Testosterone is manufactured in women by the ovaries and adrenal glands, enhances libido and sexual response. It strengthens ligaments, builds muscle and bone, assists brain function, and is associated with assertive behaviour and a sense of well-being. The level of testosterone influences both stamina and restful sleep. It has a protective effect against cardiovascular disease in both men and women. It is considered to help prevent