In medical school we were taught that menopause is when a woman goes without a period for a full year. Some (usually male) doctors would tell women in the first and worst part of “menopausal meltdown” that they were not yet candidates for hormonal treatment because they had not yet satisfied the diagnostic criteria for menopause. Like now, women were offered too little too late: just a few years of a little estrogen with progesterone to take the edge off those most intense mood disturbances and hot flash/vaginal dryness symptoms, then get off them. So, at age 55 or so, women were given a brief course of estrogen-dominant therapy. But that completely missed the boat, because estrogen is only 20% of menopausal symptoms. 80% of what a woman complains about for up to 20 years before official menopause is testosterone deficiency symptoms, which start in the mid thirties! Fatigue, not sleeping deeply, brain fog, memory and concentration problems, the ability to stay positive, motivated, confident and emotionally buoyant, feelings of depression that are new after age 35, anxiety and irritability: these are all testosterone deficiency symptoms that hit women when they are in their prime and facing the challenges of career advancement, raising children, and maintaining a successful marriage. And I’ve mentioned only the brain symptoms of testosterone deficiency! How about the physical body: loss of muscle strength and tone, body fat going up, muffin tops and love handles, loss of response to working out, and loss of motivation to work out. The average American woman gains 25 lbs in her peri-menopausal years of 35-55, largely due to her loss of testosterone. And what about the sexual mind and body? Sexual interest, or libido, depends on testosterone for women as much as for men. Also sexual performance, including ability to reach orgasm, is optimized by youthful testosterone levels. Bio-identical hormone pellets are designed to restore levels and functionality the moment symptoms begin, not years too late based on outdated notions of when menopause starts. Women need their testosterone back in their 40s to enjoy all the benefits, including an 8.3 % per year increase in bone density and a 70% lower risk of developing Alzheimer’s disease. Instead of treating testosterone deficiency symptoms with anxiolytics, sleeping pills, attention deficit, weight loss, and antidepressant medications, it’s time to give women their testosterone, just like we do for men, back to youthful levels.