully reverse. |
MONITORING PATHWAY
Testosterone should be kept within the female physiological range. Blood tests help your clinician check whether the dose is safe and whether symptoms match the blood picture.
If Tostran is prescribed, LIVVE will remind you when your monitoring is due. In most cases, your blood test and treatment review need to be completed before your next prescription can be approved.
After prescribing
Starting treatment is only one part of the journey. LIVVE follow-up helps you understand expected timelines, side effects and when treatment may need adjusting.
Application instructions, transfer precautions, missed-dose advice and reassurance around careful measuring.
Check sexual desire, arousal, distress, wellbeing factors and any side effects before increasing dose.
Review testosterone results, SHBG/FAI, side effects and whether the dose is safe and clinically useful.
After prescribing
If Tostran is prescribed, LIVVE will guide you through the next steps by email. You will receive support on delivery, how to apply your treatment safely, what side effects to look out for, what changes you may or may not notice, and when your blood-test monitoring is due.
Your prescription is checked and prepared by the LIVVE Pharmacy team. You will receive clear next-step information before your treatment arrives.
We explain what to check when your parcel arrives, how to store your treatment and what to read before your first application.
You will be guided on measuring your dose, applying the cream safely, washing your hands and reducing the risk of transfer.
We remind you when your blood test or treatment review is due, so repeat prescribing can be considered safely and without unnecessary delays.
If low sexual desire is affecting your confidence, intimacy or quality of life, LIVVE can help you understand whether Tostran, HRT optimisation, vaginal treatment, blood tests or another approach may be most appropriate.
Medical disclaimer: This page is for information only and does not replace individual medical advice. Tostran 40.5mg gel pump gel are licensed for male hypogonadism and may be prescribed off-label for menopause-related low sexual desire only when clinically appropriate after assessment. Always read the patient information leaflet and follow your prescriber’s instructions. Seek medical advice if you develop concerning symptoms, side effects, abnormal bleeding or signs of testosterone excess.
