Low testosterone can lead to weight gain, changes in mood, decreased energy levels, and a reduction in libido.
What’s more important is this:
Many women suffer from low testosterone and this condition is missed by most physicians.
As a result, it becomes very important for you to understand the signs and symptoms of low testosterone to determine if you would benefit from replacement.
In this article, I’m going to go over why testosterone cream may be one of the best ways to replace low testosterone levels and all of the benefits that you may experience during replacement.
Let’s dive in…
Why you should consider Testosterone Replacement Therapy
Both men and women have and need adequate levels of testosterone.
While men do have more testosterone than women, that doesn’t mean that testosterone isn’t important for women.
In fact:
Women with low testosterone get many of the SAME symptoms that men get when they have low testosterone.
In addition, replacing testosterone is not that difficult and the benefit can be tremendous.
Not only that but the diagnosis and management of low testosterone are often missed/ignored in women due to a general lack of understanding about hormone management by most physicians.
With that in mind let’s go over several reasons that may make you rethink the importance of testosterone for women and consider using it yourself:
#1. Testosterone can help increase libido and sex drive
One of the main reasons that both men and women lose their libido over time is a decline in testosterone.
Testosterone has been shown to INCREASE sex drive (1) and libido in women with low testosterone levels.
Not only does it increase sex drive but it can also reduce the time to orgasm and increase pleasure during intercourse.
To see a full list of therapies that can help improve libido and increase sex drive please read this post.
#2. May improve overall mood, reduce depressive symptoms and reduce irritability
Do you feel yourself getting more irritable as you age? Or that you can’t control your emotions as well as you used to?
Some of these changes may be related to low testosterone levels.
Studies have shown that replacing low testosterone levels can act as an anti-depressant (2).
In addition testosterone in physiologic (normal) dosages actually has a calming effect on the mind and body.
#3. May help increase lean muscle mass and increase metabolism
Supplementing to normal and healthy testosterone levels has been shown to increase lean muscle mass (3) in both men and women.
This has two beneficial side effects:
First, an increase in lean muscle mass helps with weight loss by increasing your metabolism.
Everyone is looking to shed a couple of extra pounds and increasing your metabolism is one way to do this.
A higher metabolism means it takes more energy at rest to eat, breathe and sleep. Much of this metabolism is mediated through your muscle mass.
So higher muscle mass = higher metabolism = more weight loss.
Make sense?
Second, it improves body composition and can tighten up loose skin in certain areas of the female body.
One symptom of muscle mass is “loose skin”, especially in the upper arm area.
As muscle mass declines (termed sarcopenia (4)) and your muscle mass shrink your body will replace that excess space with subcutaneous fat.
This process may result in sagging skin.
Taking testosterone can help replace that lost mass in the skeletal muscle and restore much of the strength that was lost.
This issue is more than just cosmetic.
Reduced muscle mass leads to a higher frequency of falls, inability to maintain balance, and weight gain.
Giving you more than just 1 reason to build those muscles up.
#4. May help with weight loss (especially weight gained after menopause)
This is a big one.
Most women tend to gain weight during menopause (5) (sometimes as much as 15 pounds) and this weight gain is felt to be caused by changes in hormone levels.
At least some (if not a huge portion) of this weight gain is secondary to lower testosterone levels showing the impact that this hormone has on weight.
Replacing testosterone levels isn’t going to be a weight loss miracle pill, but it can certainly go a long way to helping reduce any extra weight that was gained due to its deficiency.
This is one of the reasons that many women opt to use testosterone cream and other forms of testosterone replacement: to lose extra pounds.
This effect on weight loss is probably mediated through the factors we mentioned previously: changes in skeletal muscle mass and metabolism.
Although testosterone also alters energy levels and helps women stay up and active.
#5. May increase or stabilize low energy levels
Testosterone Cream vs Pellets vs Shots
If those benefits listed above were enough to at least pique your interest then keep reading…
There are several factors to consider when replacing testosterone levels and different vehicles to make it happen.
Some methods are definitely better than others so it’s worth discussing each in detail and giving the pros and cons of each.
You can then use this as a general guide to determine which form of testosterone will be best for you.
Note: all of these various methods of giving a person testosterone should ultimately result in an overall increase in testosterone in the body.
Benefits of Testosterone Cream (Including gels/patches as well)
Testosterone cream is probably one of the most common forms of testosterone replacement therapy and for good reason.
When replacing hormones it’s best (whenever possible) to mimic or emulate how the body produces hormones.
This is especially important with testosterone:
In the female body, testosterone is produced by the ovaries and the adrenal glands (6).
This hormone is then dumped directly into the bloodstream (avoiding the GI tract) where it hits target tissues and exerts its effects.
Using testosterone as a cream or anything that goes through the skin closely mimics this natural progression through your body.
This should be compared to taking testosterone (or any other hormone) in a pill or capsule.
By taking it by mouth the hormone is absorbed through the GI tract where it hits the liver and is metabolized FIRST before it can hit all of your target tissues (This phenomenon is well known and called the first-pass effect or first-pass metabolism).
This reduces the potency of the hormone and also may cause dangerous side effects due to potentially harmful breakdown products in the liver.
For this reason, most physicians and patients tend to opt by taking trans-dermal (meaning through the skin) formulations of testosterone.
Using testosterone cream allows for a sustained and controlled release throughout the day that avoids this first-pass effect.
Who should use testosterone cream?
Most women who know they have low testosterone and are experiencing any of the symptoms of low testosterone should at least start with a trial of testosterone cream, gel, or a testosterone patch.
Attempting testosterone cream for at least 2-3 months and checking blood tests at the 6-8 week mark will allow for adequate time to determine if it is working for you.
Pros and cons of using Testosterone cream:
PROS
- Avoids first-pass effect from the liver
- Reduces the number of potentially harmful breakdown products
- Allows for sustained and controlled levels throughout the day
- Most compounding pharmacies should be able to fill your prescription without any issues
CONS
- May require higher doses and changes in dosing over time
- Will require blood tests to measure levels
- Absorption varies between individuals (may work better for some women than others)
- May need to be bound to alcohol to increase absorption
Benefits of Testosterone Shots
Instead of getting testosterone through creams, gels or patches sometimes patients opt to use injections once every week instead.
Using injections is worth considering in the following circumstances:
- You have previously tried and failed testosterone creams
- Your testosterone blood levels are not increasing even after increasing the dose and concentration of your cream
- You haven’t noticed any positive side effects from creams/gels/patches
- You prefer once-a-week dosing over once-daily dosing (or have a hard time remembering to use your testosterone)
- You are having trouble getting your cream/gel/patch prescription filled
Generally, I reserve testosterone injections for patients who fall into the above categories.
The benefit of using shots is that you get a higher concentration of testosterone in one sitting, this makes positive (and potentially negative) side effects easier to identify.
One of the downsides is that testosterone levels peak after days 2-3 of the injection and then slowly fall back down over the next 4-5 days.
This doesn’t allow for the same sustained tissue levels of testosterone that creams/gels allow for.
Having said that some women just do better on testosterone injections vs creams so it is worth considering this option for most women.
Pros and cons of using Testosterone shots:
PROS
- Works better for women with absorption issues
- Usually results in higher doses throughout the day
- Infrequent dosing (only need to use it once per week)
- Avoids first-pass metabolism in the liver and works well
CONS
- Small risk of infection at the injection site
- Lack of control in dosing (easier to take too much compared to creams/gels)
- May have difficulty filling the prescription in your state
- Must inject the hormone into your body (a problem if you have issues with needles)
Pellets and Oral/Sublingual Testosterone
Another commonly used form of testosterone replacement (or other hormones) is through pellets.
