Testosterone: Do you need it? For women in menopause, it's complicated. | Felice Gersh, MD

[@Wendy-t1v]

Progesterone helped with sleep, testosterone cleared my brain fog, forgetfulness, more energy, better sleep, much happier, estrogen helped with anxiety, guilty feelings, and made me feel much more relaxed. I started with the cream of estrogen and testosterone, then switched to the estrogen patch and testosterone injections twice a week. Ladies you DON’T have to suffer!!! No adverse affects!!!

[@monicerezo9558]

Hola, qué dosis usas de testosterona? Y de parches?

[@easolis24]

Did you lose hair from testerone

[@ThriveCollective1188]

What dose of Testosterone

[@urbanmermaid2232]

Yes same questions here , about hair ...did you grow unwanted hair ? Did you lose head hair ?

[@HeatherB-z5b]

I wish I lived closer to you. You would be my doctor

[@zorinaganpaul1598]

What an eye opener for me. I was sprouting chin hairs and couldn't understand why until Dr Gersh cleared it all up. I switched from oral premarin to estradiol patch and voila no more chin hairs. Thank you Dr Gersh, great lesson ❤❤

[@jaymeous]

I learn so much from you! Thank you for sharing your wisdom. You’re one of my new favorite menopause doctors on KZbin.

[@marytaylor2824]

My dr wanted me on 40mg of testosterone a week. I have very low estrogen. Thank you for this! You are so helpful. It makes me feel normal to hear your videos.

[@ThriveCollective1188]

Milligrams or micrograms?

[@marytaylor2824]

⁠@@ThriveCollective1188mg milligram. Not mcg. I inject 10mg typically.

[@russvet]

You are brilliant! Like your lectures so much ❤

[@niclifts3831]

OMG! That is what happened to me! My OBGYN gave me just enough Estradiol patch .05 and a testosterone Pellet. I lost so much hair and grew facial hair. I still had menopausal symptoms. It took 8 months (this January) for the testosterone to go from 400 to 10 (August 1st bloodwork). However, my Estradiol never got above 40; but after waiting for testosterone to drop to 10, now my Estradiol went up to 180! Doc is going to do one more blood test in 6 weeks to see if that comes down; but I feel good now. And, while I don't have any more sexual desire, I can't afford to lose more hair. I am very afraid of ever taking testosterone again. I need to wait to see if my hair grows back. Wish you were in Las Vegas to try and see you, so thank you for the video! I'll try Metagenics DHEA 5mg pill once my hair grows back.

[@j.j.l.]

She does tele-health. As a post-menopausal, post-full hysto, post “trans” identified woman, I wasted no time in getting the proper help. Our health care system (at least in the states) is in the dark ages. I only trust doctors like Gersh, and, unfortunately, there seems to be very few of them.

[@olderandwiser127]

Check out fixaflash and womens health network.

[@brendanolasco2214]

Testosterone pellets are often not dosed correctly and not easy to reverse once you have one implanted. I have done good with a testosterone cream which I heard is not as profitable as the pellet. My levels were all checked before starting hormone replacement and my estrogen and testosterone were nil. I felt horrible until I started on HRT but it took a few months. Sorry you got too much testosterone which is probably worse than having none. Also it was impossible to get HRT from my doctors even my gyn. They referred me to the menopause clinic in my health plan where not a single appointment was available for the entire year. I had to pay out of pocket and go with a group outside my plan. Good luck getting everything back in balance. It will take time.

[@ozarkcyn1]

I'm in Vegas too. It's ALWAYS been a desert for QUALITY doctors.

[@jessicafeit4758]

I accessed Dr Gersh through a phone call to her office, made a telehealth appointment, I live overseas. She is GREAT.

[@gypsyrose5502]

I wish I would have seen this video prior to an appointment with a new doctor for HRT. She was a provider for Renovo Pellets, said all I needed was testosterone and then my body would produce all the estradiol I needed. A month later when we discussed my blood test results was when she first told me her goal was to keep my estradiol levels low so I don’t get belly fat. When I contacted her a few days later to tell her I wanted estradiol replacement she ghosted me, not responding to my two messages. I found a new provider for BioTe pellets and did blood work in anticipation of getting pellets. Why is it so hard to get estradiol in physiologic levels?

