Sarah Neville’s Big Read article (“How medical research is failing women”, Opinion, August 2) raises important issues about sex and gender in medical research and training.
I was prescribed testosterone to help with debilitating symptoms of menopause but was surprised to be given a smallish sachet of testosterone to rub on to my skin. This was formulated for men and came with the instruction that each dose should be one-twelfth of the sachet. When I asked how I could do this with any accuracy, I was told the current recommendations were to “dip my little finger in it”.
Having worked on evidence-informed decision making for many years, I wondered how I could be sure I was taking the correct dose. Even after talking to my pharmacist, the best I could do was to take a syringe previously used to administer painkillers to our dog, calibrate the marks on the syringe to the quantity in the sachet, decant as much of the slippery gel as I could into the syringe and — accounting for spillages — work out how many doses I had. The only way I found to prevent the gel from leaking out of the end of the syringe was to stopper it with a piece of Lego.
The testosterone worked well for me, but I had to go privately before I was prescribed a formulation specifically for women (readily available in Australia for many years), with a specially calibrated syringe.
My menopausal friends who are taking testosterone but don’t have a dog, haven’t kept hold of their kids’ Lego collections and can’t afford to go privately are still being told to dip their little finger into the sachet prescribed for men.
There is an increasing recognition of how little training GPs have received and how little research has been done to unravel the extraordinary complexity of the menopause and what it means for women. But the journey from research to changing practice or to approve formulations developed elsewhere can be a long one.
While we wait, there may be some small adjustments, easily made, which could help women feel that the medical profession is taking their specific needs seriously. Accompanying prescriptions for “male” sachets of testosterone with a stoppable syringe calibrated for women would be a good start.
Louise Shaxson
Marnhull, Dorset, UK
