I have a question about testosterone and hope someone here can explain it to me:
I've read many, many times, including here on this forum, that a woman produces more testosterone than estrogen during their reproductive years. If this is true, why is estrogen (and progesterone, if needed) the main focus of HRT? And why does estrogen have to be at optimal levels before adding testosterone?
In two of Dr. Vliet's books (Screaming to be Heard and The Savvy Woman's Guide to Testosterone), she states that estrogen levels need to be optimal before considering testosterone. However, she seems to contradict herself in the 2nd book mentioned above when describing a case study:
“Both her estradiol and testosterone levels were quite low, so I wasn't surprised that she felt so miserable, or that she had so many problems with her sexual response. I started her on a compounded bioidentical micronized testosterone 1 mg tablet every morning. Since she still had her uterus and would need progesterone as well as estrogen, I suggested using Nuvaring, a vaginal ring combination of ethinyl estradiol and progestin,……â€
It seems she started testosterone, estrogen and progesterone at the same time, but later in the book she again states that estrogen levels need to be optimal before adding testosterone.
Below is a brochure from Dr. Vliet's practice:
http://www.herplace.com/pdf/testosterone-brochure.pdfUnder “Cautions†it states “Women should not take testosterone without estrogen.†Nothing about raising estrogen to adequate levels before adding testosterone. Has she changed her mind since she wrote her books? Is there new scientific evidence that contradicts this recommendation? Very confusing if you ask me.
The following brochure, though very positive, is equally confusing (to me at least). Under “Myth #2†this brochure states that estrogen and testosterone are BOTH crucial for normal sexual function; however, then goes on to say that it is recommended to reach adequate estrogen levels BEFORE adding testosterone – it says “recommended†and not “imperative.†My question is why? (I'm a ‘why' kind of person)
https://menopausedoctor.co.uk/wp-content/uploads/2017/06/testosterone-ten-tips.pdfI have to admit I have quite a bit of brain fog since menopause knocked me to my knees, and I may have missed something in all my research. Can anyone clarify this for me?