Pellets are surgically implanted pellets that contain a high dose of hormones that slowly dissolves over months.
Because of this mechanism, there is far less control over dosing meaning that the dose tends to be either too high (causing negative side effects) or too low (failing to cause positive side effects).
Couple this concern with the fact that you need to undergo a surgical incision to place it in your body and pellets look even worse.
In my experience, it’s far better to use creams/gels/creams/shots over pellets due to these reasons.
You might consider using a pellet if they have previously worked well for you in the past or if you can’t tolerate gels/creams/patches/shots.
Pros and cons of using Testosterone pellets:
PROS
- May work for patients who have failed other forms of testosterone replacement therapy
- Doesn’t require frequent dosing
CONS
- Risk of infection/bleeding at the surgical site
- Decreased control over sustained dosing (if you get too much you can’t change the dose)
- Inability to alter dose easily
- Expensive compared to other forms of testosterone replacement
Diagnosing Low Testosterone
Diagnosing low testosterone is actually not very difficult (we will go over it below).
The hard part is getting the right kind of treatment and the right type/form of medication.
The problem with hormones is that most physicians are not trained on how to replace hormone imbalances and so they don’t appreciate their importance or the benefit they may provide.
As a result, it’s usually better to look for a physician who specializes in hormone replacement therapy for the best results.
Alternatively, if your physician IS willing to work with you, you can simply ask for a couple of tests to determine how your hormones are doing.
To diagnose low testosterone you need to check the following labs:
- Free testosterone (optimal ranges for both below)
- Total testosterone
Ordering the right tests is only half the battle, the other half is understanding how to interpret them correctly.
To illustrate this I’ve included an example of real lab results below…
Example of obviously low testosterone(falling outside of the reference range):
This case is typical and very obvious.
The total testosterone is low at less than 3 with a range of 3-41.
The DHEA (another androgen) is also low at 26.7 with a range of 41.2 – 243.7.
This is an obvious case of low testosterone and if this patient also had symptoms of low testosterone she should consider a replacement regimen.
On the other hand, some patients have what is referred to as “sub-optimal” hormone levels that still technically fall within the “normal” range.
Example of sub-optimal testosterone levels in women (inside the range but still low and needs replacement):
In this example, the free testosterone is sub-optimal at 0.14 with a range of 0.06 – 0.98.
The total testosterone is also sub-optimal at 8.5 with a range of 8 – 60.
This is another example of a patient’s labs that should be treated even though they “technically” fall within the normal ranges.
As a general rule, if you are a woman who is symptomatic with testosterone levels in the bottom 50% of the reference range then you should consider testosterone replacement therapy.
Lab studies you should get checked
When checking your testosterone levels it’s also a good idea to evaluate your other hormone levels.
The reason is simple:
If you have one hormone imbalance, you are much more likely to have other hormone imbalances as well.
Because of this, you should consider getting a complete hormone panel to ensure proper treatment.
I recommend the following labs:
- Testosterone free and total
- Estradiol and progesterone
- Complete thyroid panel (see the link for the complete list)
- DHEA (another important androgen)
- Insulin and leptin (helpful if you have weight issues)
This panel is a great starting point and should allow a full evaluation of your hormone profile.
FAQ about using Testosterone
If you still have questions regarding the use of testosterone please refer to this FAQ.
If you have other questions please feel free to ask them in the comments below and I will be sure to update this list as well.
Where should I apply it?
Testosterone is usually best if applied to the upper/inner arm area.
Any area with high vascularity and low subcutaneous fat will work well but remember you should not use multiple hormones on the same area of skin.
For this reason, I usually recommend that women reserve the forearm area for estrogen/progesterone and use testosterone in the upper arm area.
If you aren’t using other hormones trans-dermally then you can also consider these areas for application: thighs, lower abdomen area, forearms, neck area, and/or vaginal mucosa.
Testosterone can also be applied vaginally (assuming your formulation won’t burn or cause problems) and may be very beneficial especially if you are suffering from low libido or low sex drive.
How long does it take to work?
You should notice an improvement in your symptoms within 4-8 weeks of starting testosterone replacement therapy.
In some cases, women continue to experience slight benefits over the next several months, and some symptoms take time (like building muscle mass), but energy levels and libido should increase within 4-8 weeks.
This assumes that your dose is adequate and that your blood levels of testosterone are increasing on your current dose.
Is it dangerous or are there any side effects?
Testosterone replacement is generally well tolerated.
Symptoms usually occur if the dose of testosterone is too high.
These symptoms include:
- Hormonal or cystic acne (may also increase oil production of the skin)
- Changes in hair growth(facial hair growth or dark/coarse hair growth)
- Changes in mood(usually more irritable)
- Very high increase in libido
If these side effects occur while using testosterone cream or gel then the side effects will fade within days.
If they occur with testosterone pellets then they may take months to improve.
Side effects from testosterone shots should improve within 7 days.
How much should I take & what is the dosage?
Dosing varies on the individual and should be based on a combination of lab tests and symptomatic relief.
The reason for this is the absorption of testosterone depends on the individual, how quickly they metabolize the testosterone and how much their body actually needs.
Because of these reasons, testosterone doses vary from person to person and will require some degree of trial and error (including lab monitoring) to find your specific dose.
Wrapping it Up
Testosterone replacement therapy, specifically testosterone gel or cream, has multiple potential benefits for women including weight loss, increased energy levels, building lean muscle mass, and helping with mood.
When diagnosing low testosterone it’s best to use a combination of lab tests plus symptoms.
Remember to use the “optimal” ranges vs the standard “normal” ranges when determining both if and how much testosterone you may need.
Now it’s your turn:
Are you currently using testosterone gel or cream?
Is it working for you? Why or why not?
Are you planning on getting your testosterone levels checked after reading this?
Are you experiencing any of the symptoms of low testosterone?
Leave your questions or comments below!
I feel like my weight gain is genetic because my family are all built the same. We carry the weight in our upper body. I even have a failed lap band still in me. Going to see my doctor soon. They want to try medication out next. I have been reading your articles and I’m impressed. I have hypothyroidism, I have high cholesterol, I take diabetic meds (1000mg) and I can’t seem to get motivated. It seems like nothing in my body works right anymore. I will bring up your article to my fat doctor and my GP . My fat doctor is going to blow me off, Mr know it all. I have a better chance with my GP. Would take to long to tell all my problems. Imy wanting to give you way a shot. I pray it works.I’m 193lbs and am stuck at this weight. I want to be more active and happy. Wish me luck and thank you.
Hey Traci,
I’m not accepting new patients, but your case is not different from many of my previous patients (even the failed lap band portion). Most (all?) of the interventions listed on my site fall outside of the realm of conventional medicine and will largely be unknown to regular physicians including bariatric doctors, pcp’s and endocrinologists. You may be able to piece some of the therapies together through my case studies but it’s far better to find someone better to help and guide you.
Hi Dr. Childs
Have you ever seen a case like this? Low testosterone, insulin resistance, low Vitamin D, very low iron, low thyroid numbers & cortisol lower than optimal? I was told to meditate and given some supplements and adaptogens for adrenal support but I have to believe there might be more I could do or focus on. I started on a testosterone, pregnenalone, DHEA cream but I’m hoping it’s not permanent. Also, I’m active and 100lbs so there is no weight issue really but I will hold excess weight in my midsection at times. I just feel like I never fit into any categories so I’m wondering if you have any case studies you could direct me to.
