Karen Martel: 0:00

The research shows that women that replaced their hormones, as you know, mainly estradiol progesterone, and testosterone have over 30% reduction in all cause mortality.

Philip Pape: 0:14

Welcome to the Wits& Weights podcast. I'm your host Philip Pape. In this twice a week podcast is dedicated to helping you achieve physical self mastery by getting stronger. Optimizing your nutrition and upgrading your body composition will uncover science backed strategies for movement, metabolism, muscle and mindset with a skeptical eye on the fitness industry so you can look and feel your absolute best. Let's dive right in Wits & Weights community Welcome to another episode of the Wits & Weights Podcast. Today I am thrilled to welcome back the one the only Karen Martell, a certified hormone specialist and transformational nutrition coach who's helped guide so many women to find new vibrancy through hormone awareness and optimization, especially throughout the Peri and post menopause phases. Last time Karen was here way back on Episode 31, where you can also hear her full backstory. We unpacked the complexities of hormones and weight loss during perimenopause. She's here today to uncover the truth about testosterone for women. You'll learn the role of testosterone in women's health and vitality, who might benefit from therapy, common questions about benefits, safety, dosage and where all this is headed. And of course, you must check out Karen's top rated podcast, the hormone solution podcast, where she empowers women to navigate Peri menopause and post menopause with grace and knowledge. So many great topics and guests. Karen, I want to welcome you back to the show. Thanks

Karen Martel: 1:43

for having me back. This is great. I was episode three. I didn't realize it was so because what are you at now you're at like 200 Or you want

Philip Pape: 1:51

not not quite there. But we're in the 120s Yeah, we're in the 120s. When this one's out, it's probably be in the 130s. Yeah, absolutely. Yeah. So

Karen Martel: 2:00

100 episodes,

Philip Pape: 2:02

it hasn't back then I was using the TV tray in my closet. So I've upgraded a little bit since then. You wouldn't know. So it's good to have you back. I know a lot of my listeners love your show and what you talk about and you know, the stuff we do tends to complement a lot of what women are looking for, with the overall holistic approach to their health. So today, we want to talk about testosterone. Hot Topic, very important. I think it's one of those hormones that kind of flies under the radar compared to others like estrogen. But we know it's important. We know women want to know more about it. So let's start with the basics. What's the primary function of testosterone in the woman's body? And then we'll go from there, huh?

Karen Martel: 2:43

Yeah, so women don't think of their testosterone, first of all, because we associated being the man's hormone. And it is it's an androgen, so it's falls under the category of the more masculine hormones. But what's interesting is we actually as women produce more testosterone in our fertile years than we do estrogen or progesterone, which are the two main female hormones that every most people have heard of, you know, estrogen and progesterone. And so they think that that's like our primary hormones. But actually, testosterone is our most abundant hormone. And so the ovaries will produce about 40% of our testosterone, and they produce that first, and then that's converted, or what's called aromatize into Astra dial, which is our main female feminine hormone. And so we without the testosterone, we couldn't be women, which I think is really interesting. It's like man makes women woman which, you know, maybe we go back to the whole Adam, Adam, wasn't a rib wasn't a rib that they gave or that he gave, I think it was the testosterone for actually had to give you testosterone so you can become a woman, which I just think that that's interesting. And what's with on the flip side of that, men don't think that they need extra dye all but in actual fact, it is extremely important for men and when men go on like aromatize inhibitors, which stops the conversion of testosterone to estrogen. They can get super sick and actually feel really bad and have bone issues. They can have depression, they can have low libido from not enough Astra dial. So we both need these hormones, but it's just not recognized in women and the mainstream medical system like men will have their testosterone covered by extended medical if they have it here in Canada. It's covered. We have Andrew gel, and it's in the States as Andrew gel and all the guys get it whenever they want it. There's no testosterone made by a pharmaceutical company for women. I've heard of one like last year. I have yet to see it, though. But I heard that there was going to be one coming for women. And so right now we can only compound testosterone replacement.

Philip Pape: 5:19

And that's even even in the US. That's the case in in the US.

Karen Martel: 5:23

Yeah, yeah. So right now, it's primarily compounded. I have yet to see anybody actually get this pharmacy brand of testosterone. So it's not covered for women. But men have it covered,

Philip Pape: 5:35

which men just walk into a clinic like shoot me up, let's get let's get it. Yeah, there's just

Karen Martel: 5:40

offering clinics on every street corner these days. And it's all about oh my gosh, don't, God forbid you have erectile dysfunction. And if you have one day without an erection, we're gonna hop you up on testosterone and whatever you need, so that you can have sex. And then these poor women whose testosterone is going down as their over ovarian function goes down to Cicerone goes down, and then their libido goes, but oh, that doesn't matter because we can still have sex even if we don't have a libido. So testosterone is number one really important for libido. It's also extremely important to, of course, maintain muscle tissue and to gain muscle tissue. Without testosterone, it's really difficult for women to put on muscle. So if your testosterone is dropping, and you're not able to keep up with your muscles and build that muscle, especially in perimenopause, and menopause, will actually become more insulin resistant, just from the drop of that muscle tissue, as you talk about loss and muscle tissue is our glucose sink. So without it, women become very insulin resistant. It's part of that puzzle and menopause estradiol also when we lose, it makes us become more insulin resistant. So we have this kind of double whammy happening, where it's, you know, that's one of the main causes of all the weight gain that happens for most menopausal women. Is that drop, and then that insulin resistance coming up? Yeah,

Philip Pape: 7:10

I think that's that's a really excellent point, those three things so for people are listening, right? more muscle mass, more insulin sensitivity, easier to lose fat easier to maintain your weight, the opposite is the opposite, right? Easier to gain weight. And so this imbalance that occurs or this lack of testosterone, how much of that is responsible for these inability to gain or maintain muscle mass versus other factors? Like, is it huge? Is it the main factor?

