Testosterone for Women: The Evidence that the Guidelines Ignore
by Neal Rouzier, MD Treatment Scenario Recently, a Midwest NP was reported to her nursing board for prescribing excessive doses of testosterone. One of her gynecology-physician peers did not like the NP prescribing testosterone for a shared patient who was not receiving HRT from her gynecologist. Note that the patient was quite pleased with the
Hormones and Long-Term Brain Health
Hormones and Long-Term Brain Health by Krista Russ We have now discussed several etiologies behind Alzheimer’s Dementia. We know that a healthful lifestyle, including maintaining a healthy weight, are important factors correlated with lower AD risk. Many of the pathways that contribute to AD are unique from each other, but what all of them share
Testosterone for Women: The Levels Necessary to Achieve Symptom Improvement
In the first course, Testosterone for Women (Part I), I reviewed the current controversy in prescribing testosterone to women. In a separate consensus paper that is different from the one discussed in the first course, the authors recommend testosterone replacement based on symptoms and signs and not on serum levels. In fact, in this second consensus paper from “experts that have experience in the field of testosterone administration,” the authors stressed the importance of replacing testosterone to improve symptoms and not by being guided by numbers or levels. These authors specifically emphasized that testosterone should be supplemented based on symptoms and not just on serum levels alone, as testosterone levels do not correlate with symptoms as per much of the medical literature. The authors also suggested that testosterone should be dosed and adjusted based on symptom improvement, and not by testosterone levels. The authors reiterated that no number (or testosterone level) denotes a deficiency as symptoms denote a deficiency. Furthermore, improvement in symptoms do not correlate with numbers either as all women will respond differently and not based on any number. So, in contrast to men where the guidelines state that we must follow levels and numbers, these guidelines for women recommend that we do not test baseline levels nor treatment levels, rather symptoms should guide treatment initiation.