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I do not know this specific patient in Cincinnati but this is a patient I see all too often- a woman with crazy high testosterone levels.

PELLETS are unregulated and should not be used!

Testosterone pellets cause SUPRAPHYSIOLOGIC (above normal ) levels and have side effects!  I see patients with levels over 1000 and above the normal MALE range all the time. 

Why do women get pellets? There are many reasons including lack of access to providers with knowledge about menopause and T use, lack of an FDA approved T product dosed for women, AND the business of medicine- there is money to be made. Women also feel great after pellet #1- her libido and energy is great so she promotes pellets to her friends.

But with each pellet the euphoric feeling diminishes and over time- just like we see with transgender individuals using testosterone- masculinization side effects (that transgender individuals want) kick in. Voice change, change in body shape and muscle development, scalp hair loss, facial hair growth, acne, clitoral enlargement, acne, change in facial bone structure, increase in lipids and weight gain. 

And mood effects are common. When women want to come off they have mood disturbance for some period of time. 

Testosterone use in women is “having a moment” on social media now and I am seeing many women in my practice who are using pellets (I do not and have never done pellets) prescribed at local medispas and hormone centers. Many others are asking me about using T as part of menopause hormone therapy to prevent body composition changes and preserve muscle mass. 

The only indication for testosterone in women currently is for hypoactive  sexual desire disorder in midlife women after and appropriate evaluation and in doses appropriate for women to keep their level in the normal female range- which is 50ng/ml not 200 no/ml or 1000ng/ml -levels I often see and reported here. 

I encourage women to JUST SAY NO to PELLETS. This case represents bad medicine!! Find a clinician with expertise in this area and following @isswshoffice @acog_org @menopause_society @internationalmenopausesociety guidelines.
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