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Do you need testosterone right now?

YO. Folks! Are you starting to think that testosterone is a BIG menopausal issue? Is the internet convincing you that testosterone is the answer to alllllllll your menopausal problems? Well let me slide in with some super boring science and suggest that sometimes social media is terrible. It's terrible because the algorithm has no interest in reality - it just shows content people find interesting - and it doesn't have to be accurate to be interesting. In fact, the more outrageous and surprising the better. Good news though, the algorithm might not fact check but nerds do fact check! And for us fact checkers, the best research on testosterone and menopause doesn’t compare older women to younger women. It compares maturing women to themselves. That takes a lot longer but is far better science.

In the picture above we have a graph - from a well executed longitudinal study - showing total testosterone. Blood levels were measured from several years before through several years after the menopause transition. In this study women recorded their menstrual cycles, allowing the researchers to accurately identify the Final Menstrual Period (FMP - the time that we date menopause to) which is shown at time 0 on this graph. If menopause severely disrupted our testosterone levels, this data would be able to capture that - we would see a dip, or a rise, or maybe a wave. Sometime in those years around menopause things we would see things get…squirrely.

But, dear reader, things do not get squirrely! We see a boring straight line showing that testosterone continues the relatively slow decline it’s been doing since the mid 20s. So if social media has been making you think your testosterone is tanking, science up! Remember your body is Super Cool and menopause is not a disease! If you’re having menopause problems you can handle them. Without fear!

If you are trying to schedule with me to get testosterone because you heard about it on social media, we're probably not a good fit. I don't want you to waste your time on my waiting list only to find this out in our first visit!

To be clear: I’m not here saying no one should use testosterone. We can use testosterone as a therapy, when it makes sense, without spreading disinformation and fear that leads regular perimenopausal people to fret about their testosterone levels. The FOMO is real right now. I'm anti-FOMO.

Image from the article (available online to everyone) A Prospective Longitudinal Study of Serum Testosterone, Dehydroepiandrosterone Sulfate, and Sex Hormone-Binding Globulin Levels through the Menopause Transition from the Journal of Clinical Endocrinology & Metabolism published 8/1/2000.


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