Regain Functional Medicine + Aesthetics offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our healthcare clinic.
Female FAQ
Women need replacement if they desire to:
- Delay the symptoms of aging
- Reverse depression and anxiety
- Regain libido
- Preserve skin and muscle tone
- Look younger
- Increase energy
- Strengthen the immune system
- Improve physical stamina
- Cure insomnia
- Thicken hair
- Protect against osteoporosis, dementia, diabetes, and heart disease
- Prevent need for long term care from loss of ability to walk
- Improve general health
Menopause is the third stage of aging. The first stage is losing your testosterone. The second stage is losing your progesterone. Menopause is when
you enter the last stage of aging. You are in this stage through the rest of your life. That is why we need to learn how to treat it and live with it.
Estradiol injections adequately treat hot flashes, vaginal dryness, painful intercourse, dry skin, and thinning hair.
Testosterone injections treat the symptoms of low libido, difficulty with orgasm, depression, fatigue, muscle mass loss, weight gain, belly fat
accumulation, immune system abnormality, autoimmune diseases, mental decline, loss of exercise stamina, loss of motivation, and many other
symptoms of testosterone deficiency.
Deficiency is diagnosed through its symptoms and thorough a medical history review, in conjunction with a low total and free T level in your blood
Yes. Most patients begin treatment sometime after 40 or if their ovaries are removed. Testosterone from the ovary disappears before menopause
and should be replaced when a woman becomes symptomatic.
Every treatment plan is unique. We recreate what the normal daily production of testosterone and estradiol should be and deliver enough of that
dose to last until the next injection. This dose is then adjusted according to body mass, exercise frequency, stress levels and any medications the
patient is on.
Every treatment plan is unique. We recreate what the normal daily production of testosterone and estradiol should be and deliver enough of that
dose to last until the next injection. This dose is then adjusted according to body mass, exercise frequency, stress levels and any medications the
patient is on.
Injections are intramuscular and given in the upper-outer quadrant of the hip/buttock.
It takes about 4-6 weeks to get the full effect. Injections must be given at least every 7-10 days before symptoms recur
Injections last 7 days. If you don’t get a lot of sleep, exercise, do stressful work, or participate in athletics, you will use the hormones more quickly
and we may need to dose you with a stronger dose on your next visit.
Testosterone increases the thickness of bones and muscles which increases lean body mass. But, it also decreases fat at the same time. Many
women taking hormones start by dropping sizes and don’t begin to lose weight for 9-12 months. A high protein, lower carb diet is recommended.
Some women have water retention when they begin treatment until their body adjusts to new hormone levels.
That depends on how much exercise you do, how over weight you are when treatment begins, and what other relevant medical conditions you
have. We always try to help you with your weight loss by optimizing your injection dose and balancing your other hormones.
How long can I take injections?
- Osteoporosis
- Auto-immune diseases
- Fibromyalgia
- Immune Deficiencies
- Dementia and Alzheimer’s Disease
- Parkinson’s Disease
- Frailty Heart Disease and Stroke Type II
- Diabetes
- Obesity
- Insulin Resistance
The reason someone might need DHEA is because their testosterone level is good, but they still have “sagging skin.” In this case, we recommend
only 7 keto-DHEA in doses of 25 mg or less. Other types or doses above 25 can cause an increase in estrone which means weight gain and increased
risk of breast cancer.
Yes. Testosterone is very safe for diabetics and generally increases insulin sensitivity, which will decrease triglycerides and stabilize blood glucose. It
will improve the status of your diabetes and help you lose weight.
Yes. It often replaces anti-depressants (which decrease libido) after only a few months of treatment for patients whose anxiety and or depression
began around age 40.
There is a risk for bleeding with any ERT (estrogen replacement therapy) but we minimize the amount of estradiol you receive and increase the
dose of progesterone. This helps to protect you from post-menopausal bleeding. If this does not work, then we send you to your gynecologist for a
uterine biopsy, ultrasound, or the placement of a Mirena IUD which counteracts uterine bleeding by providing a small amount of progesterone
inside the uterus.
