Adding Testosterone TO Estrace (4 abstracts) for even more benefits...

[Guest guest]

HI triversgal

(sorry I can't remember your first name hon you didn't sign off) but you asked what else you can do besides adding the Estrace? ... what I'd really suggest is to add a small dab of Testosterone along with the E cream. I had used only the E for about 4 months and was certainly doing much better but not quite there... and when I added the T. about every 3rd night (or two to three X's a week) right on top of the E...for the next two months ( approx. 3 to 1 ratio) (total of six) was the miracle that put me fully over the top. *grin*

I've sent this below before but passing it on again to show how & why the T can be so very beneficial hon. I hope it helps and if a physician is reluctant these abstracts might be worth showing to him/her as to 'why' you'd like to try the T. (and stress it's a bare peasize used topically)..

Hugs and good luck hon... don't give up the fight! Dee

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HI all, Dee here again,

I've sent this and many others in individual sections before quite a few times over the years, to try to explain 'receptors' and our hormones and how the lack of those hormone receptors play a large part in V pain in the skin or tissue itself...... so what I did here was put several of them together from four separate abstracts that I've collected and put them together since they concern the same subject...about how & why using 'both' Estradiol 'and' testosterone (E & T) can help restore the vulvar tissue to health.

It's long (believe me it is) but well worth the read (I think) *smile* to understand what may be going on and what might help or benefit you too as it was my KEY to wellness after suffering for 10 long horrible nightmare years, the last 3 of those were with total celebacy because the pain was so excruciating, ..

Today? I'm fantastic and 'me' again and have been for years as long as I minimally maintain with those two. (the E 'and' T)

The 4 abstracts are about:

1. V pain shows in patients lacking Estrogen (E) receptors,

2. V pain shows in patients lacking Testosterone (T) receptors (and birth control tie in)

3. Using Testosterone increases those E. receptors. (why the T used additionally is so benefical)

4. Birth control & testosterone loss and V pain

I've put those few together to show why and how the E & T creams ''together'' in combination can be so beneficial for tissue restoration whether it's for vestibulitis, vulvodynia or for LS, LP etc. AND especially how it talks about the hormone 'receptors' in the vulvar tissue being defective or lost in women with V. pain to understand 'why' those two hormone creams can be so beneficial and that it has nothing to do with the blood levels (which if younger are probably fine) but with the 'receptors'. And this applies to Vestibulitis, vulvodynia, and Lichen Sclerosis, which falls under the umbrella of vulvodynia, in other words conditions with ''vulvar tissue damage''. But of course I mean once all infectious causes, or radiating pelvic floor disorders, even celiac or diet etc. etc. has been ruled out. So if it's tissue damage itself this should hopefully help in restoration giving you back your elasticity, color, tone and most of all that stretchability to where it doesn't feel like the skin is tearing or ripping, fissuring, or splitting apart constantly esp. with sex.

These are several abstract and you'll see how 'I' tied it all together to try to clarify what I mean or how it works. So stick with me here, *smile* and hope I can make this clear. I apologize if you've seen this before, (esp. you oldies *grin*) but it may be worth a review again just as a refresher, esp if you've not considered adding the T to the E regimen and need that extra boost.

Hugs to all,

Dee

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1. (50% in this study of V V pain showed a Lack of ANY *ESTROGEN* Receptors in the tissue)

''Estrogen receptor expression in vulvar vestibulitis syndrome''

AbstractOBJECTIVE: A pilot study was performed to investigate the relationship between vulvar vestibulitis syndrome and estrogen receptor expression. STUDY DESIGN: Women with a diagnosis of vulvar vestibulitis syndrome had tissue samples taken for vulvar estrogen receptor-á expression and this was compared with a control group.RESULTS: The study group showed a 'significant decrease' in estrogen receptor expression, and 50% of the samples did not exhibit 'any' E receptor expression.''CONCLUSION: There appears to be a subgroup of women with vulvar vestibulitis syndrome who exhibit 'abnormal' estrogen receptor-á expression. This may be helpful in explaining why some women are resistant to medical treatment and may allow treatment to be prescribed more effectively.''

