Testosterone Is Not a Male Hormone: Levels, Dosing, and What It Does During Menopause

**Mohit Khera** (0:00)
It's not a male hormone. We know if you treat women for decades, you'll see it helps with muscle mass, depression, energy, mood, sleep. Just because the data does not show it does not mean it doesn't happen.

**Mary Claire Haver** (0:11)
Why don't we have the research?

**Mohit Khera** (0:13)
It's money. The funding for men is at least 20x or more than in women.

**Mary Claire Haver** (0:18)
Talk to me about levels. What do they mean?

**Mohit Khera** (0:20)
Always start low and go slow. The side effects are related to dose, acne, facial hair, oily skin. Those are reversible. For many years, I've been treating women with testosterone, giving them hormones. I found one thing that actually makes them feel better than the hormones.

**Mary Claire Haver** (0:47)
The views and opinions expressed on unPAUSED are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis or treatment.
For years, I've watched women come into my office and tell me their libido is gone. They tell me they barely recognize themselves. They tell me their partner is patient, but they can see the toll it takes. They tell me they've tried everything and nothing works.
Their OB-GYN told them it was stress. Their therapist told them it was the relationship. Someone else suggested an antidepressant. Nobody mentioned testosterone. And for years, I didn't either. Not because I didn't believe the data, because there was no FDA-approved formulation. The guidelines were unclear. The field treated female testosterone as French, so I referred out. I hedged, and I watched women suffer with a treatable problem because the research infrastructure was built for men and the regulatory infrastructure had abandoned women. Here is what I know now.
Testosterone is one of the most biologically active hormones in the female body. The data on safety is stronger than people think. The reason it is not FDA-approved for women is not because it doesn't work. It's because nobody funded the trials. Women have been told testosterone will give them facial hair and a deep voice.
Women have been told it's experimental. Women have been told to wait. And while women have been waiting, men have had access to testosterone replacement therapy with FDA-approved gels, pellets, injections and patches for decades. Today's guest has spent his career closing that gap. Dr. Mohit Khera is a Board Certified Urologist and Professor of Urology at the Scott Department of Urology at Baylor College of Medicine, where he holds the F. Brantley Scott Chair in Urology. He earned his MBA and his Masters in Public Health from Boston University and his medical degree from the University of Texas Medical School at San Antonio. He has published more than 160 articles in peer-reviewed journals, written and edited two books in the field of sexual medicine and men's health. Dr. Khera is one of the few academic voices in this country who has consistently made the case that women deserve the same evidence-based access to testosterone that men have had for decades. He is here today to tell women the truth about testosterone, what the research actually shows, what the risks really look like, and what to ask for in a doctor's office that has never prescribed testosterone to a woman. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to unPAUSED, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.
Dr. Khera, welcome to unPAUSED.

**Mohit Khera** (4:02)
Thank you. Thank you for having me on the show.

**Mary Claire Haver** (4:03)
So you spent your training learning to take care of mostly men. I know there were female patients in your residency as well. But when most people think about urology, they think the male plumbing system.
But how did you end up becoming one of the world's loudest voices to me in the academic arena on testosterone and women?

**Mohit Khera** (4:24)
I got to tell you a story. So in 2007, I finished my fellowship at Baylor College of Medicine with Dr. Lipschultz. I was really good at getting men excellent erections, great libidos.
One day a woman called me and she was extremely upset. She said to me, you've ruined our relationship. Everything was great until my husband met you and now we fight every single day. I couldn't understand what she was talking about. In a sense, she was saying, he wants to have sex with me every day now. We haven't had sex in 10 years and we fight every single day. I thought to myself, she's right. It's okay to leave both libidos low, but you never raise one libido high and the other one to keep it low.