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updated 2/18/2004 3:58:01 PM ET 2004-02-18T20:58:01

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What is your advice on taking testosterone to raise sexual stimulation?

Question:
I'm 43 years old and have wondered if I am going through menopause because I seemed to be losing feeling when having sex. (My brain still wanted it constantly, but my body wasn't always responding). Combined with hubby's low sex drive, I was very sexually frustrated. My doctor prescribed testosterone cream, and, wow, what a difference! The feeling came back within two days, and making that doctor's appointment was the best move I could have made! I didn't have to change my birth control pills, or anything like that, just started using the cream, which is cheap.

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But I have a few questions: Why did my doctor say this only came in a cream form, when I've seen posts where people are taking pills or patches? Can you give me an idea of exactly how much per dosage I should be applying? The bottle doesn't give much info, just says "Apply to vulva, etc.," but doesn't say how much to apply. And I assume I will need to keep using this always? (The prescription has no refills, but maybe because he wanted to see if it worked first). And any other info you might want to add on this medication will be welcomed.

Answer: It's great that you are so motivated to try to build your arousal and ability to respond to sexual stimulation.

Yes, pills and patches are available, but opinion seems to be growing that a cream is best. It goes into the body without needing to go through the liver and lose some of its possible impact.

A common dosage is using 0.5 mL daily applied to the genitals. Many pharmacies that compound the cream will provide a plastic type syringe that has the markings on the side. Just squeeze out the 0.5 mL and apply. A common strength is 10 mg/mL.

Yes, you'll need to use it daily. Your physician may want to hear from you about the results before issuing a refill order.

Estratest does contain testosterone, but I don't know offhand the amount. Your physician may be deeming that it's enough and doesn't want to add any more. You do have the right to ask for your free testosterone and total testosterone levels to be measured by a simple blood test. You can insist. Of course, you may be running into a problem if your doctor's office has to deal with capitation, which can lead some doctors to resist ordering tests that don't relate to life threatening issues.

Masculinization (hair growth, voice deepening, etc.) occurs infrequently. If you do supplement, just pay attention and pull back on your dose if you happen to be one of those very rare women. Thinking about it logically, a woman who has less than measurable testosterone in her body is very unlikely to be sprouting facial hair when she is brought up into the normal zone for females. In one lab scale, the high end of normal for women is 90. That same lab measures men at the low end of normal at 350. So, a low level for men is more than three times the high end of normal for women.

Louanne Cole Weston, Ph.D., is a licensed marriage, family, and child counselor and a board-certified sex therapist in practice since 1983. Her work in the field of human sexuality includes extensive experience as a therapist, educator, and researcher.

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