IS THERE SEX AFTER MENOPAUSE??

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

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.   

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

Sandy