Susan Rako, M.D.
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Susan Rako, M.D. |
(Dr. Susan Rako's Seventh visit to Power Surge) Dearest: My guest tonight is Dr. Susan Rako, a Psychiatrist who's been in practice for over 25 years. Dr. Rako trained and taught at Harvard Medical School's Massachusetts Mental Health Center, a teaching hospital in the department of Psychiatry. Dr. Rako is the author of the groundbreaking bestseller, "The Hormone of Desire: The Truth About Testosterone, Sexuality And Menopause" and is the pre-eminent authority on testosterone deficiency and supplementation for women in menopause or following hysterectomy or chemotherapy. Her search and discovery in the medical archives of a body of information linking testosterone to women's sexuality led to her writing her much-referenced book, "The Hormone Of Desire," and to conducting workshops to teach women how to take care of themselves and to find the medical attention they need and deserve for health and quality of life. Dr. Rako's work has been featured in Mirabella, Elle, American Health, Body Smart, NBC's "Dateline, Good Morning America, Woman's Day Magazine and many more. Dr. Rako is also the author of the new book, "No More Periods? The Risks of Menstrual Suppression and Other Cutting-Edge Issues About Hormones and Women's Health" -- a book dealing with the controversial issue of manipulating women's hormonal chemistry for the purpose of menstrual suppression. Susan, it's a pleasure to welcome you back to Power Surge! Dr. Susan Rako: And my great pleasure to be here! I am so glad that you are feeling much better, Alice Dearest: Thanks, Susan :) Susan, I have a feeling our menopausal audience is interested in getting to questions about sexuality, menopause and testosterone, but, please share with us this controversial issue of your new book, "No More Periods?" -- and WHY anyone would want to tamper with nature and women's health in this manner? Dr. Susan Rako: That's what I'd like to know. I wrote my book in order to help women to know the specific risks of menstrual suppression, that too few doctors even know. Not only that interfering with the menstrual cycle interferes with women's connection to our basic nature, but that there are serious medical risks. Dearest: Susan, for years it's been a fairly common thing to associate testosterone with men. Have there been any significant studies on women and testosterone deficiency? Dr. Susan Rako: Dozens of them. The bibliography of the Hormone of Desire and the notes that back up every factual statement in the book list them all. Jules: I am 35, recently on EstratestHS and having a lot of negative side effects with nothing positive as of yet. How long before you notice positive changes? Dearest: Those who have read your previous transcripts should know that you don't recommend Estratest - you've been very vocal about it over the years. Dr. Susan Rako: How many of you here have read the updated paperback of "The Hormone of Desire?" In Chapter 8, I go into detail, and do not recommend Estratest HS. It's got more testosterone than most women need. Usually, I recommend that women begin by using testosterone in petrolatum (Vaseline) compounded by a compounding pharmacy at 2% strength, directly applied to the genital tissue in order to jump start the response -- and then, after a couple of weeks, to switch over to a low-dose preparation compounded to order. Dearest: When you say a low-dose preparation, what delivery system? Orally? Cream? Dr. Susan Rako: Oral low-dose, in capsule form. Purple: Since the birth of my son, I can't seem to lose weight on any diet. Is this hormone related? I'm on glucophage for IR and no weight loss. I need to lose 30 lbs. Is this hormonal? I will be 46 in August and I am still getting my periods. I never had a weight problem, only after birth. Dr. Susan Rako: Purple, glucophage is used for diabetes. Do you have diabetes? Purple: No, Insulin Resistance Dr. Susan Rako: I know quite a bit about insulin resistance. It is also called "type 2 diabetes." and glucophage does NOT help to lose weight. You really MUST watch your carbohydrate intake and your complete diet. It is essential for you to be working with a dietician. Purple: Yes I do, no starch no carbs. Dr. Susan Rako: Purple, one more thing. Do you test your own blood sugars several times each day? Purple: No. I get hypoglycemia attacks if I go around couple hours without food but chromium helps. Is it hormones? My doctor says my thyroid is ok. Dr. Susan Rako: You must discuss this with a dietician and your physician, and you should be checking your blood sugars. I'll bet they are still too high. GoodThing: My daughter, 28, no children yet, is starting hot flashes during period. What can she do to even her hormones out? Dr. Susan Rako: Your question is quite puzzling to me. "Hot flashes during her period?" is a new one for me. Perhaps she should consult an endocrinologist. GoodThing: She has. No problems. Victoria: I had right ovary sectioned at 18 and left removed at 34. How can this contribute to testosterone deficiency? Now 48. Periods just starting to get irregular. Dr. Susan Rako: Well, if you have even part of one ovary left, it may well have been functioning adequately, but at 48, you are approaching a time when many women begin to develop symptoms of testosterone deficiency. Have you checked the list of symptoms in my book? Victoria: Yes. I have the symptoms. Dr. Susan Rako: Did you lose sexual interest and response recently? Victoria: Yes, very suddenly. Dr. Susan Rako: I think that the little bit of ovary you have left probably functioned very well for you until now, when you are entering the perimenopause and available testosterone diminishes even for women with two ovaries. Dearest: Susan, for the benefit of those who haven't yet read your book(s), can you share some of the symptoms of testosterone deficiency, other than a waning or lost libido? Dr. Susan Rako: Decreased sexual sensitivity in nipples and clitoris, diminished orgasm or difficulty reaching orgasm, dry skin and hair, loss of muscle tone, and some women lose pubic hair. Also women can feel "flat," not exactly depressed, but no "Zing." Aunt: Do I need a prescription from an MD to get it from a compounding pharmacy? I'm not sure my doctor would prescribe it. Dr. Susan Rako: All testosterone preparations must be prescribed by a physician. If your doctor will not evaluate your needs, find another doctor. Jane25: Do you suggest woman use a natural testosterone cream and if so why? Thank you, what are the benefits besides sexual enhancement? I don't have your book yet. Dr. Susan Rako: Very complicated answer here. Plain testosterone can be converted in the body to estrogen so women who need to keep estrogen levels down would do better to use methyltestosterone, which, in oral form, is better absorbed than "natural" testosterone as well. Shabomeka: How does one go about finding a doctor and what type to go to, to address post menopausal loss of libido? My current ob-gyn tells me that hormones have nothing to do with this. Dr. Susan Rako: Find another OB/GYN. Sometimes it helps to go to a good compounding pharmacist and ask for the names of the gynecologists who are prescribing testosterone for some of their women patients who need it. Dearest: You can find compounding pharmacists on Power Surge's Resources page. HeyJude3: I have read about an under the tongue testosterone available in Europe. Any comments? Dr. Susan Rako: I'm sure that some compounding pharmacists in the US can make sublingual testosterone preparations, but I don't recommend that form of delivery for many reasons. Dearest: Susan, to address your newest book, "No More Periods?" for a moment, can you share with us some of the hazards of menstrual suppression. You always take on such interesting subjects. Dr. Susan Rako: I bet that nobody here knows that, in the normal menstrual cycle, women's blood pressure is LOWERED for two weeks of every month and that the bleeding each month rids our bodies of excess stored iron. BOTH of these normal functions contribute to women's having less risk of heart attacks and strokes than men. And the two methods for suppression menstruation have serious risks. "The SHOT", (DepoProvera) causes osteoporosis even in YOUNG women and the Pill used non-stop for three months contributes to CANCER of the CERVIX. 6,000 American women, many of them YOUNG women with families and children, will die of cervical cancer this year. Dearest: Fascinating. Do you see this menstrual suppression as some sort of "trend" or "fad?" Dr. Susan Rako: It's a 2.2 billion dollar per year industry. Dearest: That's quite a trend. Everything boils down to money, doesn't it. Dr. Susan Rako: Very frightening. It will be the largest uncontrolled experiment in medical history. Dearest: Hopefully, your work will have some impact on the outcome of this experiment. Dr. Susan Rako: The pharmaceutical companies are asking for FDA approval for menstrual suppression only for women with endometriosis or other medical conditions but they are promoting its use OFF LABLE for all women. Dearest: So, it could be a possibility for all women before too long. The pharmaceutical industry and FDA usually get their way. Dr. Susan Rako: It is my wish to educate women, so we can all know the risks we take. BrownSugar: I am 56 years old and I have no desire to have sex. I am tired most of the time. Dr. Susan Rako: There are lots of reasons for that. If it is a recent loss, that's different from a long-term loss. You have to approach it from every perspective of health and circumstance. If it's a long-term loss, it may be only partially a matter of hormones. Jules: How long should a woman be on testosterone replacement (approximately) to notice beneficial changes? Dr. Susan Rako: IF a women tries testosterone supplementation with 2% testosterone directly on her genitals and has no effect in three weeks, and has her blood levels checked, and if the levels have gone up to twice normal and she still has no improvement in libido and sensitivity, then testosterone won't help her. Most women DO get benefit. HealthyMeno: Are there any natural foods we can eat to enhance our testosterone deficiency? Dr. Susan Rako: Foods won't do it. Sorry. But zinc supplementation, no