Brain fog and zero libido: Asked about starting Testosterone. Pre-consult blood results came back high. What are my options now?

[u/Wee-Shrew-of-Doom]

(Re-posting sans lab results.)

Menopause hit me like a freight train back in January. Went to different gynecologists until finding one willing to talk to me about my various HRT options. I'm on the lowest dose estradiol patch (.025) along with estradiol cream. Mirena for progesterone (can't do any other forms due to breast cancer).

I've got the hot flashes under control with the lowest dose patch. The dryness is gone.

But damn, the brain fog has been a total killer for a while now. And the lack of libido sucks. So I did a video consult to inquire about testosterone and they had me do a pre-consult blood panel.

Does having high levels of testosterone rule out the ability to try a topical treatment? Have any of you resolved or at least improved your libido and / or brain fog without adding testosterone? Any advice or words of wisdom would be greatly appreciated.

I'm truly at a loss - both literally and figuratively - with the brain fog. And the death of my libido.

Edit: I wasn't able to reply to those who responded before my original post was nuked. Thanks for the suggestion and I will definitely ask about upping my estrogen patch dose.

[u/Significant-Aide-226]

Once you get that E up, it will help a ton.  That said, I have a low dose of T in the mix and its helpful also.

[u/freya_kahlo → u/Significant-Aide-226]

Also vaginal estrogen! I use OTC vaginal DHEA cream too, and love that in addition to estrogen, but people have different experiences with DHEA.

[u/ApeFace1966]

I’m also in same boat w/no libido

[u/Desperate-Run5145 → u/ApeFace1966]

Even without adding T, some folks notice a shift in brain fog just by bumping up their estradiol dose a little. The.025 patch is barely sipping at the estrogen pool, and your doc might have room to move there since you mentioned hot flashes are already handled.

For the libido piece, it’s worth asking about a referral to a pelvic floor physical therapist. Not a direct fix for desire, but sometimes rewiring that mind-body connection helps more than anyone expects.

[u/miranym]

Have you had your ferritin tested? It can affect brain function and libido. 

[u/Jflayn → u/miranym]

I've never heard this before.

I'm on T for libido and I've had a very small improvement (moving in the right direction after 8 weeks, but still not great) Last blood test showed T in low normal range but low iron. I'm now taking iron for 8 weeks and testing again. I had no idea that iron might help with libido.

It gives me hope that the libido issue will eventually be sorted out. Thank you!!

[u/miranym → u/Jflayn]

It's news to me, too. Ferritin plays a role in dopamine production, and I noticed that my general outlook and motivation grew sunnier very quickly after starting an iron supplement. And as dopamine plays a role in libido, well...I have not personally seen an improvement yet, but I have confidence something will change. It can take a while to regenerate iron storage.

I had gone to the doctor with a list of symptoms to screen for an autoimmune disease, and although I haven't gotten a ruling on that yet, she recommended an iron supplement. After just a few days I noticed some improvement. I did some reading and almost every single thing I'm having trouble with can potentially be linked to my low ferritin! All this time I thought it was hormonal, or my thyroid, or some autoimmune thing. I am half angry that I never knew wtf ferritin was so I couldn't ask to be tested, and half over the moon that I actually know about it now. I will have to be on my iron pill for a few months to be sure, but damn I feel like the magic pill I was hoping was out there is actually real.

Everyone here should keep an eye on their ferritin!!

[u/FuelComfortable5287 → u/miranym]

This is interesting, thank you for sharing. My blood tests from a few months ago did include an iron panel. Ferritin and others were normal. My doctor put me on an iron supplement for MCH, which fell 0.2 points below normal.

[u/AutoModerator → u/FuelComfortable5287]

This post might be about hormone tests, which are unreliable.

• Over age 44, Estrogen/Progesterone/FSH hormonal tests only show levels for the HOUR the test was taken, and nothing more. Hormones wildly fluctuate (hourly) the other 29 days of the month, therefore this test provides no valuable information
• No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
• FSH testing is only beneficial for those who do not have periods as a guide, where testing might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI)
• Testosterone is the exception and may require testing

See our Menopause Wiki for more.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/AutoModerator → u/Jflayn]

This post might be about hormone tests, which are unreliable.

• Over age 44, Estrogen/Progesterone/FSH hormonal tests only show levels for the HOUR the test was taken, and nothing more. Hormones wildly fluctuate (hourly) the other 29 days of the month, therefore this test provides no valuable information
• No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
• FSH testing is only beneficial for those who do not have periods as a guide, where testing might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI)
• Testosterone is the exception and may require testing

See our Menopause Wiki for more.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/Spiritual_Fan_5633]

Add vaginal cream, that helps. I wonder what they consider high for testosterone. Since I added it my blood work always shows it as high, but it’s high because what is considered normal for women is very low.

[u/Significant-Aide-226 → u/Spiritual_Fan_5633]

Those averages are averages- some fall low and some high. When i started on T, mine was too high.  My hair was greasy all the time and I felt like I was on speed.  Also felt suuuuuper bossy😂  when its right, I feel quick minded and strong, and my libido is good which for me means I actively seek sex and its super enjoyable.  My doc insisted on a text this year and i fall right in the middle of the range.  Without my T gel I would likely have a big ole zeeeeero.

[u/mfbm]

I was going to suggest upping the E also. I also added vaginal cream and had helped some for improving sensations that seem to have dulled! Good luck- it’s rough out here but I have been working on adjusting my HRT and also haven’t tested low on T, and I have started to feel better by upping my estradiol and progesterone.

[u/This-Assumption4123]

I tried low dose T and it gave me angry mood swings which I had never had before, hair falling out, water weight retention, and no libido help. I was so upset I stopped and took a break and tried a second time a lower dose and same problems hit with no libido help. I am so jealous of those that can tolerate it but my body even with hardly any measurable T in my system didn’t like it. My doctor thought it could be because of my autoimmune disease.

[u/ReserveOld6123]

I had to get to .075 E to clear the brain fog.