So doctors don't always "get it". Now that is not to say, they don't know what they are doing, but most physicians are not taught anything but the basics about women's health and especially the roles of hormones. And most certainly nothing about the role of ttestosterone in women. The United States, in particular, is light years behind when it comes to this.
The advent of the Internet and more "baby boomers" getting to menopause is creating a higher demand for understanding and desire to feel better. This is forcing more and more physicians to take notice. With that said, there are only a handful of doctors who truly "get it" when it comes to hormones and know how to properly treat hormonal imbalances.
So what are the problems in getting diagnoses properly......
1) Doctors don't know all the signs and symptoms of testosterone deficiency. The big ones are: mood swings, irritability, lack of patience, anxiety, depression, fatigue, loss of stamina, impaired memory and concentration, loss of libido, sleep disturbances, muscle weakness, inability to loss weight despite diet and exercise, increasing blood pressure, worsening cholesterol, impaired sugar metabolism and plain ole apathy. You may ask yourself, "why do I hate my life or feel nothing, when I have everything I want". Most doctors try to put you on an antidepressant, because this is easier than actually trying to figure out that you have a hormonal imbalance.
2) The lab reference ranges are only reflecting true endogenous hormone production of testosterone....meaning what the ovaries and adrenals make every day. This causes a perplexity to treatment and the ability to truly know what is "normal" for a particular women/patient. Most lab reference ranges suggest that levels between 6-82 ng/.dl are normal. However the labs are often inaccurate, not properly calibrated from women, do not capture the day to day variations in hormones and in peri-menopausal and menopausal women do not reflect the proper levels for treatment dosing. There is no data to support that proper dosing for exogenous (or the testosterone we give you to take) should be based on establish ranges from endogenous production. In fact, often good proper treatment levels can be 2-3time the "normal reference" range. You MUST base treatment on the unique needs of each women to find the optimum dose to provide good effect without adverse side effects. This take time and listening to each patient.
3) The media has scared the heck out of women when it comes to hormones. There is so much misinformation out there and it takes time and scientific knowledge about studies to understand and sift through all the information. This is not easy and a challenge even for the best of us.
More later......and I promise we will get to estrogen as well. Just starting with this topic for now. We will address the perimenopause and what this transition means.. Sounds like fun huh!
- Dr. Angela DeRosa AKA "Dr. Hot Flash"
- Scottsdale, Arizona, United States
- Angela M. DeRosa DO, MBA, CPE graduated from the Chicago College of Osteopathic Medicine in 1995. She went on to do an Internal Medicine Residency with a fast track emphasis in Women’s Health at Lutheran General Hospital. After her residency, she became the Director of Women’s Health Services and Education at Lutheran General Hospital. After two years of practice she started a full time career as the West Coast Senior Medical Director with Procter and Gamble Pharmaceuticals. There she worked on women's health product development, research and marketing. Seven years after starting this position, Dr. DeRosa decided to pursue other clinical endeavors. Dr. DeRosa is a nationally recognized internist and women’s health expert. Her clinical focus is on revitalizing the physician-patient relationship; striving to provide the highest quality of care to her patients in a warm compassionate environment.