My doc put me on estradiol, estriol, and DHEA in a cream, and I also take prometrium the last two weeks of the month. I've been on only two weeks now and have not noticed any increase in libido. He said the DHEA will break down into testosterone and estrogen.

1) Am I being too impatient and should I just wait on the DHEA a little longer?
2) Should I ask for testosterone in addition to DHEA, or in place of DHEA?

I just want my libido back. I feel bad for my husband. I've been a dead doorknob for about 4 years now.

In women, DHEA breaks down mostly into estrogen, and is useless for increasing libido.

Get the testosterone cream for libido.

Thanks, Armadillo, I will ask my doctor about that!

Also, can testosterone cream override the anti libido effects of seratonin? Does anyone know?

In theory, yes. But it will depend upon how much testosterone you can handle before some virilizing effects occur. Like lower voice, hair growth, increased muscle mass and enlarged clitoris. We are all different in this regard, but remember, once these bodily effects occur, they are irreversible, even after you stop the testosterone. The first thing you may notice is a sore throat, which means your larynx is beginning to enlarge. Shortly after, your voice will change. So consider this a warning sign.

may I add, it can take a few weeks to feel the full effects of the hormones. It may be the case that the level of estrodiol is too low, and needs to be adjusted. Definately discuss the benefits of testosterone on libido. It can impact a bunch of meno symptoms.

Dopamine and prolactin also impacts libido.

And there is a list of drugs that can negate libido:

Antihistamines
Sympathomimetic amines
Anticonvulsants
Metronidazole
Metoclopramide
Antihypertensives
Diuretics
Adrenergic antiagonists (terazosin, doxazosin)
β.-Blockers
channel blockers
Antiandrogens
Cimetidine
SpironolactoneAlkylating agents
Cyclophosphamide
Anticholinergics
Oral contraceptives
Drugs with abuse potential
Antidepressants
Hypnotics
Sedatives
Alcohol
Antiestrogens
Tamoxifen
Raloxifen
Gonadotropin-releasing hormone analgesics (leuprolide, goserelin)

My experience was that taking testosterone caused an almost immediate increase in libido. The first time I took my BHRT, which was 2 mg estradiol, 2 mg testosterone, (both creams I put behind the knee) and 25 mg DHEA, I was back to normal --actually feeling like a 30 year old -- within 24-48 hours. My libido had been dead for three months, ever since my last period. The libido enhancement came mostly from the testosterone. I have been on this form of BHRT (also progesterone) for about six months and I can't go back. I have my waist back (lost 7 pounds), no more hot flashes, great libido. Definitely no masculinizing effects -- unless you consider a new need to listen to loud music -- Prince -- masculinizing. Estradiol is wonderful, but I've experienced estrogen highs at mid cycle my whole life and know what they are about. This testosterone stuff is wow, now I get why guys are so energetic. The problem for me is my doctor is very fancy (associated with Cenegenics) and I can't really justify the obscene expense. I need to get these creams for less than $10,000 a year, but I find it difficult to navigate the information on this site and elsewhere about where to get compounded creams from excellent doctors whether an endocrinologist, gyno, or naturopath. If anyone knows a great doctor who prescribes in NYC, let me know!

wordsmith

Wordsmith, Contact your health insurance and see if they have a compounding pharmacy. Anthem does so I assume others do as well. One month's supply of compunded cram at a local pharmacy is $50. a 3 month supply of the same script is $20. with the mail in.

Yes, I do know that the creams themselves are relatively cheap (Aetna won't pay for them in my case.) It is the doctor's fees ($1,695 quarterly) plus bloodwork 2 or 3 times a year at $695... that is making my husband -- and me -- sick to our stomachs. I have just been researching BHRT in NYC on the web for about an hour and the results do not look promising. There is a Nancy Lebowitz, a gyno who does sottopelle pellets (why do that rather than a cream??), the doctors at Patients Medicals that Suzanne Somers recommends, and various alternative medicine types who do not specialize in endocrinology or gynecology and treat everything under the sun... If there is a favorite doctor of anyone reading this in NYC, do let me know. This is inside information at this point. I suspect the best ones are not advertising on the web.

Wordsmith

I got a referral for a doctor from a compounding pharmacy. If you don't get your present BHRT creams from a local pharmacy, go to the website for the International Academy of Compounding Pharmacists and there is a tab at the top of the page to "find a compounding pharmacy". I called several and asked them for an OB/GYN or primary care physician or endocrinologist that they worked with and they gave me several names. A woman pharmacist even gave me her own doctor's name.