Thanks for any help!
Hey Jamie,
Yes, I’ve seen many cases with hormone imbalances like that. You really won’t get results unless you treat the cause of the imbalances, not just the imbalances themselves.
While I understand the concept and avidly agree with the concept to “find the root cause”, I have worked with numerous highly reputable (and pricey) integrative docs in LA, and while they are good at testing and finding issues in various labs from micotoxins, to gut health/genova tests, urine / dutch and blood tests where they inevitably find things that are troublesome or not optimal, not one has ever gotten to the root.
It seems that most of us here have a lot of these, if not all of these hormone issues, most of which started in subtley in teens, then late 20’s / early 30’s and get worse as we age.
What is the root cause of all of this?
What is the root cause of hypothyroidism, of PCOS, of high estrogen, of cortisol issues, of elevated leptin, of insulin resistance, of hormonal acne, of weight-loss resistance, non alcohol liver labs?
I can’t help but wonder if it all goes back to the pituitary gland? I’m no medical doctor here (although I really should be by now with all of the time I have spent researching in hopes to try and help myself live a normal life) but isn’t that the factory for all hormones?
I completely understand each case is different, but would love to hear what some possible root causes of all of this disease could be coming from.
Hi SF,
I think the idea of finding the root cause sounds really good in theory but falls apart in clinical practice. In my experience, I don’t think it’s always possible to find the root cause. In fact, I would say even if you do find it, you can’t always reverse it or even fix it. This could be because we lack the proper knowledge and because we don’t understand these conditions as well as we think but it could also be that some conditions simply are not reversible.
Have you looked into Peptides? I am working through Dr Childs protocol with great success and lost over 20 pounds within 3 months (started Feb 2020)- which I haven’t been able to lose even a pound in years (52 and in menopause & a host of thyroid and autoimmune issues). The weight has slowed-but still losing about a pound a week on protocol . My Dr has been great about prescribing the necessary prescriptions but in addition he also has me doing other peptides (in addition to GLP-1 (Victoza). The ones that have helped tremendously and have almost reversed many of my issues are Thymosin-Alpha 1, 11-37 and MOTS-c (game changers) … my doc takes virtual patients and will follow Dr Childs protocol and MORE, if needed. I totally understand what you are going through as I struggled for over 10 years and been to some very expensive specialists. Glad to have found Dr Childs and Dr Bird :)… http://www.transformyou.com (Dr Robb Bird)
Thank you, Dr. Childs.
Do you have any literature you recommend for determining the possible causes of these imbalances?
I don’t have any blog posts specifically on those topics, but will likely be adding more in that area in the future.
Hi Dr Childs, I have been using Bioidentical hormones replacement before, recently changed to HRT I’m taking Activelle and testosterone cream that my doctor gave me. Is it safe to switch from Bioidentical to HRT? I’m age 57 and I wanted to switch because afraid if after age 60 it’s dangerous to do HRT! Is activellee will cause any weight gain or water retention? Please advise! Sandy
I started testosterone cream in June and in December started having severe headaches and high blood pressure and was eventually diagnosed with a dural cavernous sinus fistula which affected my right eye, I also know of someone who was taking shots and had a stroke .have you heard of this ? My headaches began after my doctor increased my dose , now I am afraid to use it although my neurologist is not sure if that is the cause.
Hi Susan,
I’ve never had any patients complain of such symptoms, I also have a hard time believing that testosterone would directly result in a stroke or a dural cavernous sinus fistula.
My father had a stroke after having testosterone shots. There is actually a huge law suit regarding it. He would have died if the ambulance team that came didn’t recognize the type of stroke he had and got him to a specific doctor within the hour.
Make sure to monitor blood count with testosterone, esp in high doses as it can raise the RBC count and make the blood “thicker”. Also there can be an increase in estrogen related to the increase in testosterone which can affect headaches.
Hello Dr. Child’s
How would you approach treating hirsutism in females with low testosterone levels. I have recently started taking Metformin 2000 mg a day along with Spironolactone 200 mg a day. A GP that I am seeing now mentioned that he would not suggest using testosterone supplementation due to hirsitism. Your thoughts would be greatly appreciated. Thank you.
Katherine
Hi Dr. Childs,
I’m living in Germany. I’m 50 years old. I always had quite high testosterone levels for a woman, total testosteron mostly between 0.7-9.0 ng/ml ( norm range 0.1-0.7), I’m a South Europian with a lot of body and facial hair, but already my mom and grandmother were the same. I look feminine, have a soprano voice and I gave burth to 2 children. So I never considered I’m having a problem with testosterone. I always war very active, competitive woman with excellent libido. In my youth I took for 3 months the androgen bc-pill and I completely lost my libido, so I refused any further trys to reduce my “abnormal” testosteron levels. My DHT levels are over the norm range too and I’m having oily skin and some occasional hair loss.
Now, during the menopause (I’m using a combi-patch), I started noticing that I’m loosing my muscle mass, gaining weight on my belly ( look like preg…) and I’m loosing not only my libido, but also my sexual fantasies and the sensitivity of my clit. I very dislike those symptoms, but my gyn said, well, it’s aging process and I should accept it. Which I don’t. I have a younger boyfriend and I want to enjoy my life fully…
My last total testosteron levels were few weeks ago 0,63 ng/ml ( 0.1-0.7), so for the first time I’m within the norm range and my gyn is very happy about it. But not me. It makes a huge difference how I feel specially regarding my libido. So I would like to have back my old T levels above 0.8. My gyn refused to precribe me a T-cream. So I considered to buy a available, prescribtion free testim- gel online to use testosteron on my own.
What do you think about my T-levels? Could it be possible that my body is used on higher T levels and I already feel like having too low testosteron?
My gyn is a hormon specialist, but here in Germany no woman gets a prescribtion for a testosteron, only if she had the ovaries removed.
Thanks!
Dr. Doctor Childs,
I am 60 years old. I have been diagnosed with Osteoporosis in my hip, Osteopenia in my lumbar spine, I have very dry skin, dry hair, dry eyes, brittle nails, no libido, trouble losing weight and my hair has been shedding (mostly around the crown) for two years or more.
I have been to a lot of hormone doctors and none of them really have been able to help. I think they don’t know how to really “optimize” patients, they just dose enough to get rid of hot flashes and when I complain of other symptoms, they are too afraid to up my dosage. Plus, I “look” healthy so they don’t seem to take my complaints very seriously.
Current Labs: (Fasting, all BHRT dosing – 12-hour time lapse before testing)
Free Testosterone – 1.4 (Quest Ref range = 0.1 – 6.4)
Total Testosterone – 29 (Quest Ref range = 2 – 45)
DHEA -171 (Quest Ref range = 102 – 1185)
DHEA Sulfate – 84 (Quest Ref range = 8-188 mcg/dL)
Progesterone – 31.8 (Quest Ref range = Luteal Phase 2.6 – 21.5)
Estradiol – 26 (Quest Ref range = Luteal Phase 56 -214)
SHBG – 240
T4 – 5.3 (Quest Ref range = 4.5 -12.0 mcg/dL)
T3, Free – 1.9 (Quest Ref range = 2.3 -4.2 mcg/dL)
TSH – 1.57 (Quest Ref range = 0.40 -4.50 mcg/dL)
Cortisol – 19.0 (Quest Ref range = 3 -22) (tested 9am in morning)
I know you said that it would be good if I was in the top 50% of the Reference Range for all the hormones, so is that what I should be shooting for? I do have a doctor i know that I think would work with me if I explained it to him in a logical way.
