Yet another Testosterone 2% Ointment Question

I had a TAH/BSO on March 13, 2001. I initially did really great - no physical problems, no hormonal issues. Physically, I still feel wonderful However, emotionally and mentally I have not done as well. I anger easily, suffer bouts of depression, walk around in a brain fog and have lost my libido. My doctor has prescribed testosterone 2% ointment to be applied twice daily for 2 months. I am currently on the .05 Climara patch. How long should it take to see any effects from the testosterone ointment?

Hi GolfTeresa,
I am sorry you are having trouble with anxiety, depression etc. Has your doctor done any labwork to determine that you were in need of testosterone? If not and it were me, I would prefer to have some lab work done to determine if I indeed needed testosterone. I would ask for estradiol levels to be checked. .05 is on the lower end and with the brain fog it is worth seeing what the level is. I would also request testosterone levels. Some women require testosterone, but many do not, and adding to adequate testosterone levels can be a disaster. The other labwork I would ask for is a Thyroid panel and blood sugar. We have to remember that the endocrine system works as a whole and when one part is altered...potentially any hormone function can be affected. You did not mention whether or not you were taking progesterone? Many women are helped with all of the symptoms you mentioned just by adding some progesterone to their HRT.
If indeed your doctor tested your levels and detemined them to be low in testosterone, then use the 2%ointment with great care. Did you get it from a compounding pharmacist? If so he can put it in a syringe so that you can accurately dose the ointment. o you know how many mg. per day you are to be using? If I am not mistaken the 2% is quite a high concentration. We have learned that a starting dose of about .25mg of the topicals is sufficient. I have personally experienced high testosterone levels, it was not pleasant, and there are some lasting effects.
When starting any new hormone you should notice a gradual decrease in symptoms...definitely within a week and the full benefit will come within a month. An overnight improvement can signal that the dose is too high for long term use.
I hope this information was helpful...if you have more questions please feel free to ask here

Becky in OHIO

Hi Becky:

I'm just jumping on the bandwagon here! What did you experience when you were on too much testosterone? I have been on it for just over 2 months, 2% cream, for 6 weeks 1ml, think I am overloaded, anxiety really bad, feeling nausea off and on. A couple of days ago I dropped my dose to .25mg, I was really glad to see that you said that is what we should start with. That is what I originally started with, but my dr. wanted me up to 1ml. He is on holidays now and I wasn't sure what to do, my compounding pharmacist said to keep it at 1ml, that it wasn't too high, and add some progesterone cream. I'm working with the progesterone, it does calm the anxiety, but my head doesn't feel well on it. I'm ok with just about 5-7mg, but this isn't enough to combat everything from the testosterone. We talked before, but just to refresh your memory, by blood levels baseline were, estradiol 87, estrone 83, testosterone 5.5. I think I was getting a really good conversion to estrogen, because the vaginal problems were completely gone. Could that be the problem? Could my estrogen have gotten too high?

Hugs AnnK

Ann K
I am not really an expert on conversions butdo know that low testosterone can cause vaginal symptoms so it would make sense. Thanks for going over your facts again, I have a hard time remembering it all from person to person. Did you mean that you went from 1ML to .25 ML? because you said you dropped to .25mg????? I think and someone can correct me if I am wrong but I think that 1ML of 2% is equal to about 10mg(I will try to get Lauren to confirm this)
My symptoms of high testosterone were mainly HAIR....omg...I had a mustache and the hair on my upper thighs got coarse and like guy hair dark and yucky...impossible to shave. After over a year I still have a little bit of it..I guess when you stimulate the hair follicles that they don't completely settle. So I have a ton of chin hairs I have to pluck or wax to this day plus the darker thigh hair still. That is why I advocate starting low on testosterone and adding as you go. The anxiety could be the testosterone or the conversion like you stated. I think I would try to go on a very low dose and watch for signs of too much the anxiety is one, oily skin and hair, as well as the hair thing and a deeper voice...oh and enlargement of the clitoris. I think that about covers it. I am glad you are getting some benefit. Incidentally my compounding pharmacist also thought I needed the 1ML of the 2% cream...it was Lauren who told me that is way too much.

Becky in OHIO

Hi Becky:

Yes I was on 1ml and dropped to .25ml. I was talking to Lauren and from what I remember 1ml of the 2% cream is equal to 20mg. I didn't get extra facial hair from that high dose, what I did notice is the little bit that I had started disappearing, another reason why I thought I was getting good conversion to estrogen. Did get more hair on my lower abdomen, which is where I am applying it. I notice when I use progesterone cream, that is when I get a lot of facial hair, what am I backwards or something! lol Thanks Becky, wasn't sure if anxiety was one of the symptoms of too much. I've been down to .25ml for 3 days now, anxiety and sore tummy, nausea, getting a little better I think. Will continue and see how it goes. If it doesn't resolve itself, I will stop testosterone for a few days, maybe have a build up right now, I'm not sure how testosterone works that way, are you? I appreciate your information Becky, thank you!

Hugs AnnK

Hi Becky and others:

Thanks for the info about the 2% creme. However, is there any difference between the crem and the ointment? Also, Becky at what point did you start noticing the hair growth? I have only been using the creme for a week now.

Thanks!
Teresa

Teresa...I am thinking I noticed the hair within a month or so...it is really a blur though being that it was a long time ago. I am checking to see about the difference between the ointment and the cream as that is a very good point. Hopefully Lauren will show up and enlighten us on this subject


Becky

Becky:

Thanks for your quick reply. You gals sure are fast . . .

I hope I do not have any bad side effects from ointment. It is only temporary and that is something I don't quite understand either. My doctor says I will only use the ointment for a couple of months and then just as necessary. Are hormones sometimes prescribed to just give a "jumpstart" to our systems that are in a state of shock. As I stated before I had a TAH/BSO in March 2001 and I was just was not myself after 5 months - moody, no libido, etc.

Will the hair growth you described ever go away or do you think you are stuck with it?

Thanks again!

Teresa...
about the hair...it has gotten better but my hairdresser says I am pretty much stuck with it. It has lightened some so I am just bleaching the lip stuff now...but it is longer and thicker than the way it was....the waxing was giving me wrinkles .... geeze sometimes you just can't win.
It sounds like your doctor wants you to take more now to get your level up more quickly and then come up with a maintenance dose. I woud just be careful...again I am waiting for Laurens pears of wisdom...now must go mow the lawn
xo
Becky in OHIO

I think the creams are probably a little better than the ointment only because they feel better, not messy, and have more consistent absorption. Ointments are fine but you may want to ask for the testosterone to be put in a cream next time.

One ml of a 2% ointment contains 20mg. Since women only produce around 0.3mg per day, you can see how 20mg is quite a large dose, especially if using twice a day. The 2% ointment is an old formula that just won't go away. It's supposed to be used for severe vaginal atrophy and pain (lichen schlerosis-sp) and not for hormone replacement therapy.