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Hormone Replacement Tips From Dr. Philip M. Sarrel (VIDEO)

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Hormone Replacement Tips From Dr. Philip M. Sarrel (VIDEO)
Hormone Replacement Tips From Dr. Philip M. Sarrel (VIDEO)
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Dr. Sarrel shares tips for women taking testosterone.

Dr. Sarrel:
Ladies, I’d like to offer you a list of tips with respect to taking testosterone or thinking about testosterone. I have talked about the importance of going to a healthcare provider prepared. So in a sense, the bottom line tip there is know before you go.

There’s a lot of information to know about testosterone in women, about androgens in women, how it’s made every day. If you go well-informed with that information and you should be able to get that from the endeavor’s site, if not Google it. But the point is whenever you are going to a healthcare provider, inform yourself first.

The next tip would be don’t be shy about initiating a dialogue. Remember that some of the special issues, especially the sexual issues, very often the nurse or the doctor in an office won’t initiate because they don’t want to impose on you, and you may not initiate because you may feel you don’t want to impose on them, but the bottom line is somebody has to start.

And so if you keep a diary of what’s happening to you, there’s a scale that I have advocated being used. Let’s say the most common of the sexual problems which would be the reason for thinking about taking an androgen like testosterone.

The most common of the sexual problems–three out of four of all women—is a decrease in sexual desire. Make a record of what you are experiencing. If you are not experiencing any feelings; if you are not having any dreams or fantasy; if it is a source of distress for you, keep a daily record of that. Bring that to the interview.

I would also recommend that you not go alone. Either you bring a friend, an advocate, or if there is no such other person or maybe you don’t want to bring another person, at least bring a tape recorder because some very important things could be said and in the midst of all of that you may misremember.

You may feel confused about it; get it all on tape. I have never had a patient come in with a tape recorder where I have said, “I don’t want this interview recorded.” I have always said, “Boy, am I glad that you are keeping a record of exactly what we are saying because we will always be able to go back to that if there’s anything that isn’t clear.”

Another tip would be don’t have an inadequate evaluation. A proper evaluation for starting androgens--remember a hormone like testosterone has 200 different actions in your body. Most of them are good, but as with any hormone you might ever take, you can take too little and be inadequately treated. You could get too much and have bad effects without even knowing that it’s happening, or you could even have some effects like a rageful outburst from too much that you didn’t know was related to taking it.

So you have to know what the good effects are and what to expect and what the adverse effects are so that you have the follow-up appointment in which you can discuss that with your physician. Don’t have a once-a-year visit; make sure you have a visit where the steps are taken and the follow-up is provided. That would be true with any kind of hormone–a diabetic for insulin, a thyroid patient for thyroid hormone, a woman at menopause for estrogen.

You don’t have single visits for hormone treatment. You always need to know that there’s a need for the hormone and then a response to the hormone and that it’s being followed and evaluated by your physician.

And that does get me to the last of the tips, and that is don’t ever take anything you don’t need. If it hasn’t been established that this is something that your body needs, then don’t start it, and very often one of the problems with any kind of hormonal treatment is being treated with something that is not right for you. Using hormones calls for individualized care, and it’s not incorrect for you to demand that.

About Dr. Sarrel, M.D.:
Philip M. Sarrel, M.D., completed his medical education at New York University School of Medicine, his internship at the Mount Sinai Hospital, and his residency at Yale New Haven Hospital. In addition to his many years on the faculty of the Departments of Obstetrics and Gynecology and Psychiatry at Yale University School of Medicine, Dr. Sarrel has also been a Faculty Scholar in the department of psychiatry at Oxford University, Visiting Senior Lecturer at King’s College Hospital Medical School at the University of London, Visiting Professor in Cardiac Medicine at the National Heart and Lung Institute in London, and Visiting Professor in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York. He is currently Emeritus Professor of obstetrics, gynecology, and psychiatry at Yale University.


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