[@juliaoneil193]

Thank you! You are by far the most knowledgeable in this area and the way you explain each topic is so easy to understand!

[@francescakolar2446]

Thank you Dr Gersch thank goodness for you . I really enjoy your informative content you have changed my life and I share your videos after all knowledge is power . Thank you 🙏🏻

[@mindyadams9041]

My shbg 115, estridiol 28, 60 yrs old, high cholesterol despite eating clean whole food diet. Now I understand! Thank you ❤️

[@mrsmichelleharris]

I have been on HRT for over a year now, but the past 6 month I've been feeling worse and worse. Low sex drive, depressed, can't put on muscle despite weight lifting. I went to my gyn requesting a testosterone test. My SHBG level was 228.5 mol/L (way over range) and my free T was at 1.8 pg/mL. Luckily my Dr. prescribed me a testosterone cream 10 mg/gm to take daily. I've only used it two days, and I can't believe how much better I feel already. I sort of feel like maybe my estrogen/cyclic progesterone levels may be out of proportion or off somehow, but my Dr hasn't been too keen on testing these levels. Regardless, I am so happy to be starting on testosterone.

[@inquisitive9248]

Thank you so much for your video! It is very helpful! You should teach medical students on the HRT , majority of the OB/GYN are not knowledgeable in this area. Many I recorded by pallet producers, and act as salesman and not as doctors. A year ago I went to the provider who recommended pellets. I was a little scared to put it under my skin in case something goes wrong. I did a lot of research and put together pieces of information that made me refuse pallets. I came to the doctor and told her about bioidentical available in regular pharmacies. Amazing she was under the impression that only compounded pharmacy can make bioidenticals! Anyway! I self-described myself HRT and she just signed the prescription.

[@muse3241]

So what do we do when our hair started thinning in perimenopause? Add progesterone? Hair thinning at the front and sides of the scalp and no dermatologist has answers.

[@lilmisfitmelanie]

Im 48 to be 49 new years eve. I went thru menopause very early tho really don't remember many symptoms of it. I stopped bleeding at 39. Im now on estradiol patch 0.2mg twice weekly and 200mg progesterone pill at night. I know i need testosterone as i feel im aging exponentially this past year and have absolutely zero drive.

[@Gladeeez]

is 0.2mg 2 patches of 0.1mg?

[@queen-b9414]

Dr G please explain. One minute you speak of single digit T being low. I’m assuming that is Total T but you also said 99% of T is bound. I have high total T but my free T is 3, which is within range. So what do you look at, Total or free? SHBG 33.

[@loribrooks7964]

Any thoughts on how GLPS1 medications affect women's hormonal levels. Many are experiencing similar androgenic effects, like hair loss, when they are on these medications. I don't have personal experience with these medications, but I experienced hair loss from too much T, and as I research hair loss treatment options, I am seeing hair loss issues with the GLP-1 patients.

[@r8chlletters]

Women need testosterone. Unlike estrogen and progesterone which have a period of fluctuation testosterone basically stops entirely. For confidence, stamina, drive, muscle building and sexual function testosterone is extremely important. See a specialist and talk about what is possible for you. Do not see anyone who doesn’t specialize in HRT. I use a testosterone cream, .75gm daily which I get from a formulary that makes it up for me. Hugely helpful and easy to use. Not FDA approved (yet) and requires annual bloodwork to demonstrate the dose is in a safe range (the range is actually fairly wide). I have no “manly” side effects as the dose is within range. It would take a lot more to get the sorts of outward responses described here. Please do not use pellets. This is a barbaric method and creams are totally effective.

[@brendanolasco2214]

Definitely the cream and it is easy to stop taking the cream if someone wants to. I was turning into a weak frail and depressed lady without it. 3 months after starting the cream I have energy and started going back to the gym. Also has helped me keep up at work. I am not ready for retirement and do not think I would have made it without testosterone. I have not had any hair thinning, facial hair or acne but my levels are being checked every couple of months.

[@susan6336]

@@brendanolasco2214what strength is your cream?