I understand that anything you say is just commentary and not a diagnosis, but any light you can shed for me would be appreciated and I will discuss with my doctor.
Thank you,
Robin
Hi Robin,
The issue with hormones is that you can’t use lab values in isolation to diagnose or treat patients. Each person is different, so lab ranges are only used as a guideline for treatment purposes. Some people need more and some people need less. For these reasons it’s always best to see a hormone Doctor who can help guide you, rather than you help guide a clueless physician.
Hi, I’m 49 years old and I’ve been using bioidentical hormone creams for several years now. I stopped getting periods without the use of Prometrium at age 45. I was deficient in estradiol, testosterone, progesterone, and DHEA.
My Rx consists of:
3 mg testosterone applied daily
2 mg estradiol, daily
50 mg progesterone, nightly days 13-25
I get regular periods now, but I think my estradiol may be getting too high because I’m getting cellulite and feel flabbier all over despite regular weight training and cardio.
I stopped using the estradiol last month and I’m only using the testosterone and progesterone. I’m not having hot flashes or any of the low estrogen symptoms I used to have. My questions are:
Do I need to supplement DHEA? My doctor said the testosterone makes DHEA treatment unnecessary. Also, could low testosterone and normal estradiol levels account for hot flashes night sweats?
Do you think the estradiol cream contributed to the reduced muscle tone and fat gain? Will using just testosterone help get rid of the flabbiness?
Hi Josie,
It’s impossible to say for sure what hormones you should/shouldn’t be taking without lab values and assessing other aspects of your health. This will require a full history, physical and laboratory assessment from a hormone literate physician.
I recently was reading about where on the body to apply testosterone cream for maximum efficiency. The chart I saw showed that the inner part of the wrists were the optimal spot for testosterone cream. But I know also that creams are meant to be rotated because sometimes the receptors can become non- responsive? Also I heard that creams only absorb 10% of the product into the bloodstream. Wondering if you can shed some light on this?
Hi Robin,
The inner soft part of the wrist is prime real estate for all transdermal hormones due to the thin skin, low fat concentration and venous blood supply under the skin. And yes, when you apply any hormone transdermally only a small portion is actually being absorbed – the function of the skin is to prevent absorption of various substances, so this makes sense.
Hi
My periods stopped when I was 42 (7years ago). I had a blood test and was told I was going through early menopause.
I started taking hrt about two years ago, only really because I was getting very forgetful and had trouble remembering things from my past (like a holiday for instance). Also libedo was non existent!
I tried a couple of different tablets but this didn’t seem to help much.
March this year a went to a menopause clinic where I was giving a hrt patch (estridol) which I have to changer every 3-4 days and a progesterone tablet to take at night. I was also given testim testosterone gel which I rubbed into my thigh. All medication doing a good job I suppose.
I have two questions if that’s ok.
1. Bearing in mind I started the above medication in March, I have started having periods again (after 7 years of not having them). Is this ok?
2. My libedo has got changed, nor has my weight (14 stone and only 5 foot 4″). I know I have to loose weight but have no inclination to do so. I’m not lazy, I work full time and have four sons. I’d do anything for anyone but just not myself. I look be my husband very much but hate my body and the fact I have no libedo.
I’ve read all the above info and have started putting the gel on my upper arm. Hopefully this will help.
My testosterone levels have never been checked. The doctor just recommended the gel after me telling her all the above.
Sorry I’ve gone on a bit. Thank you for reading this. Any advice would be welcome.
Dr. Westin,
Have any of your patients experienced sleepiness and appetite increase with testosterone cream? It was prescribed to me, but I keep experiencing this. I’d stop and start the cream, and never got a chance to reach out to the prescribing doctor who has since moved.
Hi Dr Childs, My primary MD just told me to stop my testosterone cream (dose 1mg) due to heart irritability. Have you heard of testosterone cream at that low dose causing heart problems
Hi Karen,
No, I’ve never seen heart complications from low dose testosterone cream.
I’ve been on testosterone trists 5mg twice a day for 5 months and two to three months in I started getting migraines. Other than the migraines I felt great with improvements on mood, energy, libido and satisfaction with sex life. I switched to a lower dose (3 mg once a day) and the headaches went away for a little while but then came back. All the beneficial effects went away at that does. So I switched to cream. Headaches went away for about two weeks and now are back. My practitioner has never had a patient that got headaches from TRT. Have you? Any advice? I really want don’t want to stop taking it.
Hello. I am going to paste my comments from another blog in hopes that you can further shed some light on this concern:
I read an article yesterday (link below) after coming here (to learn more about my experience on testosterone cream) and in the comment section I finally found someone who had experienced the same thing but apparently not as intensely. Her comment was:
“I am a heterosexual female. I was prescribed a tiny topical daily dose of testerone cream to boost my libido as I entered peri menopause. Within a couple of weeks I found myself looking at women the way I imagine men do. It was interesting but icky (if I were gay I wouldn’t hesitate to honor that, but I am not). Just sayin’. That s$&t is powerful!”
To which I replied:
“Thank you! It turned my world upside down and has me seeing a sex and relationship therapist for this very thing. I have seriously considered ending my marriage and coming out as gay as I have overwhelming attraction to women now.
I called my hormone doctor to ask if testosterone could change a woman’s sexual orientation and he said no, it doesn’t work that way. Still, he cut my dose in half but that changed nothing
I didn’t believe him but could find no research that even suggested such a thing. In fact, quite the opposite so I was left with the understanding that it basically juices and ramps up whatever underlying sexual attraction is already there.
Female sexuality is quite fluid. Many straight women (probably most) admit to some level of attraction to other women, watch lesbian porn, etc. So I think my natural sexual fluidity is now on hyperdrive and testosterone has my libido so jacked that I have convinced myself that if I am not full-on lesbian, I’m close.
Be careful with this stuff. Seriously, now I understand the male sex drive much better. I went from being in a happy heterosexual marriage to thinking about wanting sex with women all day long. I am not exaggerating.
I have scoured the internet for weeks trying to find a comment like yours — anyone at all who experienced the same thing — and found nothing.
Such a relief. This stuff is POWERFUL.”
My comment really doesn’t fully detail how far this all went. It stopped short of me having sex with a woman but it got very close.
https://www.marksdailyapple.com/high-t-more-wives-plus-testosterone-for-women-and-the-best-primal-roux/
BACKGROUND NOTE: I am on a compounded cream. My bottle says 5% cream and one turn/click of the bottle delivers .2 ml or product. I don’t know how that translates into exact amount of testosterone.
I have been on it since mid June, 2017. I am 56, post menopause and was initially put on bioindentical estrogen, progesterone, pregnenolone, and DHEA. I got some benefit from this in terms of skin and sleep but that’s it. I felt no increase in libido. My doctor was very conservative and waited a long time before pulling out the big guns and putting me on testosterone. My labs, before going on the testosterone were basically zero. He said I had the lowest testosterone of anyone he’d seen. So, why at such a small amount (which he told me to now only apply every other day, so cut dosage in half) am I so hypersexual and so completely turned around on sexual preference It’s as if men don’t even exist. I don’t understand what is happening.
Thanks!