Testosterone is made of cholesterol. When you take cholesterol-lowering drugs, you decrease the substrate that testosterone is made of, and
generally decrease the level of testosterone. Testosterone replacement lowers cholesterol, so we can recheck labs in 3-6 months to see if your
lipids are much lower. We then suggest that you do a trial without the medication to see if you still need it.
No. Testosterone injections improve the immune system function so you can fight all types of cancers more easily than before you started
treatment. Please see form titled “The Women’s Healthcare Initiative” for further Information.
No, it does not in women as we only require a small dose of testosterone compared to the dose men are on.
The type of estrogen that we use, estradiol, does not increase the risk of blood clots. Also, the fact that it is given intramuscularly rather than orally
also decreases the risk.
No. You will likely consume the testosterone more quickly than other women because your liver is hyper-activated to metabolize testosterone with
the same enzymes that metabolize alcohol and drugs.
In addition, marijuana increases prolactin, the hormone that increases breast size in men and women. Prolactin not only decreases your
testosterone level but decreases your sex drive and sexual stamina. It is expected that if you take testosterone, you will stop using marijuana
altogether and moderate your alcohol consumption.
We strongly suggest that you do not because it dampens the effects of the testosterone. Instead of oral contraceptives we encourage our patients
to get a Mirena IUD or permanent birth control (like a tubal ligation or have their husbands get a vasectomy) instead of taking the pill. Many
women who insist on continuing the pill are disappointed in the resolution of their symptoms, and they decide after they experience the problem
to seek out other birth control. Birth control is, of course, not needed after menopause. Any pre-menopausal woman on testosterone therapy has
to have a documented form of contraception to be on treatment.
We suggest you look for alternative medications for the following drugs:
Corticosteroids such as prednisone
Medrol Dosepak
DHEA that is not 7-keto DHEA
Other hormones given orally like oral contraceptives
Anti-depressants
Yes. This is the safest form for you and it actually improves your immune system so that you can fight abnormal cells so they don’t grow, but
instead are destroyed by T-killer cells. Approval from your oncologist may be needed.
You should begin by taking non-oral estradiol and testosterone in the form of bio identical hormones which assists in bringing the level of estrone
back to young, healthy levels. Low estrone decreases belly fat.
If you are having trouble losing belly fat and have already accomplished the above, then take DIM ES 250 mg per day with food, take iodoral (iodine
to bump your thyroid activity), eat 6 small meals each day with high protein and low carb, exercise with interval training, and always work out your
abs by doing sit-ups and core exercises.
About 5% of our patients are not “cured” of the problems they wanted to treat. Sometimes, this is because the injections are causing an effect that
does not fit their lifestyle, such as a libido when they are unmarried or feel they are too old to engage in intercourse.
In some cases, women will not experience healing as quickly as they would like. Patients with chronic fatigue are helped by testosterone
replacement, but they don’t feel the resolution of symptoms as quickly as women who do not have that illness. Women who have psychiatric
illnesses and are on multiple medications may not feel as healthy as women who do not have those illnesses. Lastly, if a patient develops breast
cancer, or uterine cancer, the treatments are discontinued until cancer treatment is completed.
Some women may experience an increase in facial hair growth, oily skin or acne. All are possible side effects of testosterone use in some, but not
all, women. We use Spironolactone to block the conversion of testosterone to 5-alpha dihydrotestosterone, whish is the active form of
testosterone in the skin. This helps block these side effects and prevents them from becoming problematic.
Male FAQ
Low Testosterone can be diagnosed if you have 3 or more of the following symptoms:
- lack of libido
- fatigue
- insomnia
- erectile dysfunction (ED)
- depression
- loss of muscle mass
- loss of stamina
- hot flashes
- osteoporosis
- migraines
- decrease in mental acuity
- loss of motivation
- loss of balance
- irritability
Along with the symptoms, we look for a low total testosterone blood level, such as something below 300mg/ml, or a low free testosterone blood
level of less than 129.
When men age, testosterone production normally declines which causes them to lose their ability to have sex without ED medications, experience
aging of their body losing muscle and gaining belly fat, developing diseases of aging including heart disease, diabetes, obesity, osteoporosis, joint
damage and autoimmune diseases. Testosterone keeps us young and healthy when we are under 40, and as it declines we must replace it if we
want to stay healthy.
They are given in the upper outer hip/buttocks.
