madman
Super Moderator
In this episode, Dr. Morgentaler and Dr. Brandon discuss the increasing interest in Testosterone Therapy (TTh) for women, driven by influencers, the skepticism of mainstream medicine, and the benefits and safety of testosterone for women in specific circumstances.
Chapters
00:41: The Rise of Testosterone Therapy in Women - More women are seeking testosterone therapy, influenced by media figures like Davina McCall, sparking debates among doctors.
02:26: Challenges and Misconceptions in Testosterone Research - Doctors often misinterpret testosterone's benefits, focusing on averages in studies rather than individual experiences.
07:34: Insights from International Conferences - The hosts share findings from an international conference where experts highlighted increasing testosterone prescriptions for women in the UK.
14:24: Understanding Testosterone Levels in Women - There is no definitive testosterone level to diagnose low testosterone in women, making individual assessments crucial.
15:20: The Role of Free Testosterone - Free testosterone, which is unattached to proteins, is key to understanding hormonal activity and availability in the body.
18:24: Challenges and Misconceptions in Hormone Therapy - Concerns about risks like cancer or permanent side effects are largely outdated, but proper monitoring remains essential.
25:49: Advice for Women Considering Testosterone Therapy - Women should discuss options with a knowledgeable doctor, consider a short trial, and not hesitate to seek a second opinion if dismissed.
The Sex Doctors Podcast: Testosterone Therapy for Women – Breaking Down the Myths and Realities
Hosts:- Dr. Abraham Morgentaler – Renowned urologist and expert in sexual medicine.
- Dr. Maryann Brandon – Clinical psychologist and diplomate in sex therapy.
Introduction: The Influencer Effect on Testosterone Therapy
Dr. Morgentaler and Dr. Brandon kick off this episode discussing a recent NBC News article titled “More Women Seek Testosterone Therapy Prompted by Influencers, Doctors Say.” The article highlights a growing trend of women seeking testosterone therapy, often inspired by online influencers, which has stirred mixed reactions in the medical community.
Dr. Brandon jokingly clarifies, “The ‘yay’ in the title is for women seeking testosterone therapy—not necessarily for influencers.”
Why Are Women Interested in Testosterone?
Dr. Morgentaler observes that more women are visiting OB-GYNs and primary care doctors requesting testosterone prescriptions or hormone level checks. This interest has been notably fueled by public figures like UK broadcaster Davina McCall, whose advocacy for testosterone as part of hormone replacement therapy (HRT) sparked what’s called “The Davina Effect.”
However, Dr. Morgentaler highlights the resistance within the medical community, often marked by skepticism and negative attitudes toward testosterone therapy for women.
Medical Skepticism and the Reality of Testosterone Therapy
The hosts address the reluctance among some doctors to embrace testosterone therapy. Despite substantial evidence supporting its safety and efficacy, many in the medical field maintain an overly cautious stance.
Dr. Morgentaler notes:
- Doctors often worry about appearing too enthusiastic about new treatments.
- Research results are based on group averages, which can obscure life-changing outcomes for individual patients.
- A study might show modest average benefits, but within the group, certain patients might experience profound improvements in quality of life.
- As Dr. Brandon aptly puts it, “For some, testosterone therapy can be life-changing.”
Clinical trials often involve participants who are not representative of real-world patients. Study volunteers might not suffer from the same level of symptoms or distress as those actively seeking treatment, potentially skewing results.
“Patients who take the time to visit a clinic, deal with parking, and take time off work are more motivated,” Dr. Morgentaler explains. “They’re experiencing real symptoms they want addressed.”
Testosterone Therapy in Women: The Global Perspective
During an international conference, a UK colleague revealed an eye-opening statistic: testosterone prescriptions for women in the UK now exceed those for men. This trend highlights the growing demand, despite limited product availability.
Key challenges include:
- In the U.S. and Europe, there are no FDA-approved testosterone products for women.
- Women must rely on off-label prescriptions or compounded testosterone, which often involves adapting male dosages.
What Do the Experts Say About Testosterone for Women?
Dr. Morgentaler cites guidelines from the International Society for the Study of Women’s Sexual Health (ISSWSH):
- Androgens (including testosterone) are essential for female sexual health.
Testosterone plays a crucial role in sexual anatomy, behavior, and overall well-being. - There is no definitive blood level to diagnose low testosterone in women.
Unlike men, where thresholds are clearer, women’s testosterone needs are highly individualized.
- Women typically require about 1/10th the testosterone dose prescribed to men.
- Side effects like hair loss, body hair growth, or voice deepening are rare but should be monitored.
- Treatment is a trial, not a lifetime commitment.
Misconceptions About Testosterone and Cancer
The hosts debunk lingering myths:
- Breast Cancer (Women): No evidence supports a link between testosterone therapy and breast cancer.
- Prostate Cancer (Men): The long-feared connection has been definitively disproven.
Advice for Women Considering Testosterone Therapy
- Start with Your Doctor: Discuss your symptoms and request a testosterone level check.
- Be Persistent: If your doctor dismisses your concerns, seek a second opinion.
- Find a Specialist: Look for sexual medicine doctors via reputable organizations like ISSWSH or ISMS.
Conclusion: Overcoming Medical Conservatism
The episode ends with a hopeful note about the potential of testosterone therapy for women. The hosts emphasize the need for more open-mindedness in the medical community to address patients’ concerns effectively.
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