Hi Elizabeth,
Thanks for sharing but I don’t think I’ll be able to shed much light on this problem. In my experience (in probably treating hundreds of women with testosterone) I’ve never had anyone endorse an increase in attraction to the opposite sex while using testosterone therapy. It’s not uncommon for libido to increase to some degree (but it shouldn’t be overwhelming), but as far as I can tell this increase seems to enhance the attraction to whichever sex/gender you were attracted to prior to the therapy.
My initial thought is that you may have an excessively high dose of testosterone or that you simply don’t respond to the type or administration of testosterone that you are currently using. This would explain your libido but wouldn’t explain your change in attraction.
I am trying the shots. I am 45 years old. How do I know which kind of testosterone should be used? I have been told there are 4 different types.
Hi Tara,
It depends on a number of factors including: patient preference, lab results, trial and error and clinical response.
i know of only 3 types of T. Enanthate, Cypionate, and Prop. All the docs I have been to use Cypionate. It’s ridiculously expensive to go through these functional medicine doctors, not only that, if you opt for the injections, you have to do it yourself. Don’t ever use the pellets, if they mess up the dose you are stuck with the affects until the pellet is done. I have a reliable source for Test and buy my own. Why should I pay a doctor to give me the same thing but charging me 4X’s the amount when I have to do the injections myself. The medical field is nothing but a money grabbing racket.
Hi Melissa,
There are other types but the most commonly prescribed is typically cypionate. I wouldn’t say the entire field is a money-grabbing racket but I do understand your point. Testosterone itself is a very low-cost medication, so doctors try to get you to come in more frequently so they can make money by giving it out. Unfortunately, this is more beneficial to the doctor than the patient.
Hi Dr Child’s,
I have low testosterone and DHT and I had the Dutch test done that shows high 5a Reductase Activity. I suffer with cystic acne and female pattern balding. How can a person increase their testosterone but not let it go down the wrong pathway?
….I’ve tried saw palmetto, and zinc.
what brand of testosterone gel/cream you recommend? do i need a prescription for it?
Hi, testosterone is only available by prescription. There is no specific brand of testosterone gel/cream that is appropriate for a woman to use – they are formulated for men. The fuses for women are much lower. You must get it specially compounded at a compounding pharmacy.
“Doses” not fuses, haha
her finger hit the wrong key since they are side by side.
The point is, you have read what you’ve written and edit before posting. So many people don’t, with terrible mistakes which sometimes don’t make sense.
I just started using a compounded testosterone cream 2 weeks ago and I can not believe the difference it’s made! I had a hysterectomy 6 months ago and was exhausted, moody and started gaining weight and getting cellulite. After just 2 weeks of use, my energy and strength are through the roof and my bodyfat went from 20.6 to 17.4%!! Best decision I’ve ever made!! Talk to your doctor
I began T cream a few weeks ago for loss of libido after menopause. So far the only result has been dozens of hot flashes. My gynecologist doesn’t understand this and suggested I quit the T. I’m not ready to quit, but do not understand why I’m having these hot flashes. Please, could you give me your opinion?
My hormone doctor told me that taking too high testosterone will lower your estrogen. That might explain the hot flashes. Maybe you need to also take estrogen?
Hi Jodi,
Testosterone should not lower estrogen and not to the degree that it would cause hot flashes.
I started Testosterone cream about a month ago. I am 64 and have had brain fog, extreme fatigue,loss of muscle mass. I take female hormone replacement and have for years but didn’t even realize I was lacking in Testosterone. I was post menopausal at 47 so went through the change early. My Urologist tested me and my Testosterone levels were almost nil. I am on the bio-identical cream and after using it for about a week, I started to notice my mood lift up and my energy level increased. Now I feel amazing. I am having weight gain and I am sure that is because my metabolism is higher and I am eating more. Need to stop that I guess. My libido also came back. So I can’t tell you how much I love this. I am having breakouts on my chin, shoulders and back of my neck but was given RX for Spironolactone 50mg daily. Seems to be helping a little. Not sure how much of Spironolactone I can take and what dose might give me better results. Do you suggest anything other than Spironolactone for these skin issues?
thanks for the blog,
Anetha
Sounds like your dose of Testosterone is too high as your side effects are in line with a too high dose. I wouldn’t get it from a compounding pharmacy either as the doses can be irregular.
Good luck!
Hi Dr childs, I was recently given bio identical testosterone cream progesterone pills and an estradiol patch I cannot afford to do all three so I’m choosing just to do the testosterone is this okay? Even though I do have insurance it’s still almost $200 a month for all three. Thank you
Started testosterone cream 5mg/ml instructed to apply .1ml daily. Has been 4wks from today with no change in weight loss or libido. Considering increasing .2ml daily. Scheduled to meet physician in 8wks.
Dr. Childs
I am a little late to this post but I have been researching testosterone supplements to help me with symptoms of pre-menopause and I came across your article. I am 47 years old, no health issues at all and very active. Hiking or running between 20 to 30 miles per week, weight lifting 4 to 5 times a week. Literally, overnight, I feel like I lost all my energy. Always tire and in spite of all the exercise, I am barely keeping the weight off. If I binge one day, I instantly gain 5 pounds and it takes me two weeks to lose it. I have been looking into and reading a lot about over the counter testosterone supplements recommended for athletes and reading many of blogs, comments, and reviews, they are getting excellent results. Some of those are also recommended for women and the ladies seem to be happy with their results as well. They are reporting weight loss, muscle mass gain, and more energy. What are your thoughts on over the counter products? Is it safe for women to take those? I’d love to hear your thoughts on it as I am thinking about giving it a go.
Ps: menopause sucks 🙁
Your info is so helpful to all of us who suffer and thank you for being legit bc there are many people opening clinics to do testosterone pellets bc they are money makers; whereas, You look out for your patients and do what’s right. Thank you so much for looking out for us!
Hi Amy,
There is definitely more money to be made with pellets because it is a procedure, but I find they aren’t always the best option. Having said that, some people can do okay with them, it just depends on the individual. I’m not a fan of unnecessary procedures, though, because of the risks involved.
Hi Dr. Childs,
I started the bioTE pellets in March of this year. (2018) My dr tested my female hormones. I am 62 but feel really good. I don’t have any hot flashes. I am 130 lbs and I eat very small amounts of processed foods I can’t drop the extra 15 lbs. I also work out 5 days a week and run/walk 5 miles every morning.
Labs from March 2018
Estradiol < 17.0
Progesterone 0.26
Testosterone 27 (<=32)
Sex Horm Bind Globulin 101.2 (17.3-125.0)
Calc Free Testosterone 2.2 (0.6-3.8)
He did the bioTE insertion and gave me:
12.5 mg of Estrogen
125 mg of Testosterone
Prometrium 100 mg capsule to be taken 1 hr before bed.
He retested my testosterone, estradiol and progesterone levels 6 weeks later in April.
Testosterone was 362 and was flagged as High.
Sex Horm Bind Globulin 91.1 (17.3-125.0)
Calc Free Testosterone 34.6 (0.6-3.8)
Progesterone 1.03
Estradiol 60.5
Sedimentation Rate 18 (0-20)
TSH 2.370
Free T3 3.4 (2.2-4.2)
Free T4 1.30 (0.80-1.90)
I can include other labs but I understand if this is way too much info.
Ferritin 48
Vitamin D 25 OH 65
Glucose 97 (70-99)
Triglycerides 120 (<150)
HDL Cholesterol 259 (,200)
Calc LDL Cholesterol 169 (<100)
Risk Ratio LDL/HDL 2.56. (<3.22)
DHEA Sulfate 230 (<112)
Insulin 5 (4-13)
Homocysteine 7.4 (5.0-12.0)
High Sensitivity CRP 1.9 (5.0-12.0)
I don’t think I want to continue the bioTE pellets and would like to use hormones in a cream so I can monitor my doses if they are too low or high. I love the bioTE Pellets but it is expensive and I am hoping I can use something over the counter that my dr or you could suggest.
