Testosterone for Women: Fear Not Hair Loss/Growth!

Speaker 1: 

Welcome to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 

Hello and welcome to the Armor Men’s Health Hour. I am Dr. Mistry, your host, here as always with my cohost , the ebullient Donna Lee.

Donna Lee: 

Such a sexy word. Does that mean I’m cute? Bubbly? What does ebullient mean?

Dr. Mistry: 

Donna Lee is our office manager, and walking thesaurus around here .

Donna Lee: 

She kinda doesn’t know what some…I don’t know what a word means… [inaudible] ebullient.

Dr. Mistry: 

I am a board certified urologist. This show is a men’s health show and this show is brought to you by our medical practice that started in 2007 NAU Urology Specialists. A urologist is a surgical subspecialty-trained physician that treats mainly genitourinary conditions for both men and women. And this includes everything from the nipples down .

Donna Lee: 

I’m giggling ebullient.

Dr. Mistry: 

The nipples, the nipples to the knees, we say. That includes the kidneys that includes the ureters, the bladder, the prostate. We do a number of things…

Donna Lee: 

And the yum yums.

Dr. Mistry: 

And the yum yums. I forgot the best part, really. We have, we also treat women for a number of conditions, whether they be incontinence , pelvic floor prolapse. We have a specific expertise in our practice when it comes to the advanced treatment of complex sexual disorders. So for that issue, we have a sex therapist on staff, we have pelvic floor physical therapy, and then I think our biggest contribution to kind of our profession and what we can provide our patients is a more holistic approach. We believe strongly in nutrition and supplements and a more integrative approach to your health. And that’ll affect you, whether you’re getting treated for cancer or stones, or even irritative urinary complaints. And it’s your questions and your participation in this show that really keep it going. I really do talk like this all the time. You have a lovely bedside manner. I appreciate that.

Donna Lee: 

I keep hearing that from patients.

Dr. Mistry: 

I try to use my words nicely.

Donna Lee: 

You should, because you’re on warning with the staff.

Dr. Mistry: 

That’s right. That’s right.

Donna Lee: 

You have to be nice. And by the way, ebullient: cheerful and full of energy. So thank you.

Dr. Mistry: 

See, there you go.

Donna Lee: 

I Googled.

Dr. Mistry: 

Nice, nice, Donna Lee, why don’t you tell people about our practice and how they make an appointment with us?

Donna Lee: 

They can call us during the week at (512) 238-0762. You can send us an email to armormenshealth.com, we can do an inquiry through that website. Or you can send us an email directly to armormenshealth@gmail.com and Dr. Mistry on our website, our little podcast pops right up, they can send in a question right there, they can see your handsome face, they can hit the play button and listen to one of the podcasts for free.

Dr. Mistry: 

I love it.

Donna Lee: 

So go to our website.

Dr. Mistry: 

I hope it counts as a download, because that’s how I measure my value now as a person.

Donna Lee: 

Oh, that’s a good point. I don’t know.

Dr. Mistry: 

It’s how mnay downloads we get.

Donna Lee: 

I don’t know about that, but you can listen to our podcast for free everywhere. And we are podcastable, and dr. Mystery is doctor worldwide. We need a pit bull song.

Dr. Mistry: 

That’s right. Well, it’s like I said, your questions really kind of drive us. Donna Lee, do you have a question?

Donna Lee: 

I do. This one is from a listener and she says, “Hi. I’m listening to your radio show and we’d love to hear more about women taking testosterone. I heard there are negative side effects with losing hair at first, then growing hair and undesirable places. Can you talk a little bit more about the pros and cons of testosterone treatment for women, especially in their fifties? I know it’s a guy show, but I also know there’s plenty of women listening.” ‘Smiley face.’ Thank you for that.

Dr. Mistry: 

I love it. Thank you so much for that question. So I’m going to include testosterone in a, just kind of a slightly broader conversation related to hormone replacement therapy in women. So we’ve been doing hormone replacement therapy for over a decade. We get referred patients from many OB-GYNs around town who don’t feel comfortable. We have to do complicated hormone replacement in women who have had breast cancer diagnosis. And because we worry about why you want the hormones, not just getting the hormones, I think that we really achieve the goal of making people feel better. When people come to us for hormone replacement therapy, they’re usually complaining of symptoms of perimenopause or post-menopause. This can include low sex drive, low energy, changes to their skin, hair, and nails. There can be a substantial decrease in vaginal moisture leading to vaginal dryness and pain during intercourse. And I think that the poor sex drive is one that drives a lot of women to us. And sometimes it’s hard to tell , you know…

Donna Lee: 

If they don’t like their husbands?

Dr. Mistry: 

That’s right. You know, because sometimes just doing the laundry…

Donna Lee: 

It doesn’t do it for her? It does it for me. That’s all I ask: fold the towel.

Dr. Mistry: 

Maybe, maybe…And so , I always think of sexual, like low libido in a woman, it’s a couples’, that’s a couples’ problem, because , if women are playing the role in which they’re more likely to be approached and initiated for sex, then they’re going to be pressured. If the man is the one of low libido, then maybe his wife is happy.

Donna Lee: 

Everything’s fine.