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So that's one part but a big part of the picture (to me at least) so many women with V pain (and that also includes LS) do not have E receptors working properly and 50% did not have "ANY" E receptor expression. I'd 'never' call that 'subgroup' by the way I thought that was a bit ridiculous to say that, and the treatment they mean that may be more effective "I" think would be the use of estrogen creams. (such as in Estrace or a compounded *estradiol*) The skin thrives on estrogen (esp. the genital tissue) so that makes sense why adding it even just topically (locally) can be so beneficial to fill in those receptors from an external source (blood levels won't generally help here) they can be just fine (and mine were) and often why a physician will just ''pooh pooh'' the idea in a younger person 'because' their blood levels may be fine but that is NOT the problem, it's the 'receptors' themselves that may NOT be there or else not functioning correctly or damaged. So keep that in mind how over 50% with V pain did not show 'any' E. receptors expression....Now on to the next one.

Another study I have states that many women with V pain ''also'' lack the (T) Testosterone Receptors. Here it mentions vestibulitis, and in LS (lichen sclerosis) that loss of T receptors has already definitely been proven and why they've used testosterone for many many years until steroids came about, so please do NOT have the misconception that T is used 'only' for LS, it is used for tissue restoration to lend strength, and keep in mind it's the 'Receptors' that open the door to make all of this work and what many may not consider using (in my opinon) was the additional estrogen topically, let alone the testosterone and both together can work wonders synergistically.

Note just for information:

Think of 'receptors' as a lock & key and they need the correct 'key' to open them and to make them active or work... but other 'keys' like progestins in birth control, or those topical Progesterone creams, or soy or even yeast can get in those locks as an 'almost' fit, to 'block' them or it 'binds' or locks up those E & T (receptors), so they aren't activated and we're depleted of the benefits of those hormones and they become non functional...

sometimes those 'receptors' are lost for who knows what reason or lessened perhaps as one ages as well, or it may even be caused from trauma such as chemical burns with some medications (like yeast meds or steroid abuse) but as the next abstract below will tell you, they can/may be restored from an external topical source of Testosterone cream .

Check out this next abstract talking about testosterone deficiency in the T. receptors & V pain and how Birth Control can tie in too.Dee

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# 2. Androgen Insufficiency May Lead to Vulvar Vestibulitis and Genital PainabstractYael WakninePresented at the 11th World Congress of the International Society for Sexual and Impotence Research in Buenos Aires, Argentina.Of 3,000 women with female sexual dysfunction (FSD) evaluated by Dr. Munarriz and colleagues, 13% had dyspareunia, 66% had physical findings of vulvar vestibulitis syndrome (VVS), 'and' 83% had concomitant androgen deficiency."What we found is that the specimens from women who had vestibulitis had significant inflammation, squamous metaplasia, and were completely 'depleted' of androgen receptors — while the controls had no inflammation, and normal staining for androgens," noted Dr. Munarriz. "This makes us believe that there is a link between genital pain due to vestibulitis and androgens. (loss of) "We believe that there's another subgroup of women, particularly young women, who as a consequence of being on the birth control pill have very low androgen or testosterone levels," said Dr. Munarriz, noting that these women also tend to have a higher incidence of genital pain. "This may be one of the pathophysiologic mechanisms [explaining] why women on the pill get pain — because they lose their ability to express androgen receptors in the genital tissue," he said."On the basis of this premise, it may be that in this subgroup of women genital pain can be effectively treated with hormones," concluded Dr. Munarriz, adding that future studies may evaluate the benefits of testosterone therapy in this population.''

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So those are just two papers I have of so many but you'll see how one talks about the loss of E. receptors and the other about the loss or lack of T. receptors with V pain.... AND you'll note that Birth Control can play a big part in it since contraceptives are high in progestins and P blocks or hinders both our E & our T receptors.. (other studies talk about that as well, I 'may' put that below too) *smile* AND by the way it's not only progestins but progesterone and so can Soy and Yeast infections also block those E & T receptors from working efficiently. But this 3rd one I'll add here nicely ties it all together and was the kicker to 'me' as to 'why' adding the T is absolutely just as beneficial as the E. and thank goodness some physicians are returning to using the T. and some at least do use the Estrace (or estradiol) creams now but working together synergistically is the 'key' to me...

But keep in mind the E & T is so apropos for any kind of vulvar tissue that needs restoration regardless of what name we may call it 'after ruling out those other causes or infectious agents of course, and if the pain is in the tissue, like in a specific spot you can put your finger on, (esp.that 6 o'clock V position at the very bottom) know of the wound healing capacity and benefits of the E & T esp. for the gential skin.