[@jennifermoffitt7294]

i have more t than i thought at 50... not sure i'm in peri or menopause but i have hot flashes here and there and some changes in sex function hit at 49.. my free T is 4.8 and my total t is 30.. no TRT just estrogen and progesterone. I was on low dose pill until 49 for severe anemia

[@Drd7682]

@@susan6336I know you weren’t talking to me but in case it’s helpful I’ve been using 2 mg/day topical testosterone cream for about 6 years now (before menopause). Saved my life truly. No side effects, blood level of free testosterone pretty much stays under 30. Of course everyone is different.

[@muse3241]

How do I get the testosterone cream? What doctors prescribe this?

[@SK-bv6yd]

Thank you so much for the great video! My obgyn doctors do not seem to have time to explain things like this. I've been using vaginal estradiol for a couple months and its been great, even helping with hot flashes and nigh seats. Does it mean that it's supposed to affect you only locally, but somehow have systemic effect? I had a partial hysterectomy, leaving ovaries and cervix, and do I have to worry about possible systemic effect of estradiol on my cervix, needing progesterone as well? Thank you!

[@doctoralisonjohnson]

You shouldn't have to worry about taking progesterone if you do estradiol and only have cervix. This is what I was told by my Gyn who specializes in menopause care. However you can continue to take micronized progesterone if you want to - it has many benefits.

[@gypsyrose5502]

@@doctoralisonjohnsonDr. Gersh has great videos on why we need Progesterone, no matter if we have a uterus or not. I intend to start cycling Progesterone as she recommends.

[@SK-bv6yd]

@@doctoralisonjohnson ,thank you for your answer!!

[@jessicahitchens6926]

The Gyn is completely incorrect. They know nothing about womens hormones. Were never trained.

[@jessicahitchens6926]

You go on Progesterone. Progesterone helps your brain and thyroid. Your bones and your skin. It also calms you down.

[@PLT722]

So, if the ovaries age as you say, would that not affect the production of ALL hormones - especially if estrogen gets converted from testosterone? Or, perhaps what we call ‘ovarian aging’ should be defined by declined ability of ripening follicles into eggs ? FYI we do not run out, ovaries can produce new eggs, but we run out of the ENERGY that makes it happen, as I tremendous amount of energy goes into doing so…

[@jackiemansfield8325]

I lost my periods at the age of 48, and the libido also disappeared(which I don’t mind). Today, 63 yo, my only symptom is low libido. Should I take any hormones to protect ovaries, uterus? I never had any hormones before…

[@hollyshult133]

Very interesting! Dr. Gersh, can you give your opinion on if sex binding globulin is high? My bloodwork came back with high sex binding globulin, and I don’t even understand what that is. I’m post menopause 8 years, and no HRT.

[@olderandwiser127]

Look at both Womens Health Network and fixaflash.

[@tranquilityseeker581]

Good info. Can you tell me if I might need it after a full ooperectomy and hysterectomy

[@Katepwe]

You might….only your health care provider can make that call.

[@123STEP23]

What is considered low testosterone in serum in women ? What is considered a normal range ? Sick out here in MO have no idea .. please help !

[@123STEP23]

Not sick ( spell check !) Supposed to say Docs out here..

[@Always-xl9db]

I think 2 is the lower limit. And upper is 45. But like she said, teens are probably good.

[@123STEP23]

Mines one .. I’m totally indifferent to anything I’m not ME anymore .. we need docs trained properly on hormone dosages

[@avalemmon7688]

Thank you. I’m 47, and three weeks in to taking 0.5 ml daily compounded testosterone for my symptoms and my blood test showing my total T 9, and my free T 0.8. I am not taking any other hormone replacement. I had a full female hormone panel done and that’s what my gyno suggested. Thoughts?

[@sweetpeace5]

You need to say what your “symptoms” are meaning why you’re using it in order to answer the question.

[@CindyLaddy]

My doctor just added testosterone a month ago but free T didn’t increase at all for me- my estrodial is now WAY too high. So way too much conversion/aromotase. Any workarounds for this? 🙏🏻❤

[@szbeatrous]

My ovaries were removed at 41, an oophorectomy. My uterus and cervix as well. I’ve been on HRT ever since, but no testosterone. I am hardly producing any testosterone and have no libido or energy. I do take 10mg. of DHEA daily. Why do doctors never address women, especially young women, who have had complete hysterectomies?! I have no ovaries to even produce any testosterone!