more than 30 mg per day, will help to enhance the effect of whatever testosterone we have. Kataneena: I am very confused as to whether testosterone builds bone or not. Have read conflicting studies. Do you recommend it for osteoporosis and does it work alone and in the same doses you would use for loss of libido? Dr. Susan Rako: Testosterone DOES build bone. Yes, I do recommend it for osteoporosis, but still would keep the dosage low. Marlo: I haven't lost my libido fully yet. I haven't had my period since three years ago. July 3rd was three years. When I have sex, it hurts a lot. I have to use lubrication. I'm okay afterwards. I'm afraid if I go too strong it might be hard on my heart. My pressure is normal low, but sometimes I don't feel sexy at all. My age is 52. How do you feel about natural hormones? Dr. Susan Rako: Really long question. I'll just say that, of all hormones, natural progesterone causes fewer miserable side effects for most women than does the synthetic form, but I do NOT recommend natural progesterone non-stop for anybody. MoonDog: What is the best testing method for finding out your hormone levels? What test(s) should I ask my doctor for? Dr. Susan Rako: Blood tests give the most accurate results. Cordy: If you take testosterone, will it increase hair growth on the face? What about increasing hair growth on the head? Will/can other manly traits occur? Dr. Susan Rako: If you use proper low dosage, there are NO "masculinizing" side effects at all. Higher dosage CAN cause increased facial hair. There is NO reason for a woman to take a dose high enough to cause these effects. Also, if a woman has the genetic disposition for losing some of the hair on her head as she gets older caused by testosterone ("androgenic alopecia"), testosterone will, of course, cause her to lose some of her scalp hair. But, for most women, without the tendency to androgenic alopecia, testosterone improves the hair, less dry. My own hair was breaking off due to dryness before I used supplemental testosterone. It is very healthy now Trish: I recently started Estradiol and haven't seen any improvement with libido. Does Estradiol contain testosterone or do I need a separate prescription? Dr. Susan Rako: Estradiol is NOT testosterone in any form. It is pure estrogen. SweetMom10: Can you get cancer if you stop your hormone medicine? I am 30 yours old --because I stopped on my own. Dearest: SweetMom, you don't get cancer from stopping hormones. Glady: Once you have begun to lose muscle tone is there anyway to build it back up? I exercise immensely now and have noticed my saggyness (word?) in spite of all my exercising. I am 56 and going through menopause. SusanRakoMD: If you need supplemental testosterone and do use it, it does help, along with exercise, to improve muscle tone. But some loss of muscle tone is inevitable with aging. Dearest: I really recommend those of you who haven't got it go out and buy THE HORMONE OF DESIRE BY DR. SUSAN RAKO. It's a fascinating, groundbreaking book by an expert in the area of testosterone. You'll find links on the transcripts of her earlier chats here in Power Surge -- in the library. Dr. Susan Rako: And I recommend that you and your daughters read "NO More Periods?" VERY important. Twinkle: Hello and thank you for being here tonight. I was wondering if Paxil can cause a woman to be less interested in sex? Dr. Susan Rako: YES, Twinkle, Paxil is one of the family of SSRI drugs that interferes with sexual libido. Rondaveu: Is it possible to have an imbalance in hormones, but not have it show up on blood tests, including thyroid? Dr. Susan Rako: As they say, "anything is possible". You need an excellent physician to look at the whole picture, blood levels and clinical picture. TeeBee: What do you think about DHEA? Dr. Susan Rako: Not enough info yet about its safety and effects for women. I don't recommend it. Mstxca: Is it safe to use testosterone (gel form) if your blood pressure is borderline high? Dr. Susan Rako: Gel form? Men's gel? As far as I know, testosterone, in the correct low dosage for women, has no detrimental effects on blood pressure. Dearest: Susan, thanks for another wonderful chat about menopause, testosterone and sexuality. I highly recommend Dr. Susan Rako's books, "The Hormone of Desire" and her newest, "No More Periods?" to everyone. You can visit Dr. Rako's Web site at www.susanrako.com. Read Dr. Susan Rako's first transcript Read Dr. Susan Rako's second transcript Read Dr. Susan Rako's third transcript Read Dr. Susan Rako's fourth transcript Read Dr. Susan Rako's fifth transcript Read Dr. Susan Rako's sixth transcript Read Dr. Susan Rako's eighth transcript Disclaimer: Every guest in Power Surge is a highly respected professional whose opinions are his/her own. An appearance in Power Surge does not constitute an endorsement of a guest's views. None of these transcripts may be reprinted or reproduced without the express permission of Power Surge™ and the respective guest. Read other transcripts by returning to the Library. Dearest aka Alice Stamm Power Surge Founder, Facilitator, Host Copyright©1994-2008 by Power Surge. All Rights Reserved.