===================================================# 3. Topical T. increases the number of E. Receptors.Receptor modifications in vulvar dystrophies before and after treatment with topical hormones:Methods: We studied 115 vulvar specimens obtained from 75 consenting women ranging from 21 to 78 years of age. Of the patients, 12 had histologically normal vulvar skin, 45 had vulvar dystrophies that were not treated by topical steroid therapy, 28 patients had vulvar dystrophies that were treated by testosterone propionate (TP) 2%, 12 patients had vulvar dystrophies that were treated by progesterone in hydroalcoholic gel and 18 patients had vulvar malignant tumors. For immunohistochemical analysis we considered 25 cases of vulvar dystrophies: 11 cases of squamous hyperplasia (SH) and 14 cases of lichen sclerosus (LS)

Among these 25 cases, 15 (5 SH and 10 LS) were treated with TP 2%. (testosterone propionate)Results: After treatment of the vulvar dystrophies with progesterone, the positivity of ERs (estrogen receptors) ‘’decreased’’ (58.3% vs. 77.8%).

COMMENT by Dee* That means that using a progesterone was not a benefit & showed the E receptors 'decreased' with using it, and note it says 'progesterone' let alone the synthetic 'progestins' which are far worse.) Dee T

After treatment of the vulvar dystrophies with TP 2% (testosterone propionate) , the 'positivity' of PRs (progesterone receptors) significantly 'decreased' (14.3% vs. 68.9%) whereas after treatment with ‘progesterone’ the positivity of PRs (progesterone receptors) increased (83.3%)...

''COMMENT" by Dee: After using the Testosterone... the P receptors were reduced and 'I' would want the P. receptors decreased (which the T did)... and it shows that when using the P, ( in the 2 paragraphs above)... the P receptors were 'increased'. That is not something "I" want because Progesterone blocks those receptors, so the T was very beneficial in this instance by lowering or lessening the P. receptors and as you'll see below, the T use even 'increased' the E receptors, even if they weren't there before. (that is truly amazing to me) Dee T''

.... After treatment with TP 2 %, (testosterone propionate) we observed an increase of immunohistochemical ‘’positivity' for ERs’’ (estrogen receptors) even in cases that were negative before treatment and a lack of PRs (progesterone receptors) even in cases that were positive before treatment. Conclusions: These data demonstrate the efficacy of androgen therapy with TP 2% in vulvar dystrophies with increased 'trophism' due to the 'increase' of ERs.

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===========================================*COMMENT* by Dee; Trophism is definied as 'nourishment' just as a-trophy (atrophy) is the opposite, not fed and withering away, so it shows how T nourishes and feeds the tissue but.... it's because of the increased E receptors when using the T. with the increased E receptors, that is when using the Estrace or estradiol cream topically should really benefit and why in 'my opinion' using both the E & T creams were my own miracle for full restoration of the V. tissue.

My thoughts summarized: What that means to me is when they added the Topical Testosterone.... it increased (showed that positivity) the Estrogen receptors. The hormone that healthy tissue thrives on (trophism) even in women who were were lacking them previously. Also note that adding the T, showed a lack or diminishing of the progesterone ones... And P is what blocks the others and the ones "I" would 'want' reduced or blocked.I wasn't going to do this since this is so long already but decided I would add one more since it also shows how birth control also blocks those receptors. This one is on testosterone that gets blocked with birth control pills but believe me they block our E. receptors as well.....so forgive the length of this but hopefully it just adds to your information and clarification about hormones and to me it all ties in together and how using E 'and' T can help heal that V. tissue .

(and to have it all in one place, *smile*)

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4. BIRTH CONTROL AND TESTOSTERONE PROBLEMS.New research indicates birth control pill could cause long-term problems with testosteroneIn the January '06 issue of The Journal of Sexual Medicine, researchers have published a new investigation measuring sex hormone binding globulin (SHBG) before and after discontinuation of the oral contraceptive pill. The research concluded that women who used the oral contraceptive pill may be exposed to long-term problems from low values of "unbound" testosterone potentially leading to continuing sexual, metabolic, and mental health consequences. Sex hormone binding globulin (SHBG) is the protein that binds testosterone, rendering it 'unavailable' for a woman's physiologic needs.

