Testosterone is a critical hormone in Women’s Health that is gaining popularity: It may be the punch you are missing.
Why is Testosterone critical for Women’s Health?
Testosterone is the number #1 sex hormone in both men and women. There is a renewed interest in sex hormones beyond estrogen with prescriptions of testosterone nearly doubling. It’s true that women have 1/10 th of the testosterone of men but still packs a powerful punch. It may be the key to Women’s Health and Wellness.
In women testosterone is a sex hormone made in the ovary. The adrenal gland also makes DHEA (another sex hormone) that is also converted into testosterone in the body. As we age and approach menopause (time when our ovaries stop working), the amount of circulating testosterone drops to 75 % of our prior levels. This causes mood swings, lack of energy, low sex drive, anxiety and difficulty sleeping at night. These symptoms are signs of low “T,” but may be missed by doctors.
Current guidelines restrict the use of testosterone in women to hypoactive sexual desire disorder (HSDD) or low sex drive despite studies saying low “T,” levels can negatively impact mood, energy, sleep, and bone density. Low levels may even cause “brain” fog. However, it is important that if testosterone is prescribed, it’s prescribed safely when other hormonal treatments fail or partially relieve symptoms.
Time magazine shares a woman’s journey after starting TRT or testosterone replacement therapy-“the effects were very dramatic,” stopping brain fog, anxiety and memory problems. She goes on to say, ” it’s the biggest quality-of-life improvement I’ve ever made for myself.”
Celebrities like Halle Berry credit testosterone for giving libido back and having more energy: “I noticed a difference.” Kate Winslet has also sung the hormone’s praises.
How to treat low testosterone levels in women?
There are more than 30 different FDA approved testosterone products available for men. Testosterone comes in oral, topical transdermal, gel, creams, injectables and “pellets,” that are implanted directly under the skin.
In the U.S., there are no prescription testosterone medications approved for women but may be prescribed “off label,” at very low doses or more commonly mixed or compounded by specialty pharmacies in the form of 1 % testosterone cream that can be applied to the buttock, or thigh. In Australia, there is a special prescription testosterone made just for women called AndroFeme (1% testosterone) used to treat “low sex drive.”
Unlike the U.S. the British Medical Society (BMS) acknowledges that low testosterone is a true deficiency worth treating in women. BMS also acknowledges that testosterone therapy should be considered more broadly for women (not just for low libido) when conventional hormone replacement with estrogen/progesterone fails to relieve symptoms.
The global consensus for women with symptoms of low libido that is “life altering,” is to first try traditional hormone replacement therapy (HRT) with estrogen or estrogen/progesterone and if fails consider testosterone creams usually 1 % testosterone applied three times a week to the thigh or buttock, or even testosterone pellets one application (dose will vary but start with low dose) implanted every 3-4 months.
How do I know if my testosterone level is low?
The best way to know if your “T,” levels are low is get a blood test for total testosterone. It can be combined with other blood tests for greater accuracy including a free androgen index (shows bioavailable testosterone), or with SHBG or sex hormone binding proteins.
Total testosterone under 20 ng/dl in post-menopausal women is considered low “T.” This is especially true if you are a woman over the age of 50 experiencing low sex drive, or lack of arousal that has not improved with traditional female hormonal replacement therapy (HRT).
Scientific data says low sex drive is the primary reason for doctors to start testosterone treatment in women in Europe and the U.S. Unfortunately, there is lack of evidence that it helps with other symptoms despite widespread antidotal reports to the contrary as many women report more energy and vitality, sleeping better, weight loss and improved quality of life with its use. There are reports that testosterone may be helpful in migraine headaches, loss of unwanted body fat, bone dynamics and building muscle strength.
What are side effects of testosterone in women?
The most common side effects of testosterone in women are growth of facial hair, and acne both considered the “male,” or androgen like side effects. It is usually minimal and most women do not stop use because of it. One of the health concerns is that it may lead to heart attacks and cancer including breast and uterine, but some studies show it may even decrease the risk of breast cancer but is still recommended to use with caution. It does not seem to increase the risk of heart attacks when used appropriately or increase the risk of prostate cancer in men when used in men at low risk.
According to the European Society of Medicine , “Testosterone: Strong enough for a Man but made for a Woman.” there is mounting evidence that testosterone pellets or combined estrogen/testosterone may be protective against certain types of breast cancer and a critical part of women’s health and wellness.
It’s important for safety to follow testosterone levels, liver tests, and hemoglobin with the goal to use the lowest dose possible to relieve symptoms and improve the quality of life.
Can I raise my testosterone levels naturally?
Regular exercise especially weight training can raise testosterone levels naturally. A balanced diet can also help including a healthy number of proteins and fats. High levels of stress can also affect testosterone so important to destress with meditation, yoga, exercise and get lots of sleep as sleeping less than 5 hours a night may lower testosterone levels.
Vitamins rich in Magnesium, Zinc and Vitamin D may boost levels. There are reports that certain herbal supplements like fenugreek can raise levels but consult your doctor first to see if these are right for you.
Any last advice on Women and Testosterone?
It is time to debunk the Myths of testosterone and make it a real part of Women’s Health. Testosterone is not just a male hormone; it is the most abundant active biological hormone in women that decreases as we age and may need to be supplemented. At very low levels it may negatively impact sexual health, and wellness but also numerous case reports and studies say it may impact emotional and mental well-being, muscle mass, and bone dynamics.
Its safety profile in women has not been studied as closely as in men but remains safe with primary side effects including acne and facial hair although there have been case reports especially with the pellet formulation (due to supratherapeutic rises in levels) with neuropsychiatric instability. It is important to discuss the risk and benefits carefully with your doctor and to review if there are contraindications to its use including pregnancy, breast, or uterine cancer, liver disease or active heart disease.
If you are experiencing side effects of low testosterone and have failed traditional hormonal replacement therapy, contact your doctor about testing for low testosterone especially if you are perimenopausal or menopausal. It may just be the punch you need, and it’s made for women.
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