Karen Martel: 7:38

I don't know what the percentages per se, but I know that Astra dial is also really important for protein synthesis and building muscle. So there are other factors. Of course, insulin is a big one, too, you know, if you are insulin resistant, it does make it harder to put on muscle. So there's different factors when it comes to that building of muscle. We also know insulin, like growth factor has a lot to do with it, because that triggers growth hormone. And growth hormone is also really important for building muscle. So there's a few different factors, but testosterone is certainly a really big player. And I've seen a lot like countless women who start to replace their testosterone when it was low in menopause or perimenopause. And they're like, oh, my gosh, look at my body now and you see it on them, they suddenly have, like, they got muscle and all the work they're putting in at the gym starts to really pay off. I noticed that even in myself when I started testosterone therapy, I, mine wasn't even super low, but it was on the very low end. And soon as I started using it, it was like, oh, there we go, I can actually start seeing some muscle now when I'm working out and it doesn't seem like it's like, okay, why am I not? You know, why am I

Philip Pape: 8:53

all that work? Now, what you talked about sir dial as a post cursor, or whatever you'd call it of sastra? What about the precursor DHEA. Where does that fall into this? Yeah, so

Karen Martel: 9:06

we make about 40% of that testosterone inside the ovaries, but we also the other half is coming from the adrenal system. So we can make DHEA which is another androgen, but it's also a pre hormone, a pro hormone, so it helps us to make testosterone and estradiol. So and it's also an adrenal hormone. So it's important for our stress, and it's, you know, we want some of it, we don't want too much, because that tells us that we're too stressed out. If we go too high on it, we can also start getting really masculine features. polycystic ovarian syndrome, we tend to see high DHEA and high testosterone levels, and it's just pouring and that's because women will be missing that enzyme that converts that testosterone into estrogen aisle, so their estradiol tends to be low and then they're pouring that testosterone went out. And that makes them insulin resistant and makes them you know, get oily skin cystic acne hair loss. So too much testosterone is also not a good thing. And when too much DHEA is also too much like not a good thing as we age DHEA also will start to go down. So we have to make sure that we're taking care of the adrenal system because then we can, you know, 40% is made in the ovary. So without the ovarian function, we notice arousal is going to drop but we know then we have to really baby our adrenals in perimenopause and menopause so that our the adrenal system can continue to make that testosterone, but most women are super stressed nowadays. And so we rarely see DHEA in a good number in menopause, unfortunately. Okay,

Philip Pape: 10:50

yeah. Because I think it's important to understand these different precursors so that you can get at the root cause, right, you can do the right testing and not overdo it with one thing, when really the other thing needs more love and care, right? Yeah.

Karen Martel: 11:03

And there's ways to you know, it's really hard for women to get testosterone prescribe to them. But there's because only 40% is made in the ovaries. There's a lot of things that we can do supplement wise to help boost it unlike estradiol and progesterone, that once we stop ovulating, we just don't produce progesterone, we produce a tiny bit from the spinal cord and from the adrenal system, but it's never enough. So testosterone, you have a bit more of a chance by taking supplements to help boost it even in menopause. So we can talk about what some of those are that I

Philip Pape: 11:37

like, Yeah, let's do that. I want to know how women can boost testosterone naturally, we'll start there. Yeah,

Karen Martel: 11:43

so one is your favorite ashwagandha. We see that Ashwagandha is really great for the stress system. So it's actually in a lot of testosterone boosting supplements, which I appreciate that I like ashwagandha too. So stress supplementation, so things that are going to support the adrenal system, which is always you want to test that first test your adrenals test your cortisol test the DHEA let's see where it's at. Because some women are super low, some are super high, some just have dysregulation in the cortisol clock. So we really want to see where is it at so that we know what type of adrenal support that you need. Do you need something to help raise that cortisol and DHEA or do you need something to lower it because you're in that high stressed out state? So doing that first I think is super important because we can make so much of our testosterone out of those adrenal hormones. The other one is Tong get Ali which is a really popular one for men. And in the research of course it's only been I don't think there's any female studies yet on target le for women but it does work the same way and it does help to raise testosterone and in the research has been like really just showed such a great increase in testosterone in a very short amount of time for men. But it does work the same for women. Tongue get so t o n g a tea and then separate word a li Tangata Li and you want to try and get Indonesian tongue get anywhere between 204 100 milligrams a day take it in the daytime because it does give you a little bit of a boost of energy as well. The other one is for dosha arrest test and and there's been some good research on that too. For men that shows that it can boost testosterone. So you will find a lot of testosterone boosting supplements that actually have both those ingredients in it. Another one is maca that I just love, love love for both for all hormones really like it really helps to boost DHEA and helps to boost testosterone. It helps with Astra dial and my favorite company is one called feminine essence. And it has it's it's got I think it's four different types of maca that you choose from and one is just for men. Another one is for women in their fertile years. One's for Peri menopause and one's for menopause and they all have a different color in strain of maca that goes more with what's happening in that person's phase of life. So if you're in perimenopause and your testosterone is dropping, estrogen is dropping, you could take that feminine essence maca, and it can really help I've seen people reverse their their perimenopause and menopause and like go back to a regular cycle by just taking that, which is pretty incredible. specimen Yeah. Fascinating. Yeah, yeah, sorry.