(Comment: That means the higher the SHBG the lower the available free & unbound Testosterone there is (ditto w. estrogen) because SHBG binds it up so less or none is unavailable) Dee

The study showed that in women with sexual dysfunction, and elevated SHBG in "Oral Contraceptive Discontinued-Users" did not decrease or go back to values consistent with those of "Never-Users of Oral Contraceptive"

(Comment: even after discontinuing usage of the birth control, those levels did not normalize in women with sexual dysfuntion. Another study I saw said in some women even after 3 yrs it did not return to normal. Dee T)

Thus, as a consequence of the chronic elevation in sex hormone binding globulin (SHBG) levels, pill users may be at risk for 'long-standing' health problems, including sexual dysfunction. Oral contraceptives have been the preferred method of birth control because of their ease of use and high rate of effectiveness. However, in some women oral contraceptives have ironically been associated with women's sexual health problems and testosterone hormonal problems. Now there are data that oral contraceptive pills may have ''lasting'' adverse effects on the hormone testosterone. The research, in an article entitled: "Impact of Oral Contraceptives on Sex Hormone Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction" published in The Journal of Sexual Medicine, involved 124 premenopausal women with sexual health complaints for more than 6 months. Three groups of women were defined: i) 62 "Oral Contraceptive Continued-Users" had been on oral contraceptives for more than 6 months and continued taking them, ii) 39 "Oral Contraceptive Discontinued-Users" had been on oral contraceptives for more than 6 months and discontinued them, and iii) 23 "Never-Users of Oral Contraceptives" and had never taken oral contraceptives. SHBG values were compared at baseline (groups i, ii and iii), while on the oral contraceptive (groups i and ii), and well beyond the 7 day half-life of sex hormone binding globulin at 49-120 (mean 80) days and more than 120 (mean 196) days after discontinuation of oral contraceptives (group ii). The researchers concluded that SHBG (binding) values in the "Oral Contraceptive Continued-Users" were 4 times higher than those in the "Never-Users of Oral Contraceptives". Despite a decrease in SHBG values after discontinuation of oral contraceptive pill use, the SHBG levels in "Oral Contraceptive Discontinued-Users" remained elevated when compared to "Never-Users of Oral Contraceptives". This led to the question of whether prolonged exposure to the synthetic estrogens of oral contraceptives induces gene imprinting and increased gene expression of SHBG in the liver in some women who have used the oral contraceptives. ''Dr. Panzer, an endocrinologist in Denver, CO and lead author of the study, noted that "it is important for physicians prescribing oral contraceptives to point out to their patients potential sexual side effects, such as decreased desire (loss of libido) , arousal, decreased lubrication and ''increased sexual pain''. ''Also if women present with these complaints, it is crucial to recognize the link between sexual dysfunction and the oral contraceptive and ''not'' to attribute these complaints solely to psychological causes." (AMEN to that one! Dee ) "An interesting observation was that the use of oral contraceptives led to changes in the synthesis of SHBG which were 'not completely reversible' in our time frame of observation. This can lead to 'lower' levels of 'unbound' testosterone, which is thought to play a major role in female sexual health.

(NOTE * the unbound portion is the active and beneficial/working portion of T (or E) and it may 'not' be reversible as later studies suggest or may not return as long as several years or more and that's IF it does return after using birth control, especially long term. Dee T)

It would be important to conduct long-term studies to see if these increased SHBG changes are permanent," added Dr. Panzer. Dr. Andre Guay, study co-author and Director of the Center for Sexual Function/Endocrinology in Peabody, MA affirmed that this study is a revelation and that the results have been remarkable. "For years we have known that a subset of women using oral contraceptive agents suffer from decreased sex drive," states Dr. Guay. "We know that the birth control pill suppresses both ovulation and also the male hormones (testosterone) that the ovaries make in larger amounts during the middle third of the menstrual cycle. SHBG 'binds' up the testosterone, therefore, these pills 'decrease' a woman's male hormone availability by two separate mechanisms. No wonder so many women have had symptoms." "This work is the culmination of 7 years of observational research in which we noted in our practice many women with sexual dysfunction who had used the oral contraceptive but whose sexual and hormonal problems persisted despite stopping the birth control pill," said Dr. Irwin Goldstein ** a urologist and senior author of the research. (Note** that is NOT Dr. Goldstein, but Dr. "IRWIN" Goldstein, a well known specialist. Dee) "There are approximately 100 million women worldwide who currently use oral contraceptives, so it is obvious that more extensive research investigations are needed. The oral contraceptive has been around for over 40 years, but no one had previously looked at the long-term effects of SHBG in these women. The larger problem is that there have been limited research efforts in women's sexual health problems in contrast to investigatory efforts in other areas of women's health or even in male sexual dysfunction." To better appreciate the scope of the problem, oral contraceptives were introduced in the USA in 1960 and are currently used for reversible pharmacologic birth control by over 10 million women in the US, including 80% of all American women born since 1945 and, more specifically, 27% of women ages 15-44 and 53% of women age 20-24 years. By providing a potent 'synthetic' estrogen (ethinyl estradiol) and a potent synthetic progesterone (for example – norethindrone) in birth control pills a highly effective contraception is achieved by diminishing the levels of FSH and LH, thereby reducing metabolic activity of the ovary including the suppression of ovulation. Several studies over the last 30 years have reported negative effects of oral contraceptives on sexual function, including diminished sexual interest and arousal, suppression of female initiated sexual activity, decreased frequency of sexual intercourse and sexual enjoyment. Androgens such as testosterone are very important modulators of sexual function. Oral contraceptives decrease the circulating levels of androgens by direct inhibition of androgen production in the ovaries and by a marked increase in the hepatic synthesis of sex-hormone binding globulin (SHBG) the major binding protein for gonadal steroids in the circulation. The combination of these two mechanisms leads to 'low' circulating levels of "unbound" or "free" testosterone.

