There is a trade-off in using in the trans-organo gel base instead of a cosmetic type cream like Dermabase. The cosmetic creams are nice to apply, but all contain mineral oil that can reduce absorption. The gel tends to be sticky if doses are greater than ¼ tsp.; most women have no problem with this dosage size.

All gels are compounded so that ¼ tsp = 1 Gram

Oral testosterone USP is rapidly metabolized in the body and has limited applications in HRT. However, sublingual and buccal forms will bypass enzymatic and first pass liver transformation.

Methyltestosterone is the most widely used oral testosterone (in Estratest). Many primary care providers feel that even the half-strength Estratest is too strong for many women. Some researchers have suggested that there is a therapeutic window for optimal benefits--too little a dose being ineffective and too large a dose causing side effects (particularly androgenic effects, agitation, and depression). The suggested dose of methyltestosterone is 0.5mg/day.

The disadvantage of methyltestosterone is that it shows no effect on testosterone blood levels and therefore is difficult to monitor with blood tests. However,  because it is not converted to estrogen in the body, it may be appropriate for those women concerned with high estrogen levels.

Testosterone USP is better absorbed and more readily utilized by the body in the form of a topical gel containing micronized testosterone that is applied externally to the inside of the forearm or upper arm.  Although this product does not produce a local benefit to genital tissue, it will produce effective blood levels and avoid first-pass liver transformation.

Testosterone gel is the most widely used form of testosterone.  It is initially used daily; after several months applications of 3-4 times a week may prove satisfactory.  Primary care providers report that the usual dosage range for most women is between 2.5 mg-5.0 mg daily. The 0.25% gel provides 2.5 mg testosterone in an easily measured ¼ tsp dose. We do not recommend dispensing more than a 90-day supply at a time to due to its short shelf life

High strength testosterone gel has been effective in elevating testosterone level in men. It is an excellent formulation for those men who cannot tolerate the transdermal patches. The usual dose is Testosterone Gel 5 % -- ¼ teaspoonful applied to the forearm daily (usually at bedtime).

Testosterone vaginal ointment has been used for years to treat lichen sclerosus. Initially, testosterone ointment 2% is used daily for a sufficient period of time to restore tissue health --then used intermittently.

DHEA taken orally is rapidly converted by the liver to testosterone. This process can be slowed down by utilizing a formulation of oral capsules in which the DHEA is suspended in oil.  Like progesterone in oil, this formulation allows direct absorption into the lymphatic system.

Probably the best use of DHEA is in a transdermal gel that not only will bypass the liver but will also allow it to be converted into estrogen and testosterone in peripheral tissues.

Since high doses of DHEA can be androgenic, low doses in the 10-25 mg range have been suggested.