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‘I’m on fire’: The promise and peril of testosterone
I read everything Susan Dominus writes. Two years ago, she wrote an influential piece about how women had been misled about menopause; how the increased risk of breast cancer that comes with replacing declining hormones like estrogen and progesterone was often vastly overstated; and how many women who could have treated debilitating symptoms like hot flashes and insomnia suffered through them instead.
That has radically changed, thanks in part to articles like Susan’s and a confluence of social media influencers and doctors who have started talki…
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Credit...Animation By Fromm Studio
‘I’m on fire’: The promise and peril of testosterone
I read everything Susan Dominus writes. Two years ago, she wrote an influential piece about how women had been misled about menopause; how the increased risk of breast cancer that comes with replacing declining hormones like estrogen and progesterone was often vastly overstated; and how many women who could have treated debilitating symptoms like hot flashes and insomnia suffered through them instead.
That has radically changed, thanks in part to articles like Susan’s and a confluence of social media influencers and doctors who have started talking openly about the benefits of menopausal hormone therapy.
Today, things have gone so far in the other direction that not only are more women leaning into conventional hormone therapy, they’re experimenting with testosterone. Lots of it, in some cases.
What got you interested in testosterone?
I started hearing all these stories from friends about women who were taking testosterone in really high doses, totally transforming their sex lives in their 50s. Women who hadn’t wanted sex with their husbands in years were suddenly having it six times a week. Others said they had orgasms for the first time in years.
The effects of testosterone in women have really only been well-studied at doses that replace the levels that a woman would have had in her late 30s. That’s very different from what I was hearing about, which was women taking doses much higher than they ever had naturally, at any stage.
Regulators in the U.S., which is where most of my reporting focused, have not approved the use of testosterone for women at all. Doctors have to prescribe it off-label. And yet these massive doses have become a cultural phenomenon.** **And a lot of women are having extreme reactions.
What kind of reactions beyond the increased sex drive?
I heard of one woman who had a terrible reaction after taking testosterone via a pellet — a little grain-of-rice-type object that is inserted beneath your skin and dissolves over three or four months. Once it’s in, you can’t take it out. It made her very aggressive and very angry. And everybody had to ride it out, and afterward she had to go back and apologize to her family.
Another woman told me her pellet gave her so much energy that she enrolled in a Ph.D. program even though she was raising four children and helping run three small businesses. But she also lost 40 percent of her hair.
You just don’t know how you’re going to respond. Are you going to be the person who feels positive and in love with her husband? Or is it going to make you the person who’s hyper-aroused but furious with her husband? Or isn’t even hyper-aroused — but is just angry all the time?
And are there any health risks?
The risks are not well understood at this point. Doctors have concerns about the possible increase in hormone-related cancers and cardiac issues that could be associated with high doses over time. But even the data on the risks of low-dose testosterone is limited. ** **There is research on women who take it for two years that shows it’s quite safe. There’s been some research on women who’ve taken it for up to six years that’s also reassuring, but isn’t as good as the two-year research. There’s just not a lot of long-term data.
Have you read “All Fours” by Miranda July, by any chance?
Yes, I loved it!
So did I! In part because it got at something that your story also highlights — this idea that female sexuality doesn’t have to be linked to fertility.
Yes. Previously, as a menopausal woman, not only were you not considered a sexual being, but the notion that you might be a sexual being was the subject of jokes.
What I love about “All Fours” is that it really normalizes this idea that many women in their 50s and beyond not only want to have sex, but, you know, deserve help with that if it’s something they want. But equally, if someone in their 50s is done with sex, we want to normalize that too, right?
Our readers are from all over the world. Is there a country that is pioneering this culture change?
I think Britain has been leading the charge on making classic hormone therapy — estrogen and progesterone** **— accessible and affordable and safe, and countries like Australia, New Zealand and South Africa are doing the same, specifically with testosterone. In America, which is a very puritanical and conservative country in many ways, things are moving relatively slowly — which might be why so many women have gone rogue.
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Prince William and Prime Minister Keir Starmer of Britain in Belém, Brazil, yesterday.Credit...Pool photo by Ben Stansall
The Amazon climate summit
Diplomats and leaders opened the annual U.N. climate conference yesterday in the city of Belém, which lies on the edge of the Amazon rainforest.
President Luiz Inácio Lula da Silva of Brazil pulled up at the venue in a fleet of Chinese-made E.V. cars, highlighting the inroads that China’s technologies have made around the world. The choice of vehicles underscored the absence of the Trump administration at this year’s climate talks. For some attendees, that’s just fine.
Video
Why Is Trump Threatening to Intervene In Nigeria?