Dr. Mistry: 

But if it’s the woman, you know, the man can feel, you know , frustrated sexually of course. But then more importantly, I think women just kind of get forced into like doing things they don’t want to do. And that’s not fun.

Donna Lee: 

That’s called rape.

Dr. Mistry: 

No, it’s just…

Donna Lee: 

No.

Dr. Mistry: 

Stop that.

Donna Lee: 

I’m sorry. That sounds terrible.

Dr. Mistry: 

It just , it’s just , you’re just kind of like forcing yourself to go into an act that you don’t necessarily feel really that connected with. It’s going to be harder to orgasm. It’s going to be harder to get aroused. And you know, for many couples , when, when you lose that sexual intimacy, it removes a part of that relationship. Now that’s not everybody. You know, some relationships thrive just fine without it. But usually people come to us, not because they themselves are distressed by a low sex drive, but because they feel like they’re letting their partner down. So…

Donna Lee: 

That makes sense.

Dr. Mistry: 

And so testosterone, we know in men is a big driver of sex drive, but it is also the same for women. So sex drive is also promoted with testosterone therapy in women. We have to do a lot lower of a dose and it can be harder to dose women because…

Donna Lee: 

Because we’re so complicated?

Dr. Mistry: 

No, because you don’t need much, and so we use creams for some women, but then some get concerned about transference or maybe it doesn’t absorb right. We use it sub-Q injections in women, which I think a lot of women really like if they’re not averse to kind of injecting themselves, and that’s super cheap. And then we have pellet therapy and the pellet therapy is the best “set it and forget it” kind of therapy. And unlike men who routinely get doses 2000 milligrams, women get a much smaller dose. That dosing is going to be dependent on your physical activity, your own size when you come to see us, and we put those pellets in like 5 minutes.

Donna Lee: 

Like a few minutes.

Dr. Mistry: 

Yeah, just super quick.

Donna Lee: 

Why are the women every three months and the men are every six months for pellets?

Dr. Mistry: 

That’s a great question. So because the dosing of testosterone in women is on the lower end of the range, if you put too much in the beginning, you risk spiking.

Donna Lee: 

Oh, that makes sense.

Dr. Mistry: 

And so, but giving testosterone without giving estrogen and or progesterone, depending on what your reproductive status is and whether you still have your uterus, it often is disappointing if you just give one. And so a lot of women get a better sex drive with just estrogen, and that’s not because estrogen is a big sex drive driver, it’s because you’re going to feel better about yourself. You’re gonna feel better both cosmetically, you’re going to feel better in terms of your vaginal lubrication and arousal. So that’s going to make it easier to get kind of turned on with the estrogen. So we do both, you know, you want the estrogen and the testosterone and in some people progesterone. And people worry a lot about whether something is bio-identical or not. There are some clinics in town that charge people thousands and thousands of dollars for this notion of bio-identical hormones. And I think that there’s , the most important thing when it comes to hormones is being able to test to make sure you’re getting the right amount, and whether it comes from the, you know , bark of a yin-yang tree and…

Donna Lee: 

A ding-a-ling tree?

Dr. Mistry: 

In some ways…and whether there are terms being used that make you feel that something is more naturally derived, I think is less important than making sure that you’re getting the consistent something that we can test for. So I tell people, of course we do bio – identical. I mean, the molecule that we’re giving you is identical to the molecule that you make in your own body.

Donna Lee: 

Thus, bio-identical.

Dr. Mistry: 

Thus bio-identical. And so , and it doesn’t have to be super expensive. And you can just test it out to see if it works well for you. The specific questioner, listener is asking about side effects of testosterone.

Donna Lee: 

And hair .

Dr. Mistry: 

And so the hair , I will tell you is often seen if you’re overdosing people. So I have had a few people that get hair kind of in the area that they’re rubbing the cream onto, which is why we have you rub it onto your calf, because you’re going to be shaving, most women shave that area anyway.

Donna Lee: 

Mhmm. Do they?

Dr. Mistry: 

Yes.

Donna Lee: 

Okay.

Dr. Mistry: 

Sorry, Michael.

Donna Lee: 

Date night.

Dr. Mistry: 

Date night. I guess that’s why you wear pants to work.

Donna Lee: 

That’s right. Once a month I’ll shave my calf.

Dr. Mistry: 

That’s right. So , there’s also the concern of growing facial hair or a hairy lip, and I will say that the complaints have been extremely uncommon for those things. We’re more likely to see a little bit of change in mood , with testosterone. Certainly you can have a better sex drive, and there’s also a concern some patients have of an elevated red blood cell count, but these are things that we check and we monitor, and most of these things are not dangerous to you if they’re well monitored. Overall hormone replacement therapy, if initiated within 10 years of menopause, decreases heart disease, decreases stroke risk, and decreases breast cancer risk, which is things that people don’t know. And so it is something protective to you to maintain a body chemistry that’s more like your younger self. And so we are, you know, when it comes to both men and women, we are big proponents of hormone and wellness.

: 

That’s awesome. What a great answer. What a great question. Huh. Okay. Well, I’m going to send that listener to this podcast and you can listen to all our podcasts for free wherever you listen to podcasts and call us during the week at (512) 238-0762. And send us your emails, armormenshealth@gmail.com. The Armor Men’s Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail .com