AI Summary
5 min readThe Truth About Testosterone in Women
We have a steroid language problem. That is the central argument Dr. Gabrielle Lyon makes in this episode, and she means it literally: the word "steroid" currently covers your asthma inhaler, the cream you put on poison ivy, the cholesterol in your blood, and a vial someone's cousin sold at the back of the gym. These things are barely related, yet they carry the same label and the same stigma. The consequence, she argues, is that women who could benefit from monitored, physiological-dose testosterone are scared away by a word they associate with bodybuilders and scandals, while other women pick up unverified synthetic compounds from gray-market sources thinking they are "just hormones."
What a Steroid Actually Is
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What you'll learn
- 1 (00:00) **The Steroid Language Problem** - Dr. Gabrielle Lyon opens by diagnosing the core issue: the word "steroid" is used for everything from asthma inhalers to gym vials, creating dangerous confusion.
- 2 (03:40) **What a Steroid Actually Is: A Shape, Not a Drug** - Dr. Lyon explains the fundamental chemistry: a steroid is four carbon rings (three six-sided, one five-sided), and what matters is what hangs off that frame.
- 3 (05:32) **The Anabolic-Androgenic Spectrum** - Testosterone is more androgenic; nandrolone is more anabolic, but both work through the same androgen receptor.
- 4 (06:14) **A Quick History: Medicine and Abuse Ran in Parallel** - Testosterone was first isolated in the 1930s, and its first intended use was medical: to treat people wasting away from disease.
- 5 (08:42) **Testosterone Is a Steroid — And Women Make It** - Every adult body makes testosterone, including women, at a lower set point.
- 6 (10:54) **Existing Guidelines for Testosterone in Women** - Published guidelines (2021, 2019) support testosterone in postmenopausal women for hypoactive sexual desire disorder (HSDD).
- 7 (12:31) **What These Molecules Do Inside the Cell** - These fat-soluble molecules pass through the cell membrane, bind to the androgen receptor, travel to the nucleus, and change which genes are read.
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Guests on this episode
Show Notes
You say "steroids" and picture a baseball scandal, a jacked guy, a bad spray tan. But cortisol is a steroid. Estrogen is a steroid. The cream you put on poison ivy is a steroid. The word covering all of them is also covering testosterone therapy for women, and that collision is quietly costing women muscle and bone they don't have to lose.
In this solo episode, prompted by a magazine interview on steroid use in women, Dr. Gabrielle Lyon breaks down what these molecules actually are, what they do inside a cell, and why the line between medicine and misuse has nothing to do with the word "steroid."
Study and References:
The Effects of Supraphysiologic Doses of Testosterone on Muscle Size and Strength in Normal Men (Bhasin et al., NEJM 1996) - https://pubmed.ncbi.nlm.nih.gov/8637535/
Testosterone Enhances Estradiol's Effects on Postmenopausal Bone Density and Sexuality (Davis et al., 1995) - https://pubmed.ncbi.nlm.nih.gov/7616872/
Global Consensus Position Statement on the Use of Testosterone Therapy for Women (2019) - https://pubmed.ncbi.nlm.nih.gov/31498...
ISSWSH Clinical Practice Guideline for the Use of Systemic Testosterone for HSDD in Women (2021) - https://pubmed.ncbi.nlm.nih.gov/33814...
The Global Epidemiology of Anabolic-Androgenic Steroid Use: A Meta-Analysis (Sagoe et al., 2014) - More from this podcast