The Truth About
Sexuality, Menopause
and Testosterone
"Menopause is a journey through poorly charted waters and most physicians approach the possibility of prescribing supplementary testosterone for women suffering symptoms of its deficiency with the resistance and ignorance of sailors who believed the earth was flat, and that if they proceeded to sail on, they would fall off."
Author, Susan Rako, M.D.
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"By combining both her personal and professional experience of libido changes at menopause, Susan Rako has created a book, The Hormone Of Desire, that can help thousands of women get the healthcare and attention they need and deserve."
Christiane Northrup, M.D.
"Women's Bodies, Women's Wisdom"
"Today, women of all ages have come to appreciate their potential for a fulfilling and enduring sexual life. Dr. Susan Rako has researched and written a landmark book... Gracefully, intelligently, and sensitively written, The Hormone Of Desire began as Dr. Rako's own story, a story of challenge, inspiration and determination ..."
From The Introduction by
Barbara Bartlik, M.D. and
Helen Singer Kaplan, M.D., Ph.D.
"In her popular book, The Hormone of Desire, Susan Rako, a psychiatrist in Boston, suggests that there's a sensitive 'window' of dosage that works best for women. In her own experience, she found that if the dose is too high, women may feel worse. On the other hand, on a much lower dose, they regain their sense of well-being and libido."
Susan Love. M.D.
"Dr. Susan Love's Hormone Book"
"Rako, author of The Hormone of Desire (Harmony Books) chronicles her own experience and research on testosterone. Eight years ago ... she tried herbs, acupuncture, homeopathy and massage, but to no avail. She still felt 'flat.' Then she went on estrogen replacement therapy, but after a month she felt 'deader' than ever. Rako began doing her own research. She discovered that her loss of libido might be due to a lack of testosterone...(After low-dose testosterone supplement), she said she 'felt like herself again... and still feels great.'"
New York NEWSDAY
Feb. 13, 1996
"Dr. Susan Rako, speaker at the annual meeting of the American Psychiatric Association ... psychiatrist and author of a popular book about testosterone for the lay public and physicians, The Hormone of Desire: The Truth About Sexuality, Menopause, and Testosterone (New York :Harmony Books, 1996) ... (discussed) testosterone deficiency .... an often overlooked problem that can turn down the sexual thermostat and dull sexual response far more dramatically than declining estrogen levels. This is a problem in many perimenopausal and menopausal women, as well as cancer survivors with diminished or absent ovarian function."
Ob/Gyn News
Internal Medicine News
Clinical Psychiatry News
August/September 1997
"In her groundbreaking book, The Hormone of Desire: The Truth About Sexuality, Menopause, and Testosterone, Dr. Susan Rako wrote that after her physician placed her on estrogen and progesterone, she actually felt worse. Unable to find the appropriate treatment from a physician, Dr. Rako devoted the next five years to doing research on women, hormones, and menopause. She ultimately learned that what she really needed to do was add another hormone to her hormone cocktail, and that hormone was testosterone."
William Regelson, M.D.
"The Super-Hormone Promise"
"I recently revisited The Hormone of Desire: The Truth About Testosterone, Sexuality, and Menopause, and what remains striking is the clarity and courage with which you challenge long-standing misconceptions about women's hormonal health. By grounding your arguments in both clinical experience and rigorous engagement with the medical literature, you offer a perspective that is not only informed but deeply necessary.
What sets this book apart is its refusal to oversimplify. You acknowledge that testosterone deficiency in women is real, nuanced, and highly individual, requiring thoughtful assessment rather than blanket assumptions or fear-driven avoidance. Your discussion of dosage, variability, and the absence of a simple dose-response curve underscores an important truth: women's bodies demand individualized care, not one-size-fits-all protocols.
I was particularly struck by how effectively you address the cultural and professional resistance surrounding testosterone treatment for women. By naming the discomfort and bias that still exist, especially within gynecology and endocrinology, you open space for more honest, evidence-based conversations about sexuality, desire, mood, and vitality during menopause. The book does not sensationalize desire; instead, it restores it as a legitimate component of psychological and physical well-being.
Your dual lens as a psychiatrist and medical thinker gives the work exceptional balance. Sexuality is treated not as an isolated symptom, but as an integrated aspect of identity, mental health, and relational life. In doing so, The Hormone of Desire speaks not only to clinicians, but also to women who are searching for language, validation, and informed advocacy around changes they are experiencing and too often dismissed.
Importantly, the book empowers both sides of the clinical relationship. Physicians are encouraged to engage more deeply and thoughtfully with their patients' experiences, while readers are equipped with knowledge that allows them to participate actively in decisions about their own care. That combination of authority and accessibility is one of the book's enduring strengths.
Thank you for writing a book that asks difficult questions and refuses to reduce women's desire to pathology or taboo. The Hormone of Desire continues to matter because it insists on complexity, individuality, and honesty, qualities that are still too rare in discussions of women's hormonal health. I would be glad to help support its continued reach and relevance."
Anna Griggs
1/29/2026
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