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(It's the unbound portion we need and want and is the active portion of our hormones. Dee)

So my final thoughts and 'my' opinion are this...

First of all, that you must be a saint to have read this far, but knowing that many women with V pain have less or no E 'or' T receptors as in the first two above show... and so by adding the T and the E topically it can be so beneficial in restoring the 'receptors' functionality with the use of T, the keys that work the active portion of those hormones. And then we get into birth control (which are mainly progestins) and how those 'block' our E & T 'receptors' (imagine being on those for years). I know using both the E & T topically certainly did the trick for me (and many hundreds more) after those 10 yrs years of suffering and why today 9 yrs later I "STILL" use both the E & T in a small dab topically (not intravaginally) once or twice a week for maintenance to make sure I 'stay' well....(I used it more often during the healing and restoration stage) and it's fairly rare to have systemic results with that small peasize amt. we'd used topically. I never did and it's been 9 yrs now.

That's why those younger (not menopausal) can have those benefits as well...and it has nothing to do with the circulating hormone levels (those can be just fine and mine were as I often tested them) so don't let age throw you. After all they've used Estrace cream on infants and children for many years for labial adhesions as a known fact to unfuse those without side effects and it certainly can work on adults with V pain, and estrogen can even soften old scar tissue, (as per Dr. J. Willems at Scripps) and by the way 'I've' never had any side effects from either medication only wonderful benefits finally after those years and years of trying about 98% of everything I've ever heard of that didn't work.

But it most definitely is NOT a fast process and skin takes it's time to restore... so it takes patience, and persistence and to not give up on it NOR to overuse any of the meds. BUT I also want to stress again that if a physician says you are too young that the blood levels are just fine, it 'likely' does not have much to do with it, because it's the hormone ''receptors'' that are likely damaged or lost (and that can be any age) and in 'my' opinion why those meds 'must' be applied directly and locally if you want it to benefit the genital area from all that 'I've' learned 'and' ''experienced'' as my own blood levels for both E & T were always in my normal range & were on the mark thru testing the whole time when I was in the process of my own healing process. And for those who are 'not' menopausal..since they likely don't need it systemically, the topical alone should do the trick and it's rare that it'll go systemic with the tiny peasize dab that's needed (in the majority of cases, as there may always be exceptions) So again don't be tempted to overuse the E or T. And that's all she wrote folks, LOL

FAR more than enough and again just MY opinion and my experience and how I was able to tie it all together and how those 2 hormone creams were what finally put me into full wellness almost 9 yrs ago after those 10 yrs of hell. (as long as I maintain) *smile* and takes me 5 seconds once or twice a week.*grin*I hope I didn't make it too muddy to understand and I KNOW it's far too long (please forgive me).... But if someone finds using the E cream alone isn't quite doing it? 'I' would definitely consider adding the compounded T. cream/gel. (Usually in a ratio of 3 to 1, 3 nights of E and on the 3rd night I also add the T. and repeated it every 3rd night of adding the T. (although knowing a LOT more today than back then, "I" would probably use both nightly for 10 days to a few weeks to speed things along and give it a jump start, (but don't be a martyr if anything stings or irritates, just back off, let things simmer down then I'd go back to it)

It's such a variable and we're all so very different. But you can see how synergistically they work together, just hoping it might be the Key to your wellness as it has so many others and it goes without saying this is 'my' opinion 'and' my experience and just the bare tip of the research that's out there. Hugs to all and most of all I hope tomorrow's a painfree day for everyone and if not to keep the faith that your day WILL come. Dee~