Some men feel the results in the first week. It takes about 2-3 weeks to get the full effect. Injections must continue to prevent symptoms from
returning.
No. The metabolites of testosterone, dihydrotestosterone and estrone, cause prostate enlargement but the expert in prostate cancer, Dr.
Morgantaler has proven that low testosterone, not normal young healthy levels contribute to prostate cancer.
Once prostate cancer has been diagnosed, the cancer cells in the prostate are completely different from the benign prostate cells that were there
before, so it is recommended that men refrain from replacing testosterone if there is prostate cancer present. However, if a man has had prostate
cancer that is completely removed surgically, and has negative nodes (does not have any more prostate cancer cells) Dr. Morgantaler of Harvard
feels that it is then a choice to be made by the patient and his doctor. If cancer is metastasized, we don’t advise replacement of testosterone, in
any form.
Yes. It often can replace the need for antidepressants which decrease the libido.
Testosterone is made of cholesterol. When you take cholesterol-lowering drugs, you decrease the primary ingredient that testosterone is made of.
Testosterone will usually help shrink the prostate. There are exceptions to this rule, but this is the typical experience. If symptoms of enlargement
occur, which is rare, you will be referred to a urologist.
Yes, they will to some extent. Testicles shrink normally with age, as they provide less and less testosterone. As the injections take over the supply of
testosterone, testicles are not producing as much as usual, so they get smaller. This is not a permanent change, and there are medical methods to
prevent the testicular shrinkage. This is purely cosmetic, not a medical complication and does NOT impact your health at all.
That depends on how much weight you have to lose at the beginning of treatment as well as how much you exercise, your diet, and how often you
work out with weights. Without testosterone replacement this transformation would not be possible even with the perfect diet and exercise.
No. You will use up the testosterone more quickly because your liver is activated to metabolize testosterone with the same enzymes that
metabolize alcohol and drugs. Marijuana increases prolactin, the hormone that increases breast size in men and women. Prolactin not only
decreases your testosterone level but decreases your sex drive, ejaculatory function and sexual stamina. It is expected that if you take
testosterone, you will stop using marijuana altogether and decrease consumption.
Yes, in most cases it will. It also increases insulin sensitivity which will decrease triglycerides and stabilize blood glucose. It will improve the overall
status of your diabetes. In men who have had many years of diabetes—especially without good control—the vessels in the pelvis are damaged and
cannot dilate anymore to get enough blood to the penis for an erection. In many cases, this leads to erectile dysfunction.
In general, that is accurate however the physiology behind it is not clear. Testosterone tends to improve the joint function and cartilage thickness
and muscle tone necessary to relieve the pain from damage to the joints from years of sports. It also replaces the testosterone that decreases
because of head injuries in contact sports.
Testosterone fixes the real problem—It is the lack of testosterone that decreases libido and sexual response. Viagra does not fix the sexual desire
issues. Viagra is only treating the symptom of ED not the other symptoms of low testosterone, and it has many side effects.
This is a concern for men who take testosterone, because the addition of testosterone can increase the red blood count by stimulating the bone
marrow to produce RBC’s in anyone. If there is an underlying condition that also elevates the blood count, then it is prudent to diagnose and treat
that condition early on in the treatment with testosterone. The reason it is important is that elevated concentrations of red blood cells cause
sludging of the blood and could cause clots to form, so it is important that this is diagnosed and treated prior to, or early in the replacement.
No, because we evaluate and treat men with an increase in blood count, we check your hemoglobin level using a fingerstick method every 3
months. If we see that it is trending higher than 18, we recommend you donate a pint of blood at your local blood bank or we can do this
procedure in our office.
No. There is no reason for you to try a method that will not bring you back to health completely before you try injections
Maybe. Most men find that they do not. However, if there is vascular compromise from arteriosclerosis or diabetes, then it is still possible that ED
medicine in one form or another may be needed. Often we find that a patient’s blood pressure medicine is contributing to the problem and we
advise our patients to switch to the blood pressure medication that is least likely to cause ED. In any case, if ED meds are needed, they are
generally used at a lower dose. WE have other procedures in our office (ie. PRP in the man shot & Trimix) that we can also discuss, to help with this
issue.
