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Testosterone as Part of Menopause Hormone Therapy

Here is what happened when I stopped taking it: I was miserable!

I started FDA-approved testosterone (off-label for women) almost exactly a year ago with a previous doctor who had advised me to rub a significant drop of gel (once daily) on my thigh, switching from right to left because I would grow dark hair wherever I put it. The best way to mitigate that would be by changing legs instead of rubbing it on the same leg every day.

My doctor wasn't wrong.

Not only did I find dark patches of hair on my mostly fair-haired body, but I also started breaking out in the area, particularly on my left leg. It got to a point where it was truly embarrassing. I felt like a teenager with acne, except the acne was all over my legs! So, in August, when I had an appointment with a new medical provider, we tested my levels, and they were high. I wasn't surprised. So, I quit it cold turkey, figuring I'd take a little break from the stuff and see what happened.

The positive was that the hair and acne disappeared in about a month, but the negative was that I WAS MISERABLE.

The most immediate thing I noticed was a return of chronic and sometimes debilitating fatigue and brain fog. The second was persistent joint pain, particularly in my knees. The third was general inflammation - this is hard to describe, but for my auto-immune disorder people, you know what I'm talking about. However, I thought it was important to leave it until my follow-up appointment to see where my levels were, so I set my mind to tough it out.

This is where it gets tricky.

Early November arrived, and I went in for my appointment and blood draw. My provider messaged me in the portal and said that everything was normal, yet my free testosterone was low and out of range, and my Sex Hormone Binding Globulin (SHBG) was high and out of range. What does that mean? If your SHBG levels are too high, it likely means that less of your total testosterone is free testosterone and available for your tissues to use. In short, your tissues may not be getting enough testosterone.

What can this result in?

  • Decreased libido.

  • Lack of motivation.

  • Irregular periods.

  • Vaginal dryness.

  • Decreased bone mass.

  • Memory loss.

  • Fatigue.

  • Mood changes and depression.

I checked all these boxes, yet my provider told me everything was normal. Now. I like this person. A lot. She is very forward-thinking and works in a department specializing in menopause care. However, the topic of testosterone is where we disagree. She doesn't prescribe it for reasons I'm still unclear about.

Luckily, I purchased my testosterone in bulk (it was cheaper that way), so I still have quite a bit from seeing my previous doctor. I began using it again immediately after getting my blood results (but using a smaller amount), and I felt the difference within two weeks. The first thing that lifted was the brain fog and fatigue, and then, slowly but surely, I began to feel BETTER. I feel more like myself again.

Only recently, testosterone has been approved for the treatment of low libido (though not covered by most insurance because the FDA doesn't give a sh*t about your sex drive), and yes, that's how I got it prescribed. Still, I was more interested in its lesser-studied effects, as indicated in this PUBMED article here, including increased muscle mass, bone density, cognitive performance, and decreased inflammation. These are all things I experience when I'm using it.

So...why isn't this acknowledged, and why isn't it included in the gold standard of care that is Menopause Hormone Therapy?

Because studies take FOREVER, and the world is run mainly by male doctors, researchers, and scientists. Only recently, somebody started giving a f*ck about our libido, and it will take years for any solid research to come out regarding the other positive effects that may come with using testosterone. The good news is that there are some forward-thinking doctors out there shouting to the world about the positive effects of its use, like Dr. Mary Claire Haver, and if you don't follow her on Instagram, I strongly recommend that you do.

With that, if you're interested in giving testosterone a try (there is also evidence that it can help with Cronic Fatigue Syndrome and fibromyalgia), it's essential to gather all of the information you can before speaking to your provider. What's more, finding a doctor who is receptive to your request is important but challenging. A great place to start is at NAMS (the North American Menopause Society), though it's not always guaranteed that every menopause specialist will prescribe testosterone.

Lastly, working with someone like me can help. I provide resources and knowledge around these issues; we discuss them in-depth so you feel armed and empowered to advocate for yourself. I can also help you search for the right medical provider, which can be an arduous and daunting task.

To schedule a 1:1 free introductory session, you can do so here.

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