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Q. I started hormone replacement therapy (HRT) with estradiol/testosterone pellets in my hips and compounded progesterone capsules. For a while, I felt like a teenager going through puberty. That feeling calmed down once we adjusted the dosage.
I’d had osteopenia in my right hip for years, but after five years of HRT, my DEXA scan was normal: No more osteopenia! The testosterone definitely affects how I feel overall and keeps my libido working as it should. I would be a basket case without these hormones!
A. Physicians have long recognized that hormone replacement therapy with estrogen can benefit women’s bones. Testosterone, which is a building block for estrogen, has not been well studied for postmenopausal women.
Investigators analyzing data from the National Health and Nutrition Examination Survey (NHANES 2011-2016) found a link between testosterone levels in middle-aged women and bone mineral density in their spines (Scientific Reports, Sept. 30, 2022). Nordic researchers have reported that low testosterone levels in women are associated with a higher chance of forearm fractures (Calcified Tissue International, November 2024).
A study presented at the 2026 annual meeting of the Menopause Society indicates that estrogen plus testosterone can help build bone back in the spine. While estrogen alone helps stabilize bone, this hormone combination actually seems to improve bone mineral density.
Q. When my doctor switched me from sertraline to Wellbutrin XL for my depression, I felt great. I had gained a lot of weight and entirely lost my sex drive on sertraline. My wife was delighted with how well I felt on Wellbutrin.
Then the pharmacy switched to generic bupropion. I didn’t think that would be a problem, but I was wrong. Within a week, I began feeling more depressed than ever. I had an upset stomach and anxiety that I had not experienced before. I was even having palpitations. As soon as I switched to a generic, it was as if my train went off the tracks.
I have read that others have had problems with generic Wellbutrin (bupropion). What can I do?
A. According to GoodRx.com, generic bupropion costs less than $10 for a month’s supply. Brand-name Wellbutrin XL 300 milligrams could cost more than $3,000. The same brand-name medicine from an online Canadian pharmacy might cost around $180 for a three-month supply.
Sadly, Customs and Border Protection has announced that it will shut down pharmaceutical imports in less than three months. This may interfere with patients’ ability to purchase their brand-name drugs from Canada.
You can learn more about bupropion and other antidepressants in our “eGuide to Dealing with Depression.” This online resource is located under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. I read in your column that someone used Biofreeze for restless legs syndrome. I have tried that and it works well. Many other solutions let me down. This rolls on and is quick and easy to use. Thank you for alerting me.
A. Restless legs syndrome (RLS) affects millions of people. They often describe it as a “creepy crawly” feeling inside their legs. It can become especially unpleasant in the evening while watching TV or trying to sleep.
Biofreeze contains menthol. When it is applied topically, it appears to stimulate specialized nerve cells containing transient receptor potential (TRP) channels. We suspect that could be the mechanism to explain how this pain reliever works to ease RLS symptoms.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”