He wants me back to discuss my hormone levels and also to discuss my thyroid labs. I am hoping he will offer some ideas and I have printed out some of the info off of your website.
Thanks if you can offer me any suggestions! I really enjoy all of the info you have to offer on your site.
I have multiple health issues from hEDS to PKD to possible Charcot Marie Tooth disease, and am on chronic pain medication. I have muscle wasting and muscle fatigue together with possible CFS/me etc., and while researching discovered the link between chronic pain meds and low testosterone. Mine was tested at 10 low for the norms. I am hypothyroid on 112mg of levotyroid and 5mg cytomel for low D3. I am obese, been menopausal since age 50 (now 65), have had a transplant, was being tested for adrenal disease which stopped due to being on daily cortisone, and generally have a lot of endocrine issues. I am a post transplant diabetic with an A1c of 5.5. My issue is my health providers won’t treat androgen deficiency due to medications, and say it is only used in women rarely for low libido. I don’t want to buy it illegally, but feel it is in my best interest to give it a try to see if it will help my energy, weight and muscle wasting. Do you have any suggestions for me? Do you think I should give up or keep trying to give testosterone a try? Do you have any information on this particular cause of low testosterone in women as they acknowledge the issue in men and will treat it, just not in women.
Hi Cathy,
Many women do very well on testosterone, but not many physicians understand this. You’ll probably have better results by looking for a doctor which specializes in female hormones including testosterone and thyroid.
I appreciate you’re no longer taking new clients but I thought I’d give you the results of my efforts I have reached out to my pain doctor who prescribes the drugs that are known to cause low testosterone, my gynecologist who is the department Chief, my endocrinologist, and my Primary Care physician. Everyone except my primary care physician suggested I was having menopause symptoms even though I’ve been in full menopause for 15 years. My primary care read the information but doesn’t feel he can prescribe testosterone. Gynecology will only prescribe it for some cases of low libido and doesn’t test for low testosterone as they conclude it isn’t useful for menopause symptoms and don’t consider it useful for anything else, and my endocrinologist replied “regarding the testosterone, since this is not a FDA approved treatment, I am not sure where to go next on that one.” There is a reason we reach out to you, most doctors are unwilling to think outside of the box, read new information, or be among the first to give it a try. Your patients are quite lucky.
I changed hormone doctors and the new doc just put me on a once daily cream with multiple hormones. I just read above that the hormones should not be absorbed into the same area of skin. I am on progesterone, two forms of estrogen, and testosterone. I used to insert the testosterone vaginally. During the past two months it has been on my forearms. I have had hair loss these last two months. Is it related? And why is it bad for all hormones to go on to the same skin?
Hi Stacy,
If you place all of the hormones in the same spot it can cause dermal fatigue which reduces the rate of absorption. This is especially true of certain hormones such as progesterone.
I was just converted from taking three different hormones, also to one cream with .3 Testosterone; 20.5 Estrodial; and 50 mg Progesterone. It is much more economical and efficient having one cream and one prescription vs. 3. I’m only on first week of this combo and ever on Testosterone. It was prescribed to put on inner thigh. So, to avoid the dermal fatigue you mention, should I change areas every night, or every week, or what would you suggest I talk to my doctor about to consider? THX
I have a wonderful testimony about testosterone. About 4 years ago I started peri-menopause. I started gaining weight which I had always been the same weight my whole life. Horrible hot flashes, no sexy drive and tons of other awful symptoms. I started on natural progesterone cream and a test/estrogen cream. I gained 10 pounds the first month! Narrowed it down to the estrogen causing the most weight gain. Started using just the progesterone cream and continued to go up in weight. Went and had my hormones tested and testosterone didn’t even register it was so low! By this time I was up 25 pounds! I felt the test cream wasn’t giving me the results I wanted so my doctor put me on injections. It took 3 months, and I started dropping weight like crazy. It’s been 6 months since the weight loss started and I’m only 5 pounds away from my original weight. For me, testosterone was the key. Im still low in estrogen, but I don’t react well to supplementation with it. I’m just taking the testosterone and progesterone now. Love it!
What mg. Progesterone are you using? Is it bio? Once or twice daily? What mg. testosterone and how often?
I heard docs say to use progesterone twice a day, then some say use as little as possible.
I had a total hysterectomy in February 2016, I feel like I still haven’t found the perfect combination. I’ve suffered depression and anxiety my entire life, after my hysterectomy everything became worse. I’m going to try to start at the beginning so I don’t leave anything out. In December 2013 I lost my best friend to Breast Cancer at 39 years old, she left behind two young children and a devoted husband. I had an extremely hard time so I resorted to a psychiatrist. She replaced my Zoloft with Effexor, and also placed me on adderall. I could focus more, had energy to get through the day, I didn’t cry all day anymore, but I lost my personality. I didn’t laugh anymore, I couldn’t feel joy in anything. I have two active daughters and a supportive husband, but I was just going through the motions of getting through each day. I was completely task oriented, I didn’t want to be around people because I felt like I didn’t bring anything to the table. Eventually my depression worsened and I had terrible thoughts of suicide. My doctor wouldn’t take me off of my Effexor, she increased it, along with increasing adderall. It has been a downward spiral. I started having issues with back, pelvic, and sciatic nerve pain. It was caused by a huge right ovarian cyst. I was somewhat relieved, I thought what if this has been my problem all along. Nope, I was so wrong. I’m going to speed things up…. I was immediately placed on the Vivelle patch 1mg. before I left the hospital from surgery. I slept fine, didn’t really have hot flashes, but I did have uncontrollable crying, weight gain, uncontrolled thoughts of just wanting to die. I felt so much guilt because I have the best family in the world, I know I’m blessed but I wasn’t strong enough to push these negative thoughts aside. I read about progesterone and talked my doctor into prescribing 20 mg. from a compounding pharmacy. I had even more swelling. I went to a doctor that supposedly specializes in hormone. I was taken off estradiol, given 200 mg. of oral progesterone, 40mg. Test. Injection monthly. I broke out with acne like a 13 year old boy. He placed me on 50mg. of Spirlactone. It didn’t seem to help. I wasn’t swollen anymore, my breast no longer hurt and their size decreased, which was a blessing but my depression and suicidal thoughts were worse. I stopped Test and only took progesterone for a couple of months, still on adderall and Effexor. I felt like I could barely put one foot in front of the other, to make things worse I felt stupid, like my brain was shut off. It was horrible, I work in the medical field, I couldn’t remember words, events, family members birthdays, I didn’t want to be around people, I wanted to stay home, I had no quality of life. I started seeing a wonderful doctor about four months ago, I believe he’s taken me on as a challenge for himself, like if he can help me, he can help anyone. Lol he said this is going to take some time. He took me off Effexor, replacing it with Trintellix, not weening, which was the worst thing that I’ve ever been though. I had hallucinations, etc. it lasted about four days, I now know why my other doctors never wanted me to switch over. The Trintellix has helped, I’m also trying to ween myself off of adderall. My new doctor thinks I still need to be on a small amount because he believes I do have some ADD issues. I just want to feel normal, with normal emotions. I’ve been using EvaMist spray 1.53mg. (I pump) 1/4 tea. progesterone cream once daily at night and .1ml of Test. Weekly, 10mg. Trintellix, 2mg. Ativan nightly, Supplements: Melatonin 10mg. (nightly), Magnesium Citrate 500 mg. (Nightly) Sweet Wheat (day) vitamin D 5000, 1000mg. Vitamin C, biotin 10,000mcg. DIM 200 mg. (Nightly), rhodiola rosea (during the day) Eleuthera (day) to help with energy since I’m trying to decrease adderall. I’m 30 pounds overweight, I have terrible acne, oily skin, large pores on my face, my thighs are bigger, I have terrible cellulite, my upper arms have saggy fat hanging like an old woman (I’m only 46 years old) I feel swollen, my thoughts are all over the place, My new doctor didn’t tell me to use the the EvoMist, progesterone, Rhodiola, Eleuthera, or Sweet Wheat. I took these on my own to see if my skin, weight issue, depression, anxiety, fatigue and adderall withdrawal would improve. I feel like i’m a train wreck. I’m just starting to feel like I have enough energy and motivation to start exercising. I read that progesterone is supposed to give you energy, and be a diuretic, am I not taken enough, but then I worry about it worsen my depression. What would happen if I only took Testosterone alone, or should I take Estrodiol along with it and illuminate progesterone totally? I’m completely hating the fact that my face looks like I’m a crackhead. I’ve always had good skin, people would compliment my skin, my self esteem is zero. My self esteem is not only coming from my skin, and body issues but my mind. I wish there was support groups near me for post-menopausal women, I would definitely go weekly.
