What this episode is about
Dr. Susan Hardwick-Smith reveals the truth about testosterone's critical role in women's health and why proper treatment could help you reclaim your vitality.
Key takeaways
- Gabriella says she asked her doctor to start on the lowest dose of testosterone and see how it felt. A very low dose has given her the benefits she hoped for.
- Dr. Susan Hardwick-Smith says women make more testosterone than estradiol across our lives, though about 10 times less than men. So testosterone is a hormone we've always had.
- Dr. Hardwick-Smith says every study of testosterone for low libido in women has shown better sex drive than placebo. She says it helps many women, though not all.
Moments from this episode
Word for word from the recording. Tap a time to hear it.
More sex drive means more life drive
“I personally feel when I have more sex drive, I have more life drive. I'm more likely to go out to lunch with you, or play pickle ball, or go on a trip, or try a new thing, learn a new activity.”
A hormone dose matters most
“I always say the dose is the poison. The hormone isn't the poison, it's the dose.”
The myth that desire ends
“It also speaks to this cultural myth that still is very prevalent, that women's sex drive isn't important, or that after we go through menopause we just don't have sex anymore, or that it's not something to talk about.”
Pleasure is feeling deeply okay
“Really feeling seen and heard and being comfortable on my own skin, right, even though my skin's wrinklier than it used to be, just being okay with it and feeling just deeply okay. It feels great.”
“I love this time that we're living right now, where we are witnessing women empowering themselves with knowledge.”
Gabriella Espinosaat 10:06
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Show notes
Testosterone remains one of the most misunderstood hormones in women's health. In my recent conversation with Dr. Susan Hardwick-Smith, board-certified gynecologist and founder of the Complete Midlife Wellness Center in Houston, we explored the vital role testosterone plays in women's health and why it's often overlooked in treatment.
Dr. Susan shared that women actually produce more testosterone throughout their lives than estradiol - though about 10 times less than men. This hormone peaks around age 25-30 and gradually declines with age, often leading to noticeable changes during perimenopause and menopause.
Read the full show notesShow less
Beyond Libido: Testosterone's Wide-Ranging Benefits
While many associate testosterone primarily with sexual desire, its benefits extend much further. Dr. Susan emphasized that testosterone supports:
- Bone density improvement
- Muscle mass maintenance
- Enhanced cognitive function
- Increased energy and motivation
- Greater sense of optimism
- Overall feeling of vitality
The impact can be profound. Dr. Susan described how testosterone affects overall life energy - when sex drive increases, so does the desire to engage in life, try new activities, and maintain social connections.
The Treatment Gap
One striking revelation from our discussion was the significant disparity in treatment options between men and women. While men have access to over 20 FDA-approved testosterone products, women currently have zero. This reflects a broader issue - only 1% of research funding goes to women's sexual health compared to men's.
Safe and Effective Treatment Options
Despite the lack of FDA-approved products specifically for women, treatment options exist through qualified healthcare providers. Dr. Susan outlined several approaches:
- Topical creams and gels
- Pellet therapy
- Carefully monitored dosing protocols
Most women notice improvements within 2-3 weeks, with full benefits developing over 6-8 weeks. Regular monitoring through blood tests ensures safety and optimal dosing.
Finding the Right Support
For women interested in exploring testosterone therapy, Dr. Susan recommends:
- Seeking certified menopause practitioners through menopause.org
- Starting with low doses and careful monitoring
- Finding providers who understand proper dosing protocols
- Being prepared to advocate for yourself
A Holistic Approach to Sexual Wellness
Dr. Susan emphasized that testosterone works best as part of a complete approach to sexual wellness, including:
- Self-awareness and body connection
- Open communication with partners
- Intentional focus on pleasure
- Regular exercise and overall health maintenance
Moving Forward
Dr. Susan's insights highlight that sexual vitality has no age limit. Whether through hormone therapy or other approaches, women deserve access to treatments that help them feel their best. Her powerful reminder that "it's not done, she's just taking a nap" speaks to the potential for reawakening sexual energy at any age with proper support.
This conversation reinforced what I've long believed - that pleasure and vitality are our birthrights at every age. If you're experiencing changes in your libido, energy, or overall vitality, know that options exist. Start the conversation with a qualified healthcare provider and explore what might work best for you.
About our guest: Dr. Susan Hardwick-Smith is a Board-Certified Gynecologist and certified menopause practitioner specializing in women's midlife wellness, hormone optimization and sexual wellness. She is the founder of Complete Midlife Wellness Center in Houston, TX, and the best-selling author of "Sexually Woke- Awaken the Secrets to Your Best Sex Life in Midlife and Beyond." She also hosts the popular podcast "Empowering Midlife Wellness." Dr. Susan is the recipient of the Texas Super Doctor award over a dozen times, as well a multiple time recipient of H-Texas magazine's Top Doctor and Top Doctor for Women awards. She also has been chosen as one of Houston's "3 best rated" gynecologists several consecutive years. Dr. Susan is also an ICF certified life and leadership coach, multiple time marathoner and Ironman triathlete, and mother of 3 teenagers.
Connect with Dr. Susan:
- Website: drsusan.com
- Book: drsusan.com
- YouTube: youtube.com
- Instagram: instagram.com/drsusanofficial
About the guest
Dr. Susan Hardwick-SmithBoard-Certified Gynecologist and certified menopause practitioner specializing in women's midlife wellness, hormone optimization and sexual wellness2 episodes with Dr. Susan Hardwick-Smith on Pleasure in the Pause.See all their episodes
