Dr. Virginia Loewenstine, CEO and medical director of Tristate Preventive Health, answers your questions
Q: I am female and have been a career firefighter now for 18 years. For about five years, bloodwork has shown my testosterone to be consistently below normal. My doctor prescribed testosterone cream which brought my levels up slightly, but then they came crashing back down once I went off the cream. Just wondering if you have other suggestions? I have no sex drive, my muscles are deteriorating, and I’d really like to sort this out.
A: Symptoms of low testosterone (low T) are many, and those you describe do fit the diagnosis. Some people are surprised to learn that testosterone is a vital hormone not only for males but for females, as well, so I commend your doctor for checking your levels. Hormones work hand in hand and even the slightest change in one can produce symptoms no one wants.
Once a hormone is found to be low, the question should be “Why?” so I would go back to your doctor to check other hormone levels and further testing, if warranted. Once a hormone is known to be deficient, hormone replacement is in order. Unless an underlying cause can be found and treated, this replacement therapy would be considered indefinite so the replacement hormone should not be taken “as needed.”
Hormones work in concert with each other so taking a replacement on a regular basis keeps the others from getting out of line. It is a fine balance.
In the case of testosterone replacement therapy, there are three ways to provide the replacement, all with pros and cons. Creams can be used but the hormone in the cream does not last long in the body so it has to be applied often. Because it is on the skin, anyone – particularly children – who comes in contact with the area where you’ve applied the cream can potentially have the testosterone enter their body.
Injections are a common method and can work well; however, these are self-administered and have to be given every few weeks. Oftentimes the symptoms of low T will appear before the next injection is due.
A third option is inserted bioidentical hormone pellets. These are the size of a grain of rice and are inserted as a doctor’s office procedure using local anesthesia. Symptomatic relief is usually seen in 48 to 72 hours and lasts three to six months, depending on your body’s metabolism of testosterone. Worth looking into!