Philip Pape: 14:34

There's more. More on the element. Boron? Yeah, well, we're

Karen Martel: 14:37

on the element at about 10 milligrams, actually. So that's a much higher dose than what you'll usually see in a supplement. And it only works if you're deficient in it, which is interesting. So you can take it, it's not going to harm you to take it necessarily. If you have lots. I haven't heard any adverse side effects. Um, it's a hard one to get tested, of course, I think you'd have to do probably like hair, mineral analysis or something. But boron helps us to lower sex hormone binding globulin. And sex hormone binding globulin is the protein that testosterone binds to, and carries it around your system. But it has to get like, become unattached from that, that protein for your body to use it. So I think of it as a bus sh VG is the bus that our hormones get a ride on. But they have to get off the bus for the cells to use it and for your body to actually get that hormone. So if your sh BG is elevated, which functional range, we don't want to see it for women above 85. And if it is, it means that you could have a lot of testosterone, but it's getting bound up by that protein. So your body is deficient in it in the free levels. So always get free and total testosterone tested, because you could have lots of total. But then you look at your free and it's all bound up by that sh VG and it's actually super low. So you're not you're you're having deficiency symptoms.

Philip Pape: 16:09

Yeah, I want to get into testing in a second just on its own. So when women know exactly like how I should, they should get tested. But as we wrap up the supplement section, I think what, what's nice about these kinds of supplements being their herbal they're easy to access is you can do sort of an elimination diet or the reverse of that, right? You can try one at a time. I mean, if you try them all, it might one of those might one or two might work, but you don't know which one it is right. Yeah, do it

Karen Martel: 16:36

that way. You recommend a good supplement that has all of it in there except for Okay, okay.

Philip Pape: 16:41

Is it? So do you recommend doing that versus just trying like a few and then seeing if one is the big hitter for you? Or is it kind of a crapshoot, when it comes to that,

Karen Martel: 16:50

I think you would get success with let's say, just using maca, or just using Tang Gat, those would be my two top favorites for boosting testosterone. But I think you would get more success with raising testosterone if you had them all in there. Because it's, you know, you're hitting all the angles, it's got zinc in it, it's got all the things. And so my favorite as of right now is called sigma. And it's by a company called gorilla minds. I'm not associated with them at all. I've just seen it work really well. And it's got the dojo restless has got Tonga in proper form, like improper levels, and it's got the zinc, it's got the boron in proper levels as well. And some other stuff in there. So it's got

Philip Pape: 17:35

mines, yep. Okay. Yeah. Well, that'd be good. Yeah. I mean, again, as a coach with women with these issues, as well, I will be looking at that and suggesting it to people. So that's good. Let's go back to testing, right? Because testing is always a point of confusion, especially in the traditional healthcare system, where it's like, if you could even get them to give you a test, it's bloodwork. And usually that's not adequate, but it might be for testosterone. So let's, let's break it down. Exactly. That's one thing that makes it easy, right? So how should a woman get access, get tested, and then use the results properly.

Karen Martel: 18:07

So once again, some really shitty man to woman things here, which is testosterone is the only one that they'll ever test free and total. Women when they won't do estradiol free and total or progesterone free and total. It's only testosterone, which is a little bit frustrating. But you that's a very accurate way to test your testosterone and testosterone. We have a little bit of a peak right before we ovulate, I think to give us that drive to go out and have sex and procreate. But pretty much we don't fluctuate like we do with our other hormones throughout the month. With testosterone, it stays pretty even keel we have that little flux on day 12. Right before we ovulate on a 28 day cycle. But you know, besides that, you can kind of just test whenever in the cycle, you probably don't want to test on that peak day, day. 21 is what I would recommend because that's where we test the estradiol and progesterone in fertile women so might as well do your testosterone then too. And so it is very accurate, but you definitely want to do both free and total in case your sh VG is too high. And then test your DHEA sulfate in blood test your sex hormone binding globulin so we see if it's elevated, because one of the things that's happening right now is that a lot of women are fasting and fasting like hardcore fasting one meal a day two meals a day and they've been doing this for a long time, or they've been eating a really low carb diet or and when they're fasting and not eating that much. They're also really low on protein. So low protein diets, low carb diets, too much fasting we'll all raise sh VG, because it makes sense. If we were back in hunter gatherer days and there wasn't a lot of food around so we're fasting right? Then the body is being told don't get pregnant. There's not a lot of food around So as hBg naturally would go up, because there's a food shortage, so it wants to bind up your testosterone bind up your Astra dye, and so that you can't get pregnant. And so too much of that starts to signal to the system, don't get pregnant, which is really the only reason why we're here. So your body's kind of compensate for this, whether you like it or not, it's aware of whether you want kids or not, or care about being fertile. This is what happens. So we have to be really careful with that. So testing, that's a good idea.

Philip Pape: 20:31

So a couple of things, because I actually just put together a new episode about carbs coming out. And one of the interesting things about a higher carb diet was the increase in testosterone to cortisol ratio that they've seen, not, in addition to the increase in IGF one that you talked about, so the fasting and the low carb or the low protein. Are you saying that that, in general, for most women that's not recommended because of this? Or what are you saying there?

