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What if all my other hormones are low too, besides estrogen?

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?

Woman in garden with question about her estrogen level

Our answer

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 you take it orally, and it 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, women can consider bioidentical testosterone products. 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 applied daily to the skin of the thigh, pubis or clitoris area.

Alternatively, bioidentical testosterone is available with a 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 Protocol that specifically addresses adrenal imbalance.

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Last Updated: June 4, 2025
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