Testosterone Therapy: A Voice from the Trenches

Ever have a medical professional say to you, “This procedure is a piece of cake. You’ll be back on your feet in a couple days,” only to be popping Tylenol and cursing the day you were born fully a week later?

Ever step off the plane into a throng of strangers and realize you really should have researched this off-the-beaten-track destination a whole lot more before you booked the flight?

I don’t know about you, but before I venture into uncharted territory, whether It’s a medical procedure or a new travel destination, I like to talk to someone who’s “been there,” who knows what she’s talking about and is willing to tell it straight. The voice of experience is always reassuring.

So for Part 2 of our discussion on testosterone therapy, we bring you the voice of one of my patients who is on testosterone therapy and who was kind enough to share her experience with us.

As I mentioned in Part 1, in my clinical experience about 40 percent of women aren’t helped by testosterone therapy at all. A few others experience unpleasant side effects, and others still, like this patient, experience additional positive effects. While each woman’s experience is unique, many really do benefit from small dosages of the hormone.

Here’s a Q&A from one who did. Let’s call her Elaine.

MiddlesexMD: What were your expectations of menopause? Did you have a general idea of what to expect?

Elaine: The only idea I had of menopause was what is popularized by general media: hot flashes, temperamental moodiness, weight gain, fatigue, dry vagina, low sex drive. I didn’t want that to be my experience, and I decided I would do all I could not to have that be my story, but I really didn’t know what that would mean. Lucky for me, I have a smart, proactive health care provider that has always felt like she was on my team with my health story.

MiddlesexMD: What was your experience of menopause?

Elaine: My complaints were: intermittent feelings of anxiety, which I had never experienced before. Also I experienced somewhat diminished sex drive, but worse than that, when my hubby and I did have sex, it was SO MUCH WORK to achieve orgasm for me. Exhausting. I am so glad I am a runner and in good shape, because there is no way an out-of-shape me could even hope to work that hard without having a heart attack!

Then finally the orgasm was very flat and not very satisfying. Also I experienced some mild general fatigue; almost daily I would require a 10-minute nap, which never bothered me, but was relatively new to me.

MiddlesexMD: What was the problem--or set of problems--that you wanted to solve by seeking medical help?

Elaine: I described the symptoms listed above (anxiety, diminished sex drive, flat orgasm, some fatigue), without really expecting a solution. I expected Dr. Barb to say, “Yep, that’s menopause! Most women experience those things.” I thought she might recommend some herbal remedies, at most. I was obviously delighted with the solution she prescribed!

MiddlesexMD: What was the impact on your relationship of the symptoms that you had?

Elaine: My sex drive is improved, and the quality of orgasm is VERY much improved. Also, it doesn’t take forever for me to achieve orgasm. I almost never require a nap anymore, can’t think of the last time I took one, actually.

MiddlesexMD: Any other effects of testosterone therapy for you?

Elaine: The following are the unexpected effects: My anxiety symptoms, which were mild, are gone. I have noticed that mentally I feel more assured; I am able to more clearly see the forest for the trees; I am able to make confident decisions more quickly. I also have noticed that I am less likely to worry about whether people agree with me, or if they like what I have to say. I feel I can make intelligent decisions without being bogged down by wondering how my responses are received and if people agree or like me more or less for what I say.

I feel I am more able to present my true, authentic self/opinions. I am able to make decisions more quickly and with more confidence. I notice I don’t tolerate as much B.S. as I used to. (I am not rude, but I don’t go down that road with people anymore?) I feel somehow more clear and comfortable in my skin. I never expected this, but I love it.

I also have noticed that my muscle tone is improved, nothing freakish or dramatic, but I do notice it. I am running a tad bit faster, and I have more energy after a long run. I am no longer whipped for the day following a long run. I have noticed I have more overall energy, actually. I still sleep well at night, always did. I have experienced no other side-effects, such as extra hair growth or acne. I have noticed no negative side effects, actually.

MiddlesexMD: Does this experience suggest anything that you wish other women knew or were told?

Elaine: It sure makes me happy that I have such a great health care provider who is on the cutting edge with drug therapies, knew about this option, and took the time to explain it to me. I have mentioned it to several friends, and they have never had such a discussion with their health care providers. I wish women knew that all the stories about menopause (icky side effects, moodiness, weight gain, etc.) are not necessarily the experience of every female.