Hi Elizabeth,
I’m sorry to hear about your situation! Hormone management is highly individualized and depends on a number of factors. Often, when I am working with patients, it takes many attempts to get it just right. I can’t really guess what would work for you or not without an in-depth history, lab testing and so on.
I just started testosterone cream last night and I’m wondering the optimal time of day to use it? The pharmacist consult said morning because it can disturb sleep and the doctor said evening because it can cause fatigue…
Hi Jennifer,
The short answer is that it depends on you and your body. It can be taken morning or night it really doesn’t matter.
I am in early stages of menopause. I had a complete hysterectomy over 16 years ago, but I recently (48 years old) began having hot flashes, weight gain (a lot, even with continued good eating habits and exercise), night sweats and mood swings, as well as extremely low energy levels. My ob/gyn ran all of he above tests and discovered I had very low esteogen and total test and free test. He gave me pellets. I did well with the estrogen (it came into the optimum range, however after two more boosts of testosterone pellets, my total test is very high (in the 400 -500 range), but free test is still below 2. I have no energy and am still gaining weight. My thyroid was completely normal. I don’t want to keep doing pellets because they don’t seem to be doing anything for my free testosterone but increasing my total. What would you suggest for me to request from my doctor? I am paying out of pocket for the pellets because insurance won’t cover it. But I know insurance will cover patches and creams and vials of test and estrogen. Should I continue the estrogen pellets and try another option of test or should I try something new for both or just keep trying the pellets for both? Please help! I’m discouraged and broke and so frustrated.
Hi Lisa,
If your current physician isn’t able to help you then it may be time to seek a second opinion, there isn’t enough information here for me to make any declarative statements.
Hey Dr. Childs,
I am so happy to have ran across your information as I have been struggling with Hashimotos for 8 years. I am a nurse practitioner and have done vast amounts of research and can’t seem to get it right. My TSH and free t4 are always “normal” and free t3 low. My doctor put me on nature throid and synthroid because my t4 kept dropping with nature throid. After reading your blogs, It seems I could have euthyroid sick syndrome. It appears My free t3 is constantly dropping. I am currently on 130mg nature throid and 100mcg synthroid. I recently had my estrogen, testosterone, leptin, DHEA-S, and reverse t3 checked. My Estrogen levels werr 40, testosterone, total 17, and free testosterone 0.3. DHEA-s was 145. I am awaiting my other labs to result. My doctor told me I may benefit from testosterone cream, but I am unsure I want to start HRT as I am only 30. Would taking DHEA be just as beneficial until we straighten my t3 levels out? If my t3 levels were leveled out, could my testosterone elevate on its own? Thanks!
Hi Johnna,
I don’t find a lot of success using DHEA compared to other hormones, but it does work for some people.
My Dr started me on testosterone because of lichen sclerosis of the vaginal area. I also have osteoporosis. We are trying it to see if it stops it from coming back. I was afraid to start it but after reading your article I feel better about it. Thank you.
Hi Joann,
No problem and I hope it helps with your issues! Keep us updated on your progress.
Updating on Testosterone cream. Was using cream 1% gel(25MG) 30×2.5GM once a day .It was working well with no side effects. When I went to refill my insurance said they don’t cover that one( perrigo). So it was changed to androgel but now it is 1% (50MG) 30x5GM but apply 2 packets. That seems like 4 times the amount than what I was using so I’m only using 1/2 of a packet not 2. I’m afraid of side effects and when I call doctors’ office to ask why she says that’s what the doctor said. I feel that somebody wrote it down wrong or misread the prescription. The pharmacist gives me the same answer. Is the dosage too strong and too much?
Two years ago after knee replacement I had a pulmonary embolism. I was wearing a hormone patch at the time and was told this should have been removed two weeks before surgery. In the last six month I just have not felt well. I’m 60, weight gain, unable to exercise, fatigue, increased feeling down even though I take an antidepressent. Yes I turned 60 but did so choosing to embrace it and own it. I look younger then my age and have always tried to take good care of myself. I now feel as though I feel 60 or older. I approached my GYN about going back on hormone therapy and the response was no way. That prior PE had thrown me into a group who must suffer because it increases the risk of another PE. He did mention that testosterone could be an option as many women get the same benefit as they do from female hormones. I have researched it and really want to try it. The GYN stated I must find a hematologist who would okay this. I go to see the hematologist who appears to be stuck in 1950, he says he does not believe any person man or woman should be on hormone replacement for any reason much less someone who has had a PE. the doctor stated he himself had low T and he would never take replacement. So I’m stuck. I feel I would really like to try it and do so with the blessing of my doctor understanding that my quality of life is worth more to me then feeling the way I do now. I understand the risk of another PE is higher but by using topical I can bypass the liver. All my clotting studies are normal and I would have never had the PE if not for joint replacement. Can you please advise? Thanks so much. Kat
I just have a question. In your podcast, you mention to use bio-identical hormones, which I am trying to make sure I am. I was seeing a doctor who used only creams. However he doesn’t feel women really need testosterone, so I am changing. Per my lab results, I am still low in progesterone and testosterone is almost non existent. Estrogen is fine. She has suggested the oral progesterone, Prometrium, and testosterone injections. The pharmacist stated the testosterone is not bio-identical. Is there an injectable testosterone that is bio-identical? The name of the one I have is Testost Cup. Is Prometrium bio-identical? I know it is better to use cream, but for some reason this doctor likes the oral pill form? Thanks!
Hi Terri,
Yes, Prometrium is bio-identical. You can read more about it here: https://www.restartmed.com/progesterone-pills/
Hello! I’m currently seeing a hormone specialist that is saying in order to use testosterone cream (my levels were really low) I need to be taking progesterone as well. Is this how you prescribe to your patients? She said if I’m not taking progesterone, the testosterone wont work correctly. Im just curious as to what your thoughts are on this. Thanks for your input!
Hi Laura,
I don’t find that to be true at all. I’ve used testosterone by itself and it has worked well for many patients.