Karen Martel: 20:55

It's a fine line is what I'm saying. Because we also become more insulin resistance resistant because of the drop in hormones as we age, which means intermittent fasting, can be a really, really important tool to start implementing, because we need help being insulin sensitive. It's that women are taking it too far. They get results. And then they're like, Oh, my God, and then they stop getting results. And they think I better do it harder, longer. Right? Like I bet, I'm eating two meals a day, I'm very one meal a day, oh, I should be doing a 36 hour fast or a five day fast. And you hear this from a lot of like, the big practitioners that are out there on social media saying that, you know, do five day fast once a month, you know, do 136 hour fast every single week. And I'm like, No, most women can't handle that, especially in menopause, it stresses the system out too much. So you have to find that balance, you have to know where your cortisol levels are, you have to know where your insulin that so testing, of course, is super important. And we don't, we don't want to guess what's happening in the body. So some women that are insulin resistant, their cortisol is okay, or let's say it's high, then I would probably say You know what, you need to be intermittent fasting more, but you still want to make sure you're getting in the protein. Because if not, then that sh VG will go up, and it'll bind up those hormones. The other thing that will raise it is thyroid hormones. So if somebody is on thyroid medication, which a lot of women are, they don't realize that that's actually binding up their hormones and sending them into menopause early, which is something that happened to myself and nobody told me. And I was like, why is what's going on my total levels of estradiol and testosterone are great, but yet I'm missing a period. I'm getting hot flashes, low libido. And then I finally heard Peter Atea, on who's huge. He was on Huberman lab podcast, and he was talking about thyroid medication raising sh VG and I'm like, Frick, why isn't anybody talking about this? Like how many women are on thyroid hormones? So many of

Philip Pape: 23:01

you? Yeah, is this is why women are so frustrated, right? Because it's I can just imagine, like, a piano of keys. And every single key is like a different hormone. And as soon as you press one, the other one goes up or down. And they're also interrelated. Right? And yeah, even the thing about energy availability, which shameless plug that's what we talked about on your podcast, when when my episode comes out energy availability, is that you you need the energy there to support your hormones, but you don't want so much energy that you're gaining a ton of weight, right? And that's where it's like this balance for women.

Karen Martel: 23:35

Like cannot be we got to get away from this one size fits all because even though we know that we're still doing it, majority of women are still going what's the next best diet out there? And trying it? And oh, everybody's doing keto. Well, I'm gonna do keto. And it's like, but is that a good fit for you? Like where's your thyroid hours? Your adrenal system, our your hormones, like you got to look at this full picture and then decide, okay, I'm, you know, inflamed. I've got PCOS, I'm insulin resistant. And yeah, keto could be great. And it could reverse all of those things. But then you want to, you know, start carb cycling and you know, there's there's a lot of nuances to it, and everybody has to find what's going to work for them. So

Philip Pape: 24:19

going back to the bloodwork free, and total testosterone DHEA Soulfire. SP, Bg. What else just needs

Karen Martel: 24:25

PG. Yep. And then of course, you want to test your estrogen progesterone as well. Because there is some some evidence that shows that women should actually be like if you're going to replace your hormones in perimenopause and menopause. There is some some research that shows it's actually better to replace estrogen and progesterone first for three months, then put in the testosterone. So I always want to see that full picture. The other way that I want people to test is through urine metabolite testing Now, oddly enough, testosterone is actually the least accurate on urine metabolite test dates. So you think, Okay, well, then why are you saying that we should do this, Karen? Well, in a Dutch test, which is dried urine hormone testing, we have testosterone on there, we've got the DHEA sulfate on there. But if you have a genetic snip, or you're missing these enzymes called the UG T enzymes, you won't pee out that testosterone. So it looks like you have none, when you actually have plenty. So I always want women to do bloodwork on the same day or the next day. So that we can compare the two just in case is more common in Asian backgrounds. So if you're, you've got, you know, if you're Asian yourself, or you've got Asian in your family history, then you may not have that enzyme. I don't have it. So I always look like I have low testosterone. But the other piece of the puzzle that we want to see on a urine metabolite test that bloodwork won't show is something called Five alpha reductase enzyme. And so there's a fan gauge on the Dutch test and there's five betta, and there's five alpha, if you are leaning towards a five Alpha pathway. So the on the fan gauge, if your way over to the five alpha, it means you convert your testosterone at a higher rate to what's called Dihydrotestosterone which is the most androgenic out of all the androgens and so that's where we'll see women if they go on to sauce from replacements, then the if that goes up the DHT goes up, they start having the hair loss the greasy skin, the acne and so that's not that's not pleasant when we can get whispers Have you know Korean start growing the cattiness as I call it so your your peed your clitoris can actually start to get longer. And you? Yeah. Which is not fun. And I've heard of women this happening to their voice cracking. And just from being on testosterone replacement, that's if

Philip Pape: 27:09

you lean more toward the Alpha side. Yep. And does that mean you shouldn't be taking therapy if that's the case, we just have to modulate it be more careful the dosage.

Karen Martel: 27:17

Exactly. And you have to possibly take something that's going to stop that conversion. So it blocks the five alpha reductase pathway. There's herbals that do it. There's also medication, finasteride and dutasteride that will block that conversion. So a lot of women will take the medication so that they can get the benefits of testosterone without having the masculine features. But there's lots of that like Saw Palmetto is really good for it. Pumpkin seed, there's a bunch of different things zinc that can help with that.

Unknown: 27:51

Before my coaching session with Philip, I was really struggling with staying consistent with my nutrition, Phillip really showed me the importance of being consistent day to day, he also helped me see that it's not a bad thing to take a rest day, he really helps me get in that more positive headspace of a rest day being something really good for me. I've been doing this for a month now. And I'm finally starting to see some progress and my numbers. And I'm really excited about that. And I just appreciate so much the help that Philip has given me. He's always willing to answer questions to offer resources that are totally free and very, very helpful. So I just want to say how much I appreciate that. Thanks, Philip.

Philip Pape: 28:37

This is all fascinating. Let's continue the story here. Right. So we've talked about testing, we talked about natural supplementation. Now we talked about testosterone therapy in more detail. So we're what are the options women have then you do that.

