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Understanding Testosterone Options for Women | Empowering Midlife Wellness

Dr. Susan Hardwick-Smith

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Periodically it's important to revisit the topic of testosterone replacement for women, and to understand all the nuances regarding the options in delivery methods and dosing.

Today I'll discuss options for testosterone replacement, including using 1/10 of an FDA approved male product, compounded creams and gels, as well as appropriately dosed hormone pellets.

I'll particularly focus on how to safely dose hormone pellets, and will share the method which my office has used in many thousands of patients, and has been proven to reach safe levels. Appropriately dosed pellets should be thought of as a viable option for those who don't prefer to use a topical cream or gel.

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✨ Dr. Susan Hardwick-Smith is a Board-certified Gynecologist and Certified Menopause Practitioner with over 25 years of experience in women's health, specializing in women's midlife wellness hormonal optimization and sexual wellness.

She is the founder of Complete Midlife Wellness Center in Houston TX, and author of “Sexually Woke- awaken the secrets to your best sex life in midlife and beyond”. She also hosts the popular podcast and YouTube channel “Empowering Midlife Wellness”. Earlier in her career, she founded Complete Women's Care Center, which became the largest all-female Ob/Gyn group in the country.

Dr. Susan is the recipient of the Texas SuperDoctor award over 15 times, as well as a multiple time recipient of H-Texas magazine’s Top Doctor and Top Doctor for Women awards. She's also been chosen as one of Houston's “three best rated gynecologists” for multiple consecutive years Dr. Susan is also an ICF certified life and leadership coach, multiple time marathoner and IronMan triathlete, and a mother of three young adults.

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❗ DISCLAIMER
Content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your health care provider with any questions you have regarding a medical or mental health condition, and before undertaking any diet, dietary supplement, exercise, or other health program.

20 Comments

@vreneli79 1 year ago

I’m a 46 yr female. 6 months on HRT via pellet insertion. Definitely a game changer…significantly more energy, muscle tone, libido, mental clarity and no more bladder leakage. I was over dosed for my 1st pellet. Given 100 mg of testosterone. At 4 weeks post insertion, my test levels were 230. The biggest negative was irritability and quick temper. Not great for my marriage. I am happy to report my body processed the over dose. My test levels came down to 25 ~5 months later. I switched providers and dropped doseage to 75 mg of testosterone and feel the best that I have in years!! Thank you Dr Susan for all of your advice. If I wasn’t on the other side of the country, I would see you for all my menopause needs. Hope this helps somebody.

@nicolebeck1269 1 year ago

Any pharmacist who says anything judgmental to a patient should be reported to the board of pharmacy. That’s completely unethical. It’s none of their business. If they question it, they can contact the doctor or provider.

@BonSid49649 1 year ago

I wish they would make Testosterone therapy available for women as a patch.

@KH-to7pr 5 months ago

We always talk about libido… what about energy, motivation, the lifting of depression, improved sleep, etc? Testosterone has impacted all of those things for me and more importantly those things! Estrogen and progesterone helped hot flashes and anxiety and sleep but didn’t touch any of that other stuff- still horrible unmotivated with zero spark, zest, joy, or motivation to do life. Add 2.5mg T cream and all of that is changing. Still waiting on libido to catch up tho 😂

@karenshipley2299 1 year ago

Problem with pellets is that if the dose is wrong, you have to live with it for 12 weeks. That's a long time to suffer.

@ReneeBaker-n7m 1 year ago

I am 57 and switched from oral Estradiol to Estrogen/Testosterone pellets last Sept and it’s been a game changer!!

