Dihydrotestosterone (DHT) (referred to as androstanolone or stanolone when used medically) can also be used in place of testosterone as an androgen. The availability of DHT is limited; it is not available in the United States or Canada, for instance, but it is available in certain European countries, including the United Kingdom , France , Spain , Belgium , Italy , and Luxembourg .  DHT is available in formulations including topical gel, buccal or sublingual tablets, and as esters in oil for intramuscular injection.  Relative to testosterone, and similarly to many synthetic AAS, DHT has the potential advantages of not being locally potentiated in so-called androgenic tissues that express 5α-reductase (as DHT is already 5α-reduced) and of not being aromatized into an estrogen (it is not a substrate for aromatase).
1. Evaluate your own testosterone levels and the state of other hormones. These self-assessments are the same ones I’ve used with thousands of my patients.
2. Heal your adrenal glands. These glands produce testosterone and many other hormones. Stress is killing us and prevents the adrenals from performing at their best.
3. Detoxify your liver. The liver activates testosterone and other hormones and converts them to safe, cancer-protective metabolites. Your liver also works overtime to filter all the pollution and pesticides you’re exposed to. A sluggish liver can’t do its job right. This detox, which is different from detoxification of the colon, includes an easy two-week cleanse that pulls out and disposes of toxins and heals and tonifies the liver.
4. Eat nutrient-dense foods. Nutrients are the raw ingredients for building our cells, detoxifying the liver, and healing the adrenals. But few of us eat enough fruits and vegetables to get the vitamins and minerals we need. Our food sources are also less nutrient-dense than 50 years ago, due to pollution, pesticides, and farming practices. Results of a landmark study in The New England Journal of Medicine in 2013 show that a plant-based Mediterranean diet supplemented with nuts and olive oil can reduce risk of heart disease by 30%. Heart disease is the number one killer of women, even though most of us are more afraid of breast cancer. The diet also promotes hormone production. My nutrition recommendations closely resemble this diet.
5. Use herbs and vitamin/mineral supplements to boost testosterone and balance other hormones you need. These are available over-the-counter. For example, maca, the herb Stephanie used, removes the testosterone that is bound to carrier proteins and is virtually useless—and makes it available to do its important work as a “free” hormone. The herb ashwagandha boosts testosterone, too, and the B vitamins—B1, B6, and B12—help the adrenals.
6. Slash stress. Low-impact, stress reducing exercises include tai chi, sitting mindfully in silence and stillness (some call it meditation), and breathing exercises. Research also shows moderate exercise like walking increases testosterone production. It’s a myth that watching TV relaxes you. You actually have to do something in order to relax. You need to turn on the “relaxation response.” These exercises are ways to do that.? Incidentally, your body’s response to stress is to produce fat. One of the stresses in our lives is malnourishment. We are an overfed malnourished society.
Potential risks and side effects
There is very little clinical research on treating pre-menopausal women. From the small amount of research available, it seems that the androgen levels achieved by treatment, as well as side effects, are the same as those in post-menopausal women. The main untoward effects are acne and facial hair. These occur if the level of testosterone is above normal. However, some sensitive women may have these effects with a level in the normal range. Occasionally fluid retention can occur. If testosterone rises above physiological levels, an abnormal lipid profile may occur. There are no side effects to DHEA itself because there are no receptors in the body for DHEA; all side effects are from the conversion product of DHEA, which is testosterone. Women with a history of breast cancer, severe liver disease, or severe deep vein phlebitis should not take androgens, as a certain amount of testosterone will be converted to estrogen. This treatment is also contraindicated during pregnancy, since testosterones, and even its precursor DHEA, cross the placenta and may cause changes in the genitals of the fetus. Special caution should be used when treating women of childbearing age. When prescribing testosterone treatment to a woman, be sure to prescribe adequate birth control and a warning that the androgen treatment should be stopped immediately if a pregnancy might be even remotely possible, or when considering pregnancy in the near future.