Should we find another hormone doctor?

[Brian O'Kane]

My wife and I went back to her hormone doctor today. We really like the guy. He has a professional, good bedside manner, and is very knowledgeable and wholistic in his approach to medicine. However, he seems to be really conservative about testosterone. We have heard great success stories about getting post-menopausal women's testosterone above average levels, into ideal levels. When we first went to him in February, my wife's (who is 50 and 4 years post-menopausal) progesterone was nonexistent, and her estrogen was low at 25. Her testosterone was a modest 50. He put her on oral bio-identical progesterone, and topical estrogen. Now, after 2 months and 3 days of therapy, her progesterone has risen to 10, and her estrogen has risen to 31. But her testosterone, for which she received no supplementation, decreased to 41.

Our sex life has really taken off in the last 4 months, even before she started therapy. And her libido has improved since being on it. We have gone from very difficult sex twice a week, to an average of 4 times a week. And she has been horny every day. A year ago, she was horny only after being intimate for about 30 minutes or so, but never horny spontaneously during the day. The changes in her have been vast and would have been unimaginable a year ago. I hope I don't sound like I am complaining, and I pinch myself daily with how wonderful it has been.

But it was hard for us to communicate to the doctor that we wanted to increase the improvement. I know some people have had success with the testosterone pellets. Her doctor was basically like "you guys are doing really really well, congratulations, there's no need to up a number just to up a number if you guys are happy." Yeah, I'm happy, but I want to maximize the improvement! I just didn't know how to say that at the time! I've read that even though 41 is a normal or good testosterone level for post-menopausal women, the ideal level is in the 100s. I wanted my wife to do most of the talking at the appointment because I didn't want the doctor to think I was some kind of greedy pervert. But we both want the absolute best we can have, especially given our past struggles with vaginismus and libido. I am so grateful we can have sex 3-4 times a week now, but the couple times we have tried sex twice in one day, it has been difficult. It's not that I want to have sex twice a day, every day! I am happy with three times a week. But I want to be ABLE to have sex twice a day, even if we don't. I want her to HAVE THE ABILITY to have multiple orgasms in one day without a refractory period. I don't know much about testosterone, and I would like to do more research, but it seems upping it in her case might make this goal more obtainable for us. Should we try to press this point forward on the next appointment, and if he's not willing to prescribe her testosterone, should we find another doctor?

[Mike smith]

There is no way to give a definitive answer as every care giver is an individual but if the care giver you visit is anything like mine the answer will probably be on the conservative side. They seem to feel that as long your numbers are within the normal range, that’s enough. There are negative side effects to too much testosterone.
I have to donate blood to keep my hemoglobin low enough to be in the normal range because of my testosterone therapy.

[Crow]

Women don’t necessarily respond positively to testosterone, and increasing levels for a particular women can actually diminish libido and sexual satisfaction. My wife saw a doctor who prescribed testosterone pellets. She went through about 3-4 pellets before giving up. They did zero for her libido, but the doctor made quite a bit on the pellets and the supporting lab work kickbacks. She eventually found a better doctor (BHRT) who put her on progesterone gel and oral progesterone. The gel also has a small amount of testosterone which converts to estrogen to raise her estrogen levels. Her mood and libido have slowly improved. I suspect that correcting her progesterone levels was the biggest factor.

Maybe some additional testosterone would boost her libido some more, but not necessarily. I would not recommend testosterone pellets. They can’t be adjusted like topical forms, and the levels are not constant.

[Ron]

Women don’t necessarily respond positively to testosterone, and increasing levels for a particular women can actually diminish libido and sexual satisfaction.

My wife's doctor said the same thing.

My wife went to a female doctor that helps post menopausal women. She analyzed her hormones and told her everything was normal except estrogen. Her testosterone was normal and she told her taking more testosterone wouldn't do anything for her low libido. She does take estrogen and I think it has helped her mood some and definitely made it physically better to have sex. I don't think it helped her libido much though.