[@hersheykiss4445]

My first test reads free and total, MS. That is 30 with range being 2-45. The next one reads just free testosterone. It's at 1.3 with range being .1-6.4. I'm not sure if I'm good or not.

[@jennifermoffitt7294]

my total is 30 with free high at 4.8... i'm shocked with my lack of energy and libido (on HRT too) i prob should have stayed on the pill. i'm 50 in a month

[@hersheykiss4445]

@@jennifermoffitt7294 try CoQ10 and B12. I don't have energy problems, even with my low hormone levels.

[@doctoralisonjohnson]

It's kind of low overall.

[@jessicahitchens6926]

The pill is poison. You would be on xeno estrogens. Body identicals hormones are not Progestins and synthetic Estradiol.

[@jeanie500]

Where can you find the formula to estimate free testosterone using SHGB and Total Testosterone?

[@cintiaspataro3205]

In the UK 0.4 the GP said it's normal 💀 next visit I'll say I want to change my sex and maybe that's the only way they'll give some testosterone.

[@bekskayll6841]

Same here, it's so frustrating!

[@narangre]

My doctor told me the hormones work better when given together. I take all 3 because of early menopause.

[@stef3565]

Can I get back on my testosterone after my knee replacement surgery? Estradiol patch and Progesterone also?

[@sweetpeace5]

I’m not understanding why you had to go off?

[@doctoralisonjohnson]

You should have never had to go off. Get back on❤

[@stef3565]

@@sweetpeace5 per surgeon's request.

[@fluffyfeathers.9541]

Added testosterone with my HRT, week 8 on T and my hair is shedding and more face hair only using pea size amount. Its not doing much for me should i just stop talking it?

[@kishaalire4622]

Hello! Sorry to hear about the side effects. Im curious if you stopped and if your still shedding hair. Thank you

[@fluffyfeathers.9541]

@kishaalire4622 I will stick it out for 6 months of the testosterone and see if it settles down. A lot of hair falls out when I wash my hair and when I brush it. I've just started the supplement Saw Palmetto ,which is supposed to help with the hair shedding, so I'll see how i go with this. 4 months on T and 1 month on saw palmetto. The T has done nothing for libido for me. I only use a small pea size amount it does come with a syringe, and you can use that. The lowest is 0.5mg, but I just put a small amount on my finger and rub on the outer thigh. I have an oily face since being on the T .

[@kishaalire4622]

@ good luck on your journey! Thank you for sharing.

[@teres1523]

I am on HRT.and Testosterone shot 100 g every two weeks ( 200mg once a month had side effects) I am now : total 84 ng/dl and free 1.5, I feel fenomenal!!!. My question is: 1) my OBGYN is amazing however I am afraid she will say testosterone is "high" to wait for the next shot, to wait longer 2) my DHEA 83.1 ugh/DL , keeps being in the low side and I can not tolerate DHEA supplements I get very angry and edgy. Is that normal and what can I do then???!. Also I added DIM, calcium D Glucarate and sulphoraphe, ( low dose) and I went back down to my best weight.

[@salleone6387]

Does your recommendation change if a patient has had an oophorectomy?

[@DianeRetton]

Is it safe to take dhea if youve had breast cancer

[@pattyfluegel7816]

When you are talking testosterone testing levels and you are saying above 20 are you talking free or total testosterone? also pg/ml?

[@tanaatkinson7833]

I might have missed this? Did you say what an optimal level for DHEA? My TEST level is 15. I’m 62yr old menopause woman. What is ideal SHBG?

[@Raaxo875]

100 or more

[@Andrea-64]

It took me 10 years to get low dose hrt. It will take some hard work to get DHEA, which is only available by prescription in Canada. It's been a month and a half, and my symptoms are the same as before starting hrt. I'm 60 and now have severe osteoporosis. Are 4 pumps of estrogel optimal?

[@Katepwe]

Everyone is different but in my experience I was started at the lowest dose and increased until symptoms were lessened. I suggest you search on the North American Menopause Society website for a menopause trained practitioner in your area. In Canada the cost is out of pocket but may be covered by some insurance.