G’day doc . Hope alls well. I’ve just been told by my local GP I have nearly no testosterone in my body, so he has put me on testosterone cream . He couldn’t believe how low it was and my estrogen as well. That’s why for the past 10 yrs or more I haven’t been horny so to speak or actually really enjoying sex, I fake it. But how long is it going to take before it starts to work, ? And what am I actually going to feel when it does start?
Regards
VIV
From Aussie land
Hi Vivian,
I would take a look at this article which outlines the answer to your question: https://www.restartmed.com/how-long-does-it-take-for-testosterone-to-work/
Hi…I was put on Testosterone replacement therapy cream 3 months ago. I started at .4 and my testosterone went up, but not a lot. So my Dr put me on .5 and my levels went way up so she put me back down to .4 and my levels are stable again. The problem is that during the time that I was taking .5 my hair started falling out like crazy and it has not stopped even though I have been on the .4 for a month and my levels are stable. I’m not sure how to fix this or if I should go off the cream altogether. Do you know if DHT blockers are safe and would help?
Hi Dr Childs,
Is there a way to get testosterone cream when your doctor won’t prescribe it?
Hi Cheyann,
Not legally. In the United States, you must get testosterone from a licensed physician using a prescription (it’s also a DEA controlled drug).
Must testosterone cream be used with estrogen, or can a woman use it without having to take estrogen?
Hi Cris,
They can be used together or alone. You don’t really want to use any hormone unless your body actually needs it.
I have been on testosterone cream for 6 plus years I am now 51 years old. I was diagnosed with Lichen sclerosis this year in February can’t spell it. My doctor had me apply clobatesal steroid and it went away. Does testosterone cream help this problem? I am struggling with anger and mood issues often. I don’t know if it’s the testosterone, or estradiol pill or just aging process?? My libido is low with the cream lately. I apply 4 mg every night.
How do I find a physical that’s hormone literate.
Hi Surai,
It’s really difficult to find one but you will probably have some luck looking for doctors who specialize in integrative and functional medicine.
Hi Dr. Childs,
I am 31 yrs old, have low hormones across the board due to burnout, and am unable to lose weight. I’m still young and do not want to be on hormonal replacement forever.
If you use the cream and reach a good level, will you be able to stop the cream and maintain the benefits? Or is this something that you have to take for life and constantly change dose the retain efficacy?
Thanks so much for this blog! Reading it has made me feel less alone in my health struggles
Hi Evelyn,
If your low testosterone is due to age then you can’t reverse it but there are many causes of reversible low testosterone that can be treated (such as weight gain or insulin resistance).
Hi Dr Childs
I recently tested very low for testosterone
0.1 nmol/L testosterone
0.001 free testosterone-calc
I’m looking into creams now however I don’t have all the above symptoms, in fact I’m losing weight rather than gaining, libido isn’t too bad but energy levels could be better
I have low progesterone and high estrogen level so could this be contributing? Another major symptom is alopecia areata
Could the Aa have anything to do with low testosterone?
Would you still recommend a cream in my case?
Thanks
Hi Raz,
It’s always possible but I don’t think it’s likely. It’s more likely that whatever inflammatory issue is causing your autoimmune disease is also probably contributing to your low testosterone.
Hello
Ive been advised to get a combination hormone cream rather than separate, what are your thoughts on this? my progesterone and testosterone is low and estrogen moderately low
Thanks
Hi Ree,
I am personally not a fan of combination hormone cream. It’s easier to use individual creams to prevent absorption issues and also dosing issues.
This is groundbreaking information. I’ve suffered for so long. Please send me more info.
Hi Kim,
I have 340+ blog posts here full of information that should help 🙂
Hey Dr. Childs
I recently had a bunch of labs drawn and received the rest today. My Dr. said everything was in the “normal” range but that my testosterone was low. I have a feeling that some of my other labs might not be optimal for me as well. Do you do consultations or would you be willing to look at my labs and advise me. Pretty desperate at this point. Thanks!!
Hello, I’m a customer and recently bought DHEA 25 MG. I have Hypothyroidism. My Free test testosterone is : <10 & my TSH is: 6.05
Hi Pamela,
DHEA can definitely be useful in potentially increasing testosterone but it can also sometimes increase estrogen as well, so be careful for that!
Dr Childs,
I have very low testosterone but I also have very low estrogen and cortisol levels. Do I need to treat each of these with a separate bio identical hormone? I’m 35 and still menstruating. Thanks
Hi Marie,
You may need to, yes, but it’s hard to say without a lot more information. Most younger women do not need estrogen therapy and, instead, it’s more likely that they just tested their estrogen at the wrong time of the month. It’s possible that younger women may need estrogen but it’s uncommon. In addition, other hormone imbalances such as thyroid dysfunction may lead to low testosterone and low estrogen which can and should be addressed.
DHEA has been a godsend for me to take my testosterone from virtually zilch to the upper end of the range. I take 25mg in the morning and 10mg at night. I take 500mg of Saw Palmetto daily to hopefully prevent the testosterone from converting to DHT (causing the hair loss, acne, etc. that goes with that), and I take 150mg of DIM and 550mg of Calcium D-Glucarate daily to hopefully clear excess estrogen. I was already taking T3. Now with DHEA, intermittent fasting, Brain Octane and weight resistance training I’ve been able to lose 19 pounds in 23 weeks (which is more weight than I gained with my NTIS), and I’m definitely stronger, more energetic, in a better mood and with an increased sex drive.
Hi Stef,
Glad it’s working for you! Thanks for sharing.
Hello Dr. Child’s,
I’m a 60 year old low in all my hormones. Starting diet restriction of the major food allergens on your list to lower inflammation & restriction of carbs & anything sweet. Sweet is a battle still. I tend to be Hypersensitive to foods/noise. I was thinking about food testing, but I tend to start eating nothin. I’m 5’9″ and 114 lbs. Haven’t been able to gain weight. I have very little desire or motivation/goals. Sleep is sketchy. Your feedback is appreciated. Thanks for All the Great info.
Hi Lori,
A great starting point would be to start replacing your low hormone levels 1 by 1 to see what kind of improvement you can get 🙂
Dr. Childs,
I’ve been thinking about starting testosterone cream because my
Libido is non existent.
My concern is transferring it to others being that it is on my skin. Wouldn’t want to transfer it on my kids or grandchildren.
Your thoughts?
Terri
Hi Terri,
Great question! There are many ways around that including doing something as simple as putting it on your body right before bed 🙂 Men have the same issue and have solved it in various ways such as the time of application, where they put it on their body, and the route that they use it. Something simple like putting it on your inner thigh and wearing pants solves the issue as well.
Hi should I begin Oestrogel pumps at the same time as Androfem 1 please? I’ve been told disbanded estrogen will negate the benefits of testosterone so a little bit confused about why I’m taking both at once whilst perimenopausal with imbalanced hormones…
Hi Vicky,
You never want to use two different hormone creams on the same part of the body. You can usually get away with taking them both at the same time, but they shouldn’t both be used in the same place. I’m not really clear how you are using them based on your comment here but that’s just some helpful information for you going forward.
The mini pump of testosterone I got from my OBGYN says,1mg/0.2 ml. I’m supposed to apply 1 pump per day. What does that mean and how much testosterone am I applying?
Hi Kim,
It depends on how many ml each pump dispenses. Your prescription should provide that information. If, for instance, you know that each pump dispenses 0.2ml then you’d know that each pump provides 1mg of testosterone. But your pump size could be more or less than that.