Hope this helps!

kimber

Thank you, kimber, I will try that!

wordsmith

Also I found it helpful going to Womensinternational.com, the BRHT compounding pharmacy, and requesting an info packet as well as a list of practitioners in my area. Then I went to womenshealth.com (a website I have long used and where I get my multivitamins and progesterone cream) and that site hooked me up with a list of doctors in my area who specialize in menopause. I looked at the list and then called a doctor (gyno) whose name I recognized from one of the best doctors lists and asked if she prescribed BRHT creams. She did and so I made an appt. She doesn't take insurance though. No surprise.

Hope this helps someone else out there!

Best,
wordsmith

Wow, Wordsmith, now I wonder if my hormone dosages are too small. I'm only on Estradiol 1mg, Estriol 2.5mg, and DHEA 15mg. Is it possible that the DHEA is not in a high enough dose?

Well, let's talk about DHEA first.

My Cenegenics printout lists optimal as 350. Suzanne Somers writes that between 150 and 350 is optimal. When first tested, before I started BHRT, my level was 84. My doctors put me on 25 mg. After three months my level was 111, when she saw this she told me to up my dosage, to take 1 pill on odd days and 2 pills on even days.

To be frank though, I don't think the DHEA is going to help the libido too much. You need testosterone and you need it now. Your doctor is probably uncomfortable prescribing it because it is not yet FDA approved (I think). It is completely safe though, more dangerous not to take it, in my opinion. (i.e. bone loss, weight gain, husband leaves you because you won't have sex, etc.)

Cenegenics lists the optimal range for testosterone in women as 50-70. Before BHRT, my level was 9 (ha, no wonder I was a dead doornail sexually). After 3 months at 2 mg of cream behind the knees daily, my level was 58. Perfect. I am now as I was libido wise at about, say, the age of 32.

If I were you, I would first ask my doctor very nicely to prescribe testosterone in cream form, armed with all the good it does for your body in terms of bones, etc. He or she probably won't do it. If that doesn't work, I would type in anti-aging doctors or bioidentical hormones into google and see if there are any practicing in your area.

I hate to say it, but these doctors don't usually take insurance. Apparently, only upper middle class women have the right to feel normal.

Best of luck to you,
wordsmith

Wordsmith, my doctor is already an anti-aging guy (cause my family doc and gyn wouldn't touch bio identical hormones with a 10 foot pole). But he says I just need to wait three months until the DHEA kicks in and starts working more. I am now finishing up the second month, so after one more month, if my libido isn't better, I will ask about the testosterone cream.

Three months is too long! Besides, the DHEA converts mostly to estrogen in women's bodies. In men it is a pre-cursor for testosterone, but NOT in women. Tell this to your doctor.

Anti-ageing doctors treat BOTH men and women. And MOST of them treat men and women the SAME WAY! Believe it or not!

Ask for testosterone now.

I am bumping this thread just to give an update. Wordsmith and Armadillo were right -- ask for the testosterone!!! After 10 months on estradiol/DHEA/progesterone, my libido was going nowhere and I couldn't lose weight. I waited so long to make changes in the regimen because we moved and I needed to find a new doctor, as my original doctor was not supportive of my desire to try testosterone. I now have a naturopath who can prescribe medicine and hormones, and she prescribed 1% testosterone cream to be applied in 1mg doses to my vulvar area daily. I wouldn't say I'm a nympho yet, but I did notice an immediate, new interest in sex! I also bumped my DHEA to 20mg daily, oral. I've only been on it for a week so can't speak to the weight loss yet, but I have noticed that I have more energy and I am not on the verge of tears every day. This is a very hopeful development. I hope anyone researching testosterone who finds this thread will be helped by this update. Testosterone should be approached carefully, but definitely, definitely consider it and give it a try.

I am so glad to hear this!

As for the placement of the testosterone, I did try that direct approach but it was too much for me.
As a possibility for your future, you can try testosterone on the arm or behind the knee for systemic
effect.

Success story at last! Yay.


wordsmith

Hi Wordsmith!

Yeah, the 1mg is a bit much for the vulvar area. It's just goopy and excessive. It's probably too early to know if the location is going to be "too much" in terms of hormonal effects, but logistically, it's just not a great place for a cream. I already take vaginal estradiol and vaginal progesterone so the area is getting a bit overloaded . . . Sorry if too much information. :-)

I haven't noticed any negative effects yet but I did have a dream last night where I spontaneously punched an obnoxious woman in the face, shocking everyone! Bwahahahaaaaaaa!!!!! I guess I will have to keep an eye on myself and my aggressions. It is not like me to have violent dreams.