[@olderandwiser127]

Can you not order from usa? Check Ona's Naturals.

[@Katepwe]

@@olderandwiser127no, not in canada

[@Andrea-64]

​@@Katepwe Thank you. I'll check that out 😊

[@lynda2844]

This was so informative! Thank you. I am interested in starting testosterone due to lack of sexual desire and painful sex/dryness. Dr G-you mentioned we must be on estradiol or have adequate amounts if we take testosterone. I’m wondering if that is also the case if I end up taking or start out taking DHEA instead of testosterone to see if that relieves my symptoms. Also, I don’t recall it mentioned on this and other videos you have done but if taking testosterone (or DHEA) can help with desire will it also fix the dryness issue or would I need to take something else for that? Please help!!

[@Sophie-qt5jx]

You need vaginal estrogen to fix the dryness and all other vagina and bladder issues.

[@vivellaz]

If you still have a uterus, you have to get a script for estradiol plus progesterone which protects uterus from estrogen (estradiol). If you just want estrogen for vaginal dryness, use the estrogen called Estriol which is weaker and safer than estradiol. It is a cream you can apply vaginally daily for a week or two and then only twice a week. All of these things usually require prescription from a doctor. Here in South Africa the Estriol creams can be obtained over the counter as they just mostly have an effect locally on the tissue and not so much systemically. Rather see a doctor, it is safer to get the right treatment.

[@doctoralisonjohnson]

Get on some vaginal estrogen if you can for dryness.

[@deannemerey6776]

Could you address testosterone supplementation in the setting of estrogen receptor positive breast cancer?

[@lisaj5041]

Would be nice if she and other doctors would address this!

[@pennyrobbins4285]

What if someone doesn't have ovaries, uterus that's had a total hysterectomy? Should they take testosterone?

[@Katepwe]

Possibly

[@ThriveCollective1188]

Wouldn’t boosting estrogen boost aromatisation of excess testosterone?

[@butyoulooksohealthy-fibrom920]

Ladies, get your free T tested. It’s the most reliable to see what your body is actually using for.

[@jennifermoffitt7294]

mine is high and i'm exhausted.. so confused - no pcos and on low dose HRT

[@lilmisfitmelanie]

​@jennifermoffitt7294 look into amino acid therapy and also remineralization. I believe we are all deficient in all of the 90 essential vitamins minerals aminos omegas and prebiotic. Its overwhelming learning all of this but I believe that we can & are created to be young for way longer than we are. The process isn't for the faint of heart that's 4sho

[@lilmisfitmelanie]

​@@jennifermoffitt7294 a young woman who worked for a bio ID trt once gave me a list of what women need after menopause: estradiol progesterone of course dhea pregnenalone dha-omega(cod liver oil great) b12 and b complex D3K2 and iodine. ❤

[@doctoralisonjohnson]

I do Testim gel for men and use 1/10. I use about a chocolate chip sized amount. It's not hard to measure and I'm not overdosed.

[@legohouse4819]

How are you finding that dose and method?

[@doctoralisonjohnson]

I feel great, increased motivation, better mood, increased sex drive. I've been on it 3+ months now.

[@prepub1]

Do you know your dose in mg? I have a micro measuring set, so I can measure as small as 1/64 a teaspoon, have you ever measured your chip sized amount?

[@cami5054]

I use my husband’s Testim 50mg 5 gram tube leftovers & empty into a 0.5ml syringe and use 0.1 ml which = 1mg

[@MommaMia-k8t]

Your doctor prescribes that even though it's for men? That is awesome. I have to have mine compounded at $65 for a small tube :( I just started and am discouraged at the cost.

[@MarcyCavalier-xc4ez]

My sex hormone globulin was 48 and testosterone was 13. Is that normal?

[@marycarver7092]

Her doctor said my daughter had too much at 17. Her level is 49. They she needs to be at 33

[@PLT722]

Sex drive ( simplified ) = estrogen + progesterone + testosterone. When is sex drive the highest? - prior a ovulation ( high estrogen, high testosterone , a bit of progesterone 😊)

[@cathybell4295]

What if you no longer have your ovaries due to endometrial cancer?

[@tanaatkinson7833]

Is progesterone also called E4?

