Q: I’m 51, and my hormone panel showed that my hormone levels are very
low — but it’s not just estrogen, it’s ALL of them, including some I
didn’t even know I had! But my doctor says all I really need is estrogen and
progesterone pills. Since my testosterone and DHEA levels are low, don’t I
need them, too?
A: Testosterone and DHEA can be difficult to obtain from a conventional doctor,
so you may want to wait on these and get the natural estrogen and progesterone first.
We do not usually recommend synthetic testosterone (methyltestosterone)
because it is taken orally, and is not natural or bioidentical. In fact, the brand
name synthetic Estratest has been taken off the market, though generic forms are
apparently still available for “off-label” use.
If really needed for libido, energy, or muscle tone, there are bioidentical testosterone
products that can be considered for women. The female testosterone patch is still
being studied, and seems held up by the FDA for various reasons. Testim gel is FDA-approved
for men only, but again, sometimes prescribed “off-label” for women.
Only a pea- or dime-sized amount is suggested, applied daily to the skin of the
thigh, pubis, or clitoris area.
Alternatively, bioidentical testosterone can be obtained by prescription from a
compounding pharmacy, in the form of a topical cream or gel. You will need to see
a practitioner versed in compounding bioidentical hormones to obtain a prescription.
I suggest only 1–4 mg applied daily for women, starting at the lower dose and slowly
increasing it. (To read more about testosterone, see our articles on low libido
and rekindling desire.)
Likewise, to address your low DHEA levels, we suggest you seek out a practitioner
familiar with compounded hormones, as most conventional practitioners do not subscribe
to its benefits as a form of hormone replacement, and have no experience with it.
You can obtain a list of practitioners from the Natural Woman Institute or the Women’s International Pharmacy
(please note we have no direct knowledge of individuals listed there). We also have
a number of articles on improving
adrenal health naturally, as well as a Health Program that specifically
addresses adrenal imbalance.
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