Karen Martel: 28:51

So we have pellets which are becoming very popular. There's a lot of pellet clinics now for both men and women. So pellets are these little tiny seed looking, they look like a seed and they get implanted into your butt. And then they're good. They will release testosterone for three months, sometimes six months. Not my favorite, and I'll explain why. But besides that injection, which is my favorite, we can do cream topical cream on the on the skin. And we can do tro keys and we can do oral so a TRO key is a little like you suck on like you put it down in stick it down in your gums and you just let it dissolve. And it's they they think they're going to tell you that, oh, we're just going to absorb into the saliva glands and go into the system. When actually you've you're going to swallow about half of that and that's a problem. So as soon as you start swallowing testosterone, so whether you're taking it as an oral capsule, or you're putting the tro key in your gum, then it's going to raise sh VG and that's going to then bind up The testosterone and estrogen so and it also can cause inflammation because it has to go through the first hepatic pass of the liver. So we, it's, it's the worst way to take testosterone is oral. So never ever do it orally, pellets. The problem with Palace is once they're inserted, you can't get them out, you have to wait for them to dissolve. And it takes about three months. And I have seen so many women who have done pellets who have a negative reaction. So maybe they go down that DHT pathway. And I see them lose their hair, they gain weight, they get greasy skin, cystic acne, we get super water retentive, and they've got to just sit and wait for it to come out. Which is horrible. And sound like I've talked to him in the game like 20 pounds in three months being on pellet therapy. Like that's how bad it can be. So if you're going to do pellet, I ask that you first do a different method. So you know how your body's going to react. Interesting. Yeah. Most people that are trained in pellet therapy, it's a bit of a cash grab so expensive. It's they're not trained to both female hormones like I have yet to come across a really good pellet. Doctor, I know they're out there. Don't get me wrong. I think they're definitely there's some out there. But there's a lot that are horrible. And they don't know anything about the female hormonal system. And it's all testosterone, testosterone, testosterone. And they, these pellets are in such high doses, that they're really androgen Ising women. And so you'll, you'll do their blood work a month in and it'll be hundreds, like top end of the range is 50. I've seen women in the 400 range being on pellets, and they're getting whiskers, they're your voice is crap. Like not, this is not good. We don't, we're not men, we're not trying to, you know, transition to men. So we have to be very careful. And these doctors, these Pella doctors, a lot of them, they won't give estrogen estradiol, or they maybe we'll give progesterone, but they they're very focused on that. Like, let's get your testosterone sky high. And I just don't agree with that. And so injection seems to be the best. I've worked with hundreds of 1000s of women. Now with testosterone therapy, I've seen I've run the gamut of each and each of these things. I've seen what what it looks like on labs, and injections seems to be the the best way to get your levels up to and to absorb it and take it into the system. For some reason cream. It does, it doesn't work as well. It still works. But I find you have to use a higher dose of cream to get the same levels that you would by using injection. So injection you do like a once or twice a week shot. And it really does seem to work well for raising a woman's testosterone. And if it's too much, then you can lower it like the next week if you want to, which is great. So if you're getting some negative symptoms, no problem. Let's lower it same with cream, we can reduce that dosage is great. Cream is awesome, too. It can be really helpful especially for sex. I always recommend to women that are having some sexual dysfunction and dry vagina. When women start to go through menopause and perimenopause, they can have really subpar orgasms when they used to have these great orgasms and then suddenly they're like, What the frick was that? Like? And so to start from rubbed actually on your labia includes Varas prior to sex can actually really help a woman to have a proper orgasm. And it's key to transfer that to your your your male partner. That's interesting. Yeah, yeah. Yeah.

Philip Pape: 33:52

Okay, so stay away from pellets most likely, unless you test them out first. The turkeys is oral don't That's the worst way. topical cream could work. But you need more of it. And then there's libido aspect. And then the injections are the best. And these are tiny needles put in your muscle tissue, right?

Karen Martel: 34:09

Yeah, yeah, you can do sub q, or you can do muscle. I personally do sub q because I don't know it's a bit bigger of a needle to go inter muscular. But most of you can handle it. I'm a bit of a chicken.

Philip Pape: 34:23

Now, you know, I imagine people select these other options simply because they don't want to get to inject themselves. So we just had to try to assuage their fears that this is super, I imagine, right? Like yeah, yeah, yeah. Okay, so great. Now, we talked about treatment, going back to the symptoms and the testing, is the testing the exclusive way you're determining that you need it, or is there a symptom aspect to it? I know for men, it's definitely a combination of the two usually.