[@cozinha8945]

P4 is progesterone, E2 is estradiol

[@JOEYDEEZ369]

Yes.. women need testosterone for the optimal maintenance of their libido…. during perimenopause & post menopause we lady folks are often deficient in this hormone…. most women often end up being oestrogen dominant as they sail through their aging journey…. I don’t think that it’s good to be oestrogen dominant over a long term… I mean it surprises women to know that we need this hormone albeit in smaller amounts than that of the pesky menfolk hahah I’m a testosterone & not oestrogen dominant female who thinks and moves like a guy but I’m all woman I’ll have you know ma’am hahah and I wouldn’t have it any other way I tells yuh… Nuff said ;)’

[@jennifermoffitt7294]

i just found out my free T is higher than normal 4.8 with total at 30 (at age 50).... wth i thought i had low T due to being tired

[@Leamoyer]

I think I’ve always been low in T. Checked at 55 for first time after learning about HRT and I was in single digits : 7!! That explains a lot. After having T added to my HRT I am about 150 total and free 10 and I feel amazing.. 😻

[@Leamoyer]

Lucky how you’re always had good T. I think I’ve always been low in T. Checked at 55 for first time after learning about HRT and I was in single digits-7!! That explains a lot of my symptoms. After having T added to my HRT I am about 100 now of total & fluctuate between 3- 10 depending on the day I took my labs. I feel amazing.. 😻

[@jennifermoffitt7294]

@@Leamoyer 70 is prob best total T for women... I don't feel great with my T level so not sure it matters as much as we though.. I have some kidney issues which might be affecting my energy level too

[@jennifermoffitt7294]

@@Leamoyer i have no idea what my T was until now at 50

[@HeatherB-z5b]

I made a appointment to ask my GYN about taking testosterone and she said at my age, (75) my levels will be low but I don't need it

[@drironmom6815]

She’s wrong. I’m 68 s and testosterone pellets give me energy and libido

[@doctoralisonjohnson]

Why wouldn't you need it? It's a vital human hormone. If you care to ask you might ask her why she thinks you don't need it. Testosterone helps maintain muscle mass, can improve brain function, etc.

[@Lisa_Tamati]

😂 sad

[@drironmom6815]

@@HeatherB-z5b find another doctor. Look up biote or evexias to find a doctor who understands hormones

[@drironmom6815]

@@HeatherB-z5b find a new doctor, one that practices functional medicine

[@deborahc7113]

my tot T was 309 on T injs

[@susan6336]

What level was your free t?

[@jennifermoffitt7294]

woah

[@deborahc7113]

@@susan6336 143.8 pg/ml Free T

[@zqueen6766]

What if testosterone injection caused me cystic acne

[@Leamoyer]

That means it’s too much for you. Find your sweet spot. Some woman push DHT more than others so some can tolerate more than others.

[@jessicahitchens6926]

Why would you get that??? You're a woman

[@fatimafreire2841]

❤❤❤❤😊

[@tamjase1978]

Testosterone make me anxious and angry. Im on estradiol and progesterone added t only .01 now it triggers my stress response. Any ideas whats happening please

[@doctoralisonjohnson]

I found anecdotally in myself that progesterone and testosterone seem to have a greater connection than I'd ever heard. I felt intolerant to progesterone then tried testosterone and had the thought to see if I could tolerate progesterone more frequently and at the dose I needed to be at - no problems anymore! So maybe you might up your progesterone and see if you tolerate testosterone better. Also make sure you are on an optimal dose of estradiol for you❤

[@tamjase1978]

That's interesting thankyou. I am on 2.5 sachets of sandrena. I did try to lower it but I couldn't sleep. I will try increase my p​@@doctoralisonjohnson

[@wendymccleary1465]

That's how DHEA creme effects me, but I feel good on testosterone. Perhaps it's the opposite with you.. and DHEA might suit you better. We are all biodiverse. The good thing is DHEA doesn't require a prescription in the US.

[@tamjase1978]

Thankyou I'm in Australia not sure if you can get it here. I have reduced my dose now to .02 it's better. ​@@wendymccleary1465

[@mamayoda123]

Thank you!

[@mindyadams9041]

Thank you!