A key treatment which could help around one million middle-aged Australian women remains unaffordable to many because it is unsubsidised by the government, experts warn.

The petition was started by Dr Ceri Cashell, a Sydney GP and the co-founder of Healthy Hormones, a national platform which aims to provide education and advocacy for menopause healthcare.

Cashell said the federal government’s decision to add body-identical estrogen and progesterone treatments to the PBS, which came into effect in March, had been a game-changer in making hormone replacement therapy more affordable for women going through menopause.

However, testosterone remained the one vital hormone still locked behind private scripts and high out-of-pocket costs, she added.

“Many midlife women need all three hormones — estrogen, progesterone and testosterone — to function and feel like themselves again,” Cashell said.

“AndroFeme (testosterone) can be the missing piece for many women. It’s safe, effective, and approved.

“But for most, it’s simply unaffordable.”

AndroFeme, the only testosterone product for women approved by the Therapeutic Goods Administration (TGA), is designed to help women regain lost libido as a result of hormone changes during menopause.

Australia became the first country to license the medication in 2020, and was followed by the UK and South Africa.

Despite nine testosterone products being available on the PBS for men, AndroFeme was yet to be added to the subsidy scheme for women, Cashell said.

AndroFeme costs around $100 to $180 for a three-month supply, depending on the dosage needed.

Even in the relatively affluent Northern Beaches area where Cashell practices, women were choosing not to add testosterone hormones to their treatment because of the cost, she said.

“Frequently, patients say it works, but they just can’t afford it,” Cashell said.

“Women are really bad at putting themselves first, and they put themselves low on the household budget. 

“As soon as there’s a cost barrier, then they often won’t pursue that treatment.” 

Cashell said the only other option for women seeking testosterone treatment was to use off-label testosterone medication designed for men, which was cheaper, despite not being available for women through the PBS.

However, it was harder to get the dosage right for women using off-label male testosterone treatments and therefore came with higher risks, Cashell said.

While around 15,000 Australian women were currently taking testosterone, there were exponentially more who could benefit from it, Cashell said.

Even applying those figures to women only aged between 50-65 would mean around one million Australian women would meet the criteria for treatment, Cashell said.

AndroFeme is only approved by the TGA for the treatment of low libido, however, emerging data was beginning to show the treatment could have other health benefits, including improved wellbeing and cognitive function, she added.

Author and podcaster Cathrine Mahoney said she started taking testosterone, along with progesterone and estrogen, as part of her “perimenopause trifecta” about 18 months ago.

“For me, the reason I wanted to put it in the mix was twofold,” she said.

“My libido had left the building, I think I was 48 at the time, and that’s way too soon for that to happen. And I just didn’t have my full ‘pep’ back, that’s the only way I can describe it.”

A long-time fan of regular exercise, Mahoney said when perimenopause hit she no longer felt like she had the same level of energy for workouts.

Mahoney said the testosterone treatment had seemed to help with both symptoms.

“My libido is firing, which is great news. And, also, I just feel I’ve got my get-up-and-go back,” she said.

Mahoney said she had only heard about the potential benefits of testosterone during menopause after listening to a podcast, after which she spoke to her GP.

“It’s just something I think should be affordable and accessible, and women should know about it. Then it’s up to them and their GP to work out if that’s something they should have in the mix or not,” she said.

The finding led to the federal government announcing the inclusion of three menopausal hormone therapies — Estrogel Pro, Estrogel and Prometrium – on the PBS as part of a half-a-billion-dollar women’s health package.

A spokesperson for the Department of Health, Disability and Ageing said adding any medicine to the PBS required a submission to the Pharmaceutical Benefits Advisory Committee, which then needed to be given the tick of approval by the committee.