@sherrieray 1 year ago

I’ve just did my 4th pellet insertion & I absolutely love the pellets - what a difference in all area of my life… yes I have to pay $300 bucks out of pocket every 3 months it’s worth every penny I’d give up just about anything if I had to in order to get my pellet insertion 💜💜

@kpeapod 9 months ago

I just turned 60, and I have used a compounded testosterone cream for 10 years now. It is mixed with estradiol so I get the best bang for the buck - both in one application. I also take progesterone slow release in pill form - best thing my doc EVER did for me. I take it only at night before bed because I would forget if not. While you noted it doesn't matter where you apply it, I will say that I have found for me that it has mattered. I used to put it on my inner arms where you suggested and rub the two together so I never had to touch it, but I quickly found black hairs growing there 😬which freaked me out. I have since moved application to my thighs, the black hairs on my inner arms went away, and I switch legs every night and where I put it because even switching, it still tends to grow black hairs, which I hate, but I shave it. I once tried to go off the testosterone, and within a WEEK, skin was sagging, dull, and I felt miserable. Unless something else comes along, this has changed my life! Thank you, Dr. Susan, for all the great information!!

@lolakathol4109 1 year ago

Muscle lose is why I take testosterone.

@JodieMesa 1 year ago

Hello Dr. Hardwick-Smith! Thank you so much for so much useful content!! I am a family medicine doc in Colorado trying to become a menopause expert and so many videos just speak to patients but yours speak to me in my prescribing which is infinitely helpful. I really love how you explain your reasoning and never throw other providers under the bus when justifying your practices. I loved the Dr. Rubin/Dr. Attia video and had watched that also feeling just a little discouraged about their feelings on pellets so huge thanks for making that make sense. I primarily practice in a community hospital based system and do traditional HRT but my husband opened a medspa a couple of years ago and we are getting set to go do our Evexipel training and I have been discouraged by all the negative opinions on pellets. I love your explanation and thanks for the lower dosing guidance.

@donnawhitecotten361 1 year ago

I watched that whole podcast you mentioned a couple weeks ago. When the Dr started talking about pellets, I was like Oh No, she needs to talk to Dr Susan! Maybe you should invite her on to your podcast!!

@queen-b9414 1 year ago

Can you please mention during your videos if you are referring to total T or free T and what unit of measurement you are referring to?

@Candleflower42-zp3sh 1 year ago

My testosterone was 220 when finally persisted to get a blood draw, I didn’t have any side effects at all. Estrogen was 557 and did end up with endometrial cancer, which the oncologist said could have been because of that but who knows. After the hysterectomy I asked, should I go back on hormones and he said, of course, so I have to give him credit for that. when I switched from BIRST to a patch my PCP gave me the impression that now there was no way to give testosterone unless I had a pellet so I need to ask her about the cream. Good thing we have YouTube specialists to listen to.

@Btrvl 1 year ago

60 years old- started Pellet 172mg one year ago- total game changer! Same benefits as mentioned by other users- had to shave legs more often- great thing is that it INCREASED head hair growth a lot!!

@bethandrews6741 1 year ago

I have been on pellets for over 2 yrs. I am so grateful Dr Susan has an open mind regarding Pellets. Game changer for me.

@ajohnson0008 1 year ago

I use generic Testim gel - apply it twice per day. I apply with a little plastic spatula on calf or inner thigh (alternate). I find about 1/5 of a tube is more what I need - did 1/10 for about a year. CVS generally has the best price with good Rx coupon - about $90 for 30 tubes - which last me 150 days.

@kslmay 1 year ago

Love the Androgel! For me it doesnt interfere with my lifestyle at all and dosing is not a problem. I wake up everyday with no joint pain! Like Martha said, "It's a good thing". :)

@cookiebuzz 1 year ago

Thanks Dr. Susan.

@leanoraspadaro9491 1 year ago

Excellent video, very informative. Thank you for revisiting this Testosterone topic.

@marcywilkinson4310 1 year ago

I appreciate your perspective on pellets. Im in peri and have tried troches, patches and creams over the last 6 months. Nothing has been able to help me keep my levels sustained throughout the day and your right, some methods are pretty inconvenient. I may be willing to try pellets in the near future because of your explanations and personal experiences with them. It totally makes sense to me.