6. Testosterone in Perimenopause & Menopause with Dr. Tami Rowen

Is testosterone the "missing piece" of your hormone puzzle, or is it a social media-fueled performance enhancer? In this deep-dive episode, Dr. Rachel Pope is joined by Dr. Tami Rowen, a lead gynecologist at UCSF and expert in sexual and transgender health, to separate data from hype. They tackle the confusing world of testosterone for women—from its role in desire and energy to the hidden history of how it was once used to protect the uterus. In This Episode, We Discuss: * The HSDD Breakthrough: Why the best-known data for testosterone is in treating Hypoactive Sexual Desire Disorder (HSDD), and the surprising truth about the doses used in successful clinical trials. * The "Menopause Cliff" Myth: Why testosterone doesn't actually crash at menopause, but rather begins a slow, steady decline in your 30s. * Dosing & Safety: The difference between "physiologic" levels (what you had in your 20s) and "supra-physiologic" doses (performance-enhancing levels) often seen in boutique pellet clinics. * The Breast Cancer Debate: Is testosterone protective or risky? Dr. Rowen explains the "anti-proliferative" nature of the hormone and the nuances of aromatization into estrogen. * The "Estratest" History: A look back at why we once used estrogen and testosterone together to protect the uterine lining—long before progesterone became the standard. * Cognition, Mood, & Muscle: Does it actually help with brain fog or gym gains? We look at why the data is mixed and the power of the "placebo effect." * The FDA Gap: Why the U.S. still lacks a testosterone product specifically approved for women and what that means for your prescriptions. Key Resources & Mentions: * ISSWISH: International Society for the Study of Women's Sexual Health [https://www.isswsh.org/] * Dr. Tami Rowen: UCSF Health Profile [https://www.ucsfhealth.org/providers/dr-tami-rowen] * Research Study: The Women's Health Initiative (WHI) and the 300mcg testosterone patch trials [https://pmc.ncbi.nlm.nih.gov/articles/PMC3963523/]. About Our Guest: Dr. Tami Rowen is a board-certified OB/GYN and Associate Professor at UCSF. She is a nationally recognized expert in sexual medicine, transgender health, and complex gynecological care for cancer survivors. If you found this episode helpful, please Rate, Review, and Subscribe on Apple Podcasts or Spotify! Your support helps us bring this vital information to more women. Follow Dr. Rachel Pope: * Instagram: @DrRachelPope [https://www.instagram.com/drrachelpope] * Website: OurWomanity.com [https://www.ourwomanity.com/]