President Trump has threatened to send troops to Nigeria, where he says Christianity faces an “existential threat,” an accusation that Nigeria has denied. Ruth Maclean, our West Africa bureau chief, describes how the violence in Nigeria is affecting people of all religions, not only Christians.
Why is Trump threatening military action in Nigeria?
President Trump and his allies say Christians are being killed for their religion in Nigeria. I talked with my colleague Ruth Maclean, who explained what’s going on.
There are different types of violence happening in different parts of the country, and religion is one of many factors, Ruth told me. It’s easy to cherry-pick incidents and make a whole country look as though it’s in chaos, but that’s not really the whole story. Click on the video above for more.
**OTHER NEWS **
The death toll from Typhoon Kalmaegi rose to 117 in the Philippines as the storm moved on to Vietnam.
Russia is on the verge of capturing the strategic Ukrainian city of Pokrovsk, which would be its biggest prize since 2023.
Cuts to air traffic in the U.S. because of the government shutdown will affect flights to 40 major airports. Here’s the list.
Scores of militants in Gaza are marooned in areas under Israeli control, including many living in vast tunnel networks, according to Israeli officials.
The R.S.F. paramilitary force in Sudan, under mounting international pressure over atrocities committed by its troops, accepted a cease-fire proposal from a U.S.-led group of mediators.
The organizer of the Miss Universe pageant apologized for berating Miss Mexico in a tirade that prompted several contestants to walk out in protest.
Mexico’s president is pressing charges against a man who groped her on the street in a shocking encounter that was captured on video.
SPORTS
**Rowing: **Jess Rowe and Miriam Payne look back on how they made history crossing the Pacific Ocean.
**Tennis: Will **Novak Djokovic play in the ATP World Tour finals?
PHRASE OF THE DAY
Mistress dispeller
— In China, a professional can be hired to break up a partner’s extramarital relationship. The profession is the subject of a haunting new documentary.
MORNING READ
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The Podpisniye Izdaniya bookstore in St. Petersburg. Credit...Nanna Heitmann for The New York Times
In St. Petersburg, home to Dostoyevsky and Nabokov, bookstores have long served as community centers. But the war in Ukraine is complicating life for Russian readers.
The Kremlin has repeatedly curtailed liberties in the arts and in speech, and this year, especially, officials have turned their sights to books. Volumes are being redacted and pulled from shelves. The rules are evolving, opaque and inconsistently enforced. And the space for exchanging ideas is shrinking. Read more.
AROUND THE WORLD
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Credit...Enea Arienti
What they’re crafting in … Milan
In the trendy Brera district, two women in their 70s sell flowers that are never out of season. For more than 30 years, Laura Goffi and Elisabetta Sonzini have been turning copper sheets and wires into lifelike roses, hellebores and peonies at their shop, Erbavoglio.
Each of their metal flowers takes anywhere from two hours to a few days to create. Take a look****.
RECIPE
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Credit...Christopher Testani for The New York Times
My family likes to bake, and our favorite recipe is lemon bars with olive oil and flaky salt, by Melissa Clark. The fruity bitterness of the olive oil is the perfect foil for the bright sourness of the lemon curd on a base of buttery shortbread. My daughters have made these bars dozens of times, and they love to deliver them to our friends and neighbors. (Melissa’s video is also very charming.) — Adam Pasick, deputy international editor
WHERE IS THIS?
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Credit...Atul Loke for The New York Times
Where are these ancient rock carvings?
Valcamonica, Italy
Serra da Capivara, Brazil
Ratnagiri, India
BEFORE YOU GO …
When the Indian women’s team won the cricket World Cup for the first time last weekend — you might have read our newsletter about it — it got me thinking about competitive sports.
Twenty years ago, I interviewed women leaders in business and politics about the roots of their success. Two things came up a lot: Several had attended single-sex schools. And a surprising number had played competitive sports.
I never played team sports as a teenager — I was a dancer. But two years ago, I started playing netball in an all-female league. Every Monday night I sweat and swear and celebrate (or commiserate) post-match with my teammates, endorphins running high.
Do competitive sports turn people into type-A leaders, or do those people seek out competitive sports? There’s a chicken-and-egg thing going on. But I can say those games make me feel alive and strong, even when we lose.
My two favorite movies that capture the thrill of women in sports are “Bend It Like Beckham” and “Copa 71.” The former is a comedy about a British Indian teenage girl who is mad about football but whose family wants to marry her off. The latter is a documentary about the first unofficial women’s football world cup, which packed out the stadium in Mexico City in 1971 and was subsequently written out of history by FIFA. (My football-playing daughter loved both.)
And in honor of Charles Bradley’s birthday this week (thanks for the tip off!), here is “Change for the World,” to play us into the weekend.
Have a great one. — Katrin
Katrin Bennhold is the host of The World, the flagship global newsletter of The New York Times.
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