Most doctors won't prescribe testosterone pills due to the risk of liver toxicity, and because of this form's ability to lower levels of HDL, the "good" cholesterol. Bioidentical testosterone (from a molecular level -- this form is nearly identical to what your body naturally produces on its own) is available in transdermal forms such as gels, creams and patches or in sublingual drops and tablets.
The key to hormone replacement therapy (HRT) of any kind (synthetic or bioidentical) is to follow a conservative three step approach:
1. Test your baseline levels and retest after starting HRT
Ask your doctor to test your androgen, DHEA, estrogen and progesterone levels. Progesterone replacement can sometimes lift libido. A saliva test may be more accurate than a blood test because this method measures 'free' hormone levels (the active hormones) rather than only overall totals.
2. Consider DHEA.
DHEA (dehydroepiandrosterone) is a precursor to testosterone, available without a prescription, and less expensive than testosterone. Testosterone is available only by prescription and is classified as a "controlled substance." In low doses, DHEA may provide some of the same therapeutic effects for women. Dr Christine Northrop, a pioneer in women's health, recommends that you take DHEA if your testosterone and DHEA are depleted, although you need to wait about four months to feel the effect. If after four months you don't notice any improvement, consider testosterone hormone replacement.
3. Avoid androgens if you're in childbearing years.
Most women in childbearing years produce ample amounts of testosterone. However, a study in the January 2006 issue of The Journal of Sexual Medicine found that long-term users of oral contraceptives had elevated levels of the sex hormone binding globulin (SHBG). SHBG is associated with sexual dysfunction. The research found that women who used oral contraceptives may have ongoing sexual, metabolic and mental health consequences.
Testosterone is not for every menopausal woman or all women with low libido. If, however, your lower sex drive is related to a hormone balance, bioidentical testosterone may help re-ignite your desire when estrogen, progesterone, and DHEA hormone replacement therapy does not.
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