Karen Martel: 34:49

Yeah, so what's interesting is some women come into this world being more androgenic and some are more estrogenic and this has to do with our DNA genetics, right, so when you get a genetic profile, you can actually see if you are more androgenic or estrogenic. And that means that your body will depend on that hormone more than the other than the average woman. So, I always use me and my sister as an example, I was born into this world very estrogenic. So I had a history of endometriosis. I've got ovarian cysts, I'm very curvaceous, I've got breasts, I've got hips, I gotta, but I'm always prone to weight gain. And then you look at my sister, and she's like this little tiny being pool that can eat as much as she wants and never gain a single pound. She's super wiry, she maintains muscle, she's got a great libido, and she just will never gain weight. Like it's crazy. And so when her testosterone drops, she really feels that when I lose my testosterone, I don't notice it that much. Okay, it's like, okay, yeah, you know, and so when I put it back in, like, I noticed difference in the muscle and little bit with the libido. And, you know, it's like, yeah, I can feel it a little bit. But for her, she takes us around, and it's like, oh, like, she just, you know, it's amazing, because she's more androgenic. So your levels could look like they're in range. But if that's low for you, and you're getting symptoms of low testosterone, and so somebody would maybe be gaining weight. Fatigue is a big one, foggy brain, testosterone is really important for our heart, our breasts, our bones. And so if you start to see these problems coming, and your testosterone is not, you know, in a good, it's not in that upper third quartile on the range, that may not be then not seeing that, that you probably don't have enough for you. And so you want to maybe start supplementing with a little bit of testosterone. So we want to always test but we also want to go by how somebody's feeling. And so if there's, if those symptoms are arising, and that person's not being able to put on muscle tissue, they've noticed a big drop in their libido. And, you know, they're really foggy brain, and they're super tired. And it gives a woman, I always say this, it gives you your, your, your balls, your lady balls. And when I say that, I mean, it gives you your drive. And that like I'm gonna go out there and get stuff done. And I'm gonna, you know, so for business women, and for women that are like in that kind of, go, go go. Lifestyle, it can be really important for you to have that testosterone at a good level. And even just stay at home moms. I mean, we all know how stressful that is, and how tired I think that's a harder job than being a high up businesswoman.

Philip Pape: 37:46

No comment, I mean, all women in the world that are working hard at something or you know, to be valued, they're all working.

Karen Martel: 37:52

Yeah. So so women can really notice it with their, with that fatigue, and just not feeling like they want to get stuff done in their life. And they just like, have that low self esteem and that there's just no get up and go. So that can be testosterone. Yeah,

Philip Pape: 38:09

no, I wanted to ask, because there's there big differences between men and women and how they, how they feel these differences. Like for men, it's like, do you feel more like a woman than your testosterone is low? It's kind of like simplified like that. Are you crying? Or are you sad, or all these other things, but what you describe is a little more unique set of symptoms for women, given women have like a fraction of testosterone men and you're already not androgenic to begin with. So it's not like you'd necessarily notice that difference, right? Yeah. So combining the testing with the symptoms is a great strategy. Of course. Yeah.

Karen Martel: 38:40

What about? Yeah, they do use it. Like some women will report like, absolutely incredible results. Like they're just like, they love their testosterone, because they're like, oh, my gosh, I feel like I'm alive. Again, I can get out there, I can exercise, I have energy, I feel amazing. And it also for women with breast a history of breast cancer, it won't convert into estrogen and the breast tissue. So you can actually use testosterone therapy safely. If you have a history of breast cancer, you will of course, want to talk to your oncologist about that.

Philip Pape: 39:13

And how young, not how young is too young. But at what age should a woman get tested? Even if they don't have symptoms? What's a good like baseline age?

Karen Martel: 39:21

In your 20s or 30s? Early 30s? Yeah, because we start to see testosterone going down typically in mid 30s. In women, sometimes in your 40s. It'll start but that's when we start to lose most of our hormones were returned, we tend to go into Peri menopause, which is the beginning of the loss of these hormones and ovarian function between the ages of 35 and 40. So we want to get a baseline when you're feeling good is is a great idea. So if you're in your 20s, early 30s And you don't have any symptoms of low testosterone, yeah, go get it tested now so that when you start aging and going into perimenopause and you start losing that libido and muscle tissue, you can then testing Compare and be like, oh, so it was 40 when I was in my 20s. But yet, look at it. Now it's at 14. And so clearly, I need to boost it and get it up to 40. So I can feel like I did when I was in my 20s

Philip Pape: 40:13

is that it's relative to you? What? So let me ask you this question, when would a traditional doctor or GP recommend that you get this tested? Never. There you go. You got to own your health people got to take control of this stuff. Yeah. So true. Yeah, yeah. Yeah. And I know, that's what you're all about. And anybody listening knows that. But still, we got to do that. Yeah. I'll

Karen Martel: 40:34

just tell you, Oh, yeah, you're in range. You know, the range for women is if they even get tested, if they even even get a test. It's like, no, no, you're

Philip Pape: 40:41

30 you're too young. That's what they'll say.

Karen Martel: 40:43

It's ridiculous. Like, you're free testosterone. If you're between like, point five and five, you're good. What. And then they like total testosterone. If you're between like 10 and 15. It's like, oh, like, we want to see you in that upper range, mid range and above, with total testosterone and free testosterone at around three or four. So keep that in mind when you go to get tested. Because your doctor is going to be like, you're great. You're in range, even though you're like point one away from being flagged as too low. They'll tell you, you're fine.

Philip Pape: 41:16

Right. And there's so much of that in life with like the minimums, you know, it's like, we're not trying to just survive and get by here people, right?

