woman riding bicycle
Illustration: Andrew Bannecker
At dinner with my family one night, I found myself crying into my soup. What the—I never cry! Then the hot flash fired up. Aha. I had long cursed my periods, and now they were divorcing me. My five-year treatment for estrogen-receptor-positive breast cancer (the kind that afflicts about 70 percent of breast cancer patients) includes a monthly injection that whispers to my pituitary gland to shut down my ovaries. At 42, I was experiencing menopause a decade early and at warp speed.

The result? A greater likelihood that I'd survive. The side effects? Exhaustion. Excessive sleep. Aching bones. A 20-pound weight gain. Brain fog. Forgetting that sex can be fun.

At my three-month visit to the oncologist, these complaints produced pinched smiles and shrugs. I could hear the unspoken reproach: You're alive, be happy. But what was alive? A strong heartbeat and a few random firings from the wet, wadded-up towel passing for my brain? The doctor offered an anti depressant, which seemed like retreat. I went home and vowed to try positive thinking: At least you didn't need radiation. A least you didn't need chemo. At least you kept your hair. But none of that changed how I felt.

When I relayed my symptoms to my gynecologist, he told me that I likely didn't need an antidepressant. Ovaries also produce the "male" sex hormone, he explained, so when my estrogen dropped, so, too, went the hormone of desire—the desire to have sex, yes, but also to learn, to reach. Testosterone helps build strength in your bones and muscles, helps you think clearly. Without it, you're not fully there.

The oncologist seemed skeptical. She had never treated her patients with testosterone before. Her job was to keep people from dying. But she agreed to discuss replacement therapy with her peers. Three months later, at my next appointment, she apologized for not putting me on that path sooner.

According to the National Institutes of Health, total female testosterone levels should be anywhere between 30 to 95 nanograms per deciliter. A blood test determined that my level was only 21. I started off with a shot in my backside and a prescription for cream that I could massage into my thigh every day.

Next: Waiting for the magic to happen

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