Rachel was a very active 45-year-old, who loved the outdoors and her job as a specialist teacher when her fit and healthy body began suffering with one problem after another. Joint problems and crushing fatigue curtailed her hobbies of hiking, climbing and cycling. The following months saw her list of unexplained symptoms grow and grow from being in constant pain, migraines, and gum problems, to palpitations, dry mouth and eyes, anxiety and electric shock sensations. Within 2 years, she describes herself as ‘just a shell who couldn’t leave the house’, she had given up her job, and living with this version of Rachel had a huge impact on her husband and son. After multiple trips to the GP and blood tests, she was given a diagnosis of chronic fatigue syndrome. In this episode, Rachel tells her story to Dr Louise Newson and takes listeners through her journey, including self-diagnosis and battles to get the help she knew she needed. After beginning on estrogen replacement and seeing some mild improvements but still experiencing severe fatigue, she learnt about testosterone and its importance for energy and stamina. Now, 6 months after starting on testosterone, Rachel describes the improvement as ‘life-changing’. She feels a fully functioning human again, is able to work part time, and even manage a 5 mile walk. Dr Newson explains what testosterone does, why we need it, and why it can be so hard to get hold of the hormone at your local GP practice. Louise reassures listeners that she is working hard with NHS England on this very matter and is hopeful that change will come. Both Louise and Rachel agree that testosterone should not be described as the ‘icing’ on the HRT cake but a crucial ingredient of the cake itself. Rachel’s top 3 tips: Remember GPs aren’t trained in peri/menopause, so go armed with useful information and the NICE guidelines to help you have a factual conversation. Don’t give up trying to get the help you need. Be kind to yourself and listen to your body. Note: Rachel had to see a menopause specialist to get her initial prescriptions for testosterone. After lots of persevering on her part, it has now been agreed to be prescribed via her usual NHS GP.

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“What did the council decide on item 42?” — answered with the speaker and the moment.