Karen Martel: 41:23

Yes, we're optimizing for? Yes. So yes, and I'm gonna just say to something that I, I really, really try to get across to women, is, once you lose ovarian function, which typically you'll start to really drop in progesterone first, you can start slowly dropping into dosterone, and then in your mid 40s, to 50, then we drop in estrogen dial. There's no amount of dieting, exercising, fasting, that will bring back ovarian function. So as even though testosterone is one of the one of them that we still will be producing a lot of the time out of our adrenal system, most women's adrenal systems are shot as we discussed. So you really want to like if the natural stuff doesn't work? Yeah, please keep in mind that there's no way to bring back ovarian function, you can come back to supplement your way out of not obviously, like out of the low of your ovulation and the low eggs like you can't bring back a cow, you can't bring back ovulation is going to end, we used to die at 45. That was the average age for women. So as we started going into menopause, we typically die. Now we're living longer than ever. And so without these vital hormones, you can only get so far with your health. Because you're missing all of these hormones that are crucial for so much more than just sex and procreation. We need these hormones for like I said, testosterone is super important for bones. And you know, if you have a hip fracture, you have a 50% chance of dying within the year. Like that's crazy. Osteoporosis, like you will get osteoporosis if you don't replace your hormones, we need them. And so the alternative alternatives is of course, medication, a lot of women will get depressed anxiety ridden from losing these vital hormones. And so I just want everybody to keep that in mind. The research shows that women that replace their hormones, as you know, mainly estradiol, progesterone, and testosterone, have a third over 30% reduction in all cause mortality. We know that heart disease can can be reduced by like 49%, which is the number one killer of women. It reduces cardiac mortality by 49%. That's crazy. So in Alzheimer's, we just a great study came out a couple years ago on like, I think it was like 400,000 women that show women that replaced estradiol for six years or longer had, you know, 75 to 80% reduction in developing Alzheimer's. So in testosterone is really important for the brain as well. So we just want to keep that in mind that it's not just about libido and there's just so much of that. The biohacking that we can do to bring back those levels and so just keep that in mind. Yeah,

Philip Pape: 44:28

it's a it's like a battery that's capacity keeps dropping and dropping and dropping, you can only charge it's even if you do everything perfectly, it only charges 50% Then you can only charge it to 25% You need this extra battery I guess from the TRT and the replacement therapy

Karen Martel: 44:43

to like yeah, for sure. men lose their testosterone like women, but you know, like we drop in hormones far more than you guys do. But there is menopause and that is the loss of DHEA you can lose your progesterone your estrogen or testosterone in Those are vitally important especially of course to sauce throne for men. And so you really want to watch that if you're not waking up with an erection in the morning if you're having poor orgasms if you're you know, have erectile dysfunction, just depression for men, high cholesterol, high insulin, fasting insulin and blood glucose. These are all signs that you could possibly use a little bit of a testosterone boost as well.

Philip Pape: 45:25

For sure. I mean, in for men, it's like if you're training well for eating well get your blood tested, you've got the things covered, you still may need TRT and it's good to have that baseline no matter whatever age you are. Same thing with women 30 years old is great. Get it then every five years or so see what happens. Yes. And treat it and once you start treatment, you have to be on it for life. But that makes sense because it's not coming back. Yeah.

Karen Martel: 45:47

And you know, your men think Oh, but if I start using it, then that's it. I'll never have to start trying again. But actually, it shows that in about a month after stopping TRT, your levels will come back to where they were they were Yeah. Which

Philip Pape: 46:02

were probably inadequate. That's why you took TRT if there's no harm Yeah, yeah, exactly. Okay, what about, we talked about the androgenic symptoms, are there any other side effects symptoms women should be aware of that would be indicated by too high of a dosage or potentially misalignment with their therapy.

Karen Martel: 46:20

Weight Gain is insulin can go up blood sugar can go up. That's like the common PCOS polycystic ovarian syndrome, which is the leading cause of infertility in women right now. That is too high of those androgens as we discussed, and so you could lose your period, you have blood sugar problems, not ovulating. And then with all the other ones on top of that, like the hair loss is a huge one, especially if you've got too much DHEA will cause a lot of hair loss and acne. Same with the testosterone loss. So, I mean, too much of the too much testosterone too much DHEA will cause the hair loss and cause the acne. You can get dark hair on your arms. Dark hair where you know, just in places you don't want it so more hair growth on the body but less hair on the head, which sucks. I think that's it. Yeah, that's a scary. Yeah, we'll we'll get swollen. Yeah. Which is very uncomfortable. So I have heard that from a few women when they're on too much testosterone. Very uncomfortable. They're everything kind of in gorgeous down below.

Philip Pape: 47:32

So that the message is get tested and modify your dosing as appropriate. Absolutely. Yeah. Yeah, yeah. Yeah. Okay. What, um, what's in the future for all of this? Like, is there are there any big changes coming in in terms of either the the approaches or the therapy itself?

Karen Martel: 47:48

Not that I've heard of, unfortunately, it's still there isn't a lot for what to research for women. And to actually, it was just at a conference over the weekend, and a woman that would did one of the talks said that it wasn't till 1993 that women were even allowed to be in scientific research studies. Because we could get pregnant. And so the we're all we've only just been in studies for hormone. Like, it's crazy. For a lot of things, a lot of things. For everything. Yeah, true. Yeah. Not just crazy. Hormones. Yeah. Yeah.

Philip Pape: 48:26

How do we know about myself? So it's changing,

Karen Martel: 48:30

but very slowly. Yeah. And so it's just about educating women about the importance of their hormones, and that testosterone is one that you really want to watch, because it can really help with, you know, just overall vitality and beating well. It'll

Philip Pape: 48:45

be ironic or maybe appropriate, if one day insurance companies realize, hey, if we had gotten on this sooner with hormone therapy, we wouldn't have such high costs of all the effects of you know, this added weight gain and stress on the system and poor health that are related hormones, but you know, they don't think long term

Karen Martel: 49:01

make money. It doesn't make money. So yes, right. Yeah, that's right. Keep us sick. Yeah, it's unfortunate. Yeah, it's good to work with a good hormone practitioners, you know, not somebody that's in it just to you know, it's like the these pellet clinics or like the wars for just kind of how many people can we get through here? It's not, it's there's no holistic approach. You know, you want to work with somebody that's going to find what's going to work for you and be able to, you know, if you start getting these masculine symptoms that they know what to do, and that they're not forgetting about these other very crucial hormones, because they all work synergistically together. And so we want to look at everything.

Philip Pape: 49:40

And Karen is and I know she wasn't trying to plug herself a carrot is one of these wonderful people in the world that do that. And I've

Karen Martel: 49:46

I'm just trying to find me you just find somebody

Philip Pape: 49:50

true and especially depends on where you live like in the US versus Canada, you might have different access to different things because I've heard some people here do get coverage for certain things that you might not in Canada and vice versus So yep, educate. Exactly. All right. So is there any other question you wish I had asked here, related to testosterone or anything else,

Karen Martel: 50:09

I guess maybe how what I have to offer which we I do work with a team of doctors who run the ER, focuses on testosterone. And so we, we can prescribe in every state, which is really cool. We can prescribe in Alberta and British Columbia, and soon to be Ontario and Canada. Because and I want to say that not to plug myself but because testosterone is extremely challenging to get for women met normal medical doctor, your medical doctor doesn't know how to prescribe it for women. They're just like, oh, I have no clue what to do here. Like they're not trained in menopause. They're not trained in perimenopause. I've heard they get like, let like less than 7% of doctors are trained in menopause in med school. So you're gonna have a very hard time finding, finding a mainstream medical doctor who will properly prescribe you hormone replacement therapy. So I

Philip Pape: 51:09

just I just have to back that statement up. I've never heard and this is anecdotally from so many clients and women in my life who have GPS, male or female GPS, but even males who just, they're 60 years old, and they've been working with how many patients all these decades. And it's like they they're clueless. It's crazy. It's there's no continued education, there's just nothing. So we have people

Karen Martel: 51:35

to become educated in bioidentical hormone therapy, they actually have to pay for the course or courses. There's a lot of incentivized Yeah, no, it's not taught in med school. They they're all going by old studies that were falsely represented. And like, there's so much horrible things that are going on the medical system for women's health. And so what they will give you what they will give you is a depressant

Philip Pape: 51:59

or the birth of general, when you're 14, they'll give you that. Okay, yep. Yeah, which causes

Karen Martel: 52:04

way more risk for breast cancer. And anyway, like, it's, it's terrible. That's a whole nother episode.

Philip Pape: 52:09

I talked about that last night, actually.

Karen Martel: 52:12

You can go back and listen to that. But yeah, it's very challenging. And women need to realize that their medical doctor sure go give it a shot, because a lot of it's covered problems. So try. So it was good to try to see if they'll work with you. But if they don't, then let it go. And don't get angry at the medical system. And I had somebody recently message me and say, I'm so mad that I have to pay for this. And it's like, well, it but you have to realize that doctors aren't trained in this. So they're not the people that we should be going to for it. Unless they've said that this is their specialty, which our doctors are they specialize in hormone replacement therapy, they've properly been properly trained. I've been properly trained by nurse practitioners improperly trained, you know, so you want to find somebody that has been specifically trained in bioidentical hormone therapy. And it's likely not your family doctor.

Philip Pape: 53:13

And like you said, Everything related to wellness versus sickness, everything related to wellness, you probably have to take into your own hands, whether it's your nutrition, your exercise, your hormones, you see, it's all starting to connect. Right. Cool. So then where can listeners learn about you? Where do you want them to reach out to you?

Karen Martel: 53:31

Yeah, so we've got you know, we've we've made sure that we've been able to help any woman that wants to get the help. So we have different tiers, we've got, you know, high ends, four month packages, where you get that one on one, help you get your prescriptions, you get your hormones, etc. And then we also have group coaching, the group coaching program has been going for about six years, we've got almost 200 Women in it. And you can get a lot of help through that we have weekly group coaching calls, where we'll look at your labs and give you recommendations to take to your doctor or to your prescriber and say, Hey, this is what you know, they've recommended I need some estrogen, I need to assess your own and then we've also got, you know, nurse practitioners that you can book with and take the recommendations to and they'll prescribe it and then I'll also I'm coming up with my own line of over the counter hormones so that women can get them even even if they don't have a lot of money. Now you can't. You can't buy testosterone counter, right? You can estradiol and progesterone, which are very key for replacing when you're in perimenopause and menopause to mitigate those symptoms and to have optimal health. So I've created my own line so that women can just get it without the prescription. If they feel they need it. Is cosmetic cream. It's not Yeah, yes. Is

Philip Pape: 54:52

that your website? katimorton.com. It's, it's coming. I

Karen Martel: 54:55

don't know when this is being aired, but it'll be here by the end of the year.

Philip Pape: 54:59

Okay, so this is A whole brand new place to find all this. Okay. All right, yeah, even even with coaching everything else, we're not using your website. There's another. No

Karen Martel: 55:07

right now it's gonna just be on my website. character.com. Yeah. And then social media. I'm Karen Martell hormones and then the podcast is the hormone solution.

Philip Pape: 55:15

Yeah. Right. And that was you renamed that few months back, right? Yeah.

Karen Martel: 55:21

Their site of weight loss. And now it's a hormone solution podcast because it was just so much to do with hormones.

Philip Pape: 55:27

Well, this episode comes out in early January. So if you have any updates, we can connect and put it in there, folks. Cool. This has been a pleasure. I'm glad we got to go really deep into this one area of testosterone. So important, not talked about enough. And it's been awesome to have you on so thank you.

Karen Martel: 55:43

Thanks for having me on.

Philip Pape: 55:45

Thank you for tuning in to another episode of Wits & Weights. If you found value in today's episode, and know someone else who's looking to level up their Wits & Weights. Please take a moment to share this episode with them. And make sure to hit the Follow button in your podcast platform right now to catch the next episode. Until then, stay strong.