Sunday, February 12, 2012

IS THERE SEX AFTER MENOPAUSE??

Well, the short answer is yes. The long answer has a few conditions and gets a bit more complicated. Loss of libido (sex drive) remains a common, usually untreated symptom in postmenopausal women, even though decades of studies universally show that replacement of testosterone has a significant imp...
Anonymous
Susan Rako, M.D.
3/25/09 8:20am

I am the author of the first and still most complete book written about the essentail role of testosterone in women's physiology: "The Hormone of Desire: The Truth About Testosterone, Sexuality, and Menopause."  The dosage range of testosterone for women that is suggested in this article is four to forty times the dose I and others have found to be effective and safe.  The effective and safe dosage range of supplementary testosterone for women is 0.25 mg to 1.0 mg per day.  A fuller discussion of how to supplement testosterone can be found in Chapter 8 of "The Hormone of Desire."

3/25/09 8:28pm

Hello Dr. Rako,

I appreciate your comments and am very familiar with your book.  I bought a copy when it first came out and found it not only informative, but affirming of what I was learning and planning to do in my clinical practice.

I have, unfortunately, not found the very low doses of testosterone to be as effective as you have.  I start at a very low dose and gradually increase to what is an appropriate level for the individual (based on reported response), but I rarely find that less than 1.5mg of cream is sufficient.  If I increase above 3 mg, I do so only after checking blood levels to insure that the patient is actually absorbing the hormone and that I am not overdosing.

I would be very interested in hearing what forms of testosterone (ie, cream, triturate...) you find to be most effective and how you initiate therapy.  I would more than happy to find that my patients could be helped at a lower level of hormone.

Thank you for writing.

and thank you for your major contribution to this field of knowledge,

Sandy Greenquist

Anonymous
Susan Rako, M.D.
3/25/09 9:24pm

In your article you did not specify that the supplemental testosterone to which you were referring was to be topically applied in a cream base -- a method which does not allow for precise dose control.   Applying what you approximate to be 1.5 of testosterone in a cream base does not result in absorption of the full 1.5 mg.  I recommend the use of compounded capsules of methytosterone to be taken by mouth, with a beginning dose of 0.25mg per day.  Methyltestosterone is very well absorbed, and in the low dosages needed for supplementation, is entirely safe.   

3/26/09 3:32pm

Thank you for sharing your protocol.  I will look forward to possible further conversation with you in the future.

Sandy

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