Introduction
Have you ever wondered why we get old? There are many theories out there. Generally they blame the environment or toxins but do not explain what triggers the process of aging. The answer is hidden deep in the medical literature of the specialty called endocrinology, and it comes down to one hormonetestosterone. In women, testosterone is produced by the ovaries, and production begins to decrease at around the age of 40; this is the first trigger for aging. Then other hormones follow suit, reducing their production in response to the drop in testosterone, and so we slide almost unconsciously into premature old age.

In this book, we will explain the whys and hows of this process, but more important, the cure for testosterone deficiency and the symptoms of aging. We will also pay close attention to the reasons for the U.S. medical community´s stance on testosterone replacement: Why does it fully embrace this treatment for men but not women? Why hasn´t your doctor considered this replacement in response to your complaints? There is a reason the American, British, and Canadian medical establishments have buried testosterone replacement for women, and you will learn why you are only now hearing of this "secret treatment."

KNOWLEDGE IS POWER
When you talk to a medical professional about hormone replacement choices, the more you know, the better. Almost all women know to ask about the benefits and risks of a treatment a doctor proposes for them, but most don´t know enough to ask about the benefits and risks of not taking a treatment like testosterone! This book offers both the pros and cons of doing so and discusses why the risks associated with refusing treatment for hormone deprivation are significant and, for most people, far outweigh the risks of accepting it. Remember, a choice not to do something is still a choice! It, too, has consequences. Know what they are.

KATHY MAUPIN, MD: WHO I AMMY TRAINING AND BACKGROUND
As a board-certified obstetrician and gynecologist, I have practiced OB/GYN medicine for more than 25 years and delivered thousands of babies. I am currently an antiaging physician, dedicated to treating women with the secret hormone, testosterone, something we all need after the age of 40, in the safest and most natural way possible.

For many years I had been listening to my patients´ complaints about exhaustion, lack of libido, belly fat, migraines, and other symptoms as they approached or experienced menopause. All too often I heard the simple, plaintive cry, "Doctor, what is wrong with me?"

It is not a casual question. It is a question almost always uttered in desperation. Until a few years ago, I did not know the answer and I had to tell my patients so.

This book is for all the women who have experienced the drastic and debilitating effects of hormonal imbalance as they approach midlife, even before menopause, and have not received help through conventional medicine.

I was one of those women. I know the desperation that sets in after many frustrating visits to doctors who do not understand the problem or the solution. So I can tell you firsthand that life does not have to end after 40! I want to share the secret of testosterone with you so you can live the next half of your life with energy, health, and joy.

I know that finding the right treatment is difficult for women who are not trained as doctors, and I understand the dilemma of experiencing symptoms that no one believes or will help try to solve. It is a blessing that I was a physician when I experienced the symptoms of testosterone deprivation; I had the training to find an answer on my own. Now I can pass along what I learned and help all women look for and request the right treatment to make them whole again. I very much want to reach women who are suffering from hormone loss, in the hope of helping them regain their health through a novel, safe, and effective hormone replacement regimen.

I can´t tell you how fulfilling my medical practice is now! I am able to sustain more than a 95 percent success rate for my patients with hormone replacement using the safest type (bio-identical pellets) while including the critical and often forgotten female hormone testosterone. This has led me to dedicate all of my efforts to my BioBalance hormone replacement practice, and I no longer practice the traditional medical specialties of obstetrics or gynecology.

The satisfaction I derive from helping women recover their lives, and from intervening in ways that restore them to vigor and health, is inexpressible, but it inspired me to write this book about my journey of knowledge and the changes in my own life. I hope that my experience will help others discover what I now know, not only from personal experience but from helping literally thousands of women journey back to health.

This book is the fulfillment of that hope.

Before I began this project, I knew I needed someone with different skills to help me. Good health care involves not only the physical but the psychological as well, so I enlisted the help of my good friend and professional colleague Brett Newcomb.

BRETT NEWCOMB, MA, LPC: WHO I AMMY TRAINING AND BACKGROUND
I have spent 30 years working as a family therapist. During that time, I have met with many people struggling with what I thought were psychologically caused and stress-induced issues. Over the years, I have learned that many psychological or emotional difficulties are also physical ones. Through the opportunity to work with good physicians such as Dr. Maupin, I have learned much about the overlapping and interweaving of the physical and the psychological.

I have collaborated with Kathy for years, consulting with clients of mine who are also her patients. Together we have worked to find the optimal interface of behavioral and physiological treatments to help our patients have the best quality of life possible as they age.

We first began working together because we had a mutual patient. Sandra was having marital problems and thought she might have depression. I always ask clients who are suffering from depression to have a medical exam to rule out any physical causes. After Sandra saw Kathy, she gave us both permission to communicate about her case. As our work progressed, we determined that Sandra was not suffering from depression after all, but that her issues were related to a lack of libido resulting from a low testosterone level, and this affected her marriage. Her husband, Bill, was 53 and still wanted sex several times a week. Sandra felt like her sex drive was depleted.

She still loved Bill, but she just had no sexual desire. I worked with Bill and Sandra on their ability to communicate, and Dr. Maupin worked on testosterone replacement for Sandra. Bill and Sandra experienced a revival of their sex lives and a strengthening of their marriage, and Dr. Maupin and I were off and running to collaborate with other patients whenever appropriate!

We have written this book together in much the same way we collaborate in our work with clients. Kathy focuses on her experience and the medical science she knows and uses to help patients. I add insights and recommendations from my own clinical perspective, concentrating on the communication skills that help people reality test what is going on in their lives and decide on a course of action to make their relationships better. These skills are to a large extent volitional. Once you learn them, you must decide to actually use them. I will provide both the tools and encouragement you need to utilize the information that both of us offer in this book.

HOW THIS BOOK IS ORGANIZED
It is important that you understand how this book is set up so you can get the most out of it. We´ve written it to explain why the medical profession should acknowledge the existence of a newly discovered syndrome in women: TDS, or testosterone deficiency syndrome. We hope this will lead to better treatment and healing for women whose complaints have long been ignored by mainstream medicine. Ultimately, we describe the treatment we believe works best for the greatest number of women. As an individual, you will need to assess what we have provided in terms of your own unique situation.

Our primary focus in this book is testosterone because it is the central hormone in the aging process, and understanding what reduced production of it brings about is important for all women. Our other hormones, progesterone and estrogenspecifically the estrogen called estradiolare also important, but these are already well known to women and you can find many books and resources that deal with their role in aging. But until very recently, testosterone has not been thought of as a woman´s hormone, even though it´s an essential part of our makeup. If you´re like many women and you suffer from TDS, you need testosterone. You may or may not need progesterone and/or estrogen, but you do need testosterone.

In Part I of the book, we identify and explain what TDS is. We underscore the importance of testosterone in the lives of women, discuss the history of TDS, explain why TDS isn´t acknowledged as a woman´s problem, and most important, offer an easy and informative questionnaire to help you determine whether you have or might develop TDS. We also introduce you to the "aging cascade" as a whole, and each stage of women´s aging: testosterone loss, progesterone loss, and estradiol loss (also known as menopause).

Part II breaks down the three female hormones involved in the aging cascade that is triggered by the loss of testosterone. As a result of these changes, our hormone-dependent systems begin to deteriorate and age us. We pay special attention to sex and libido as they relate to your hormonesnamely testosterone. In order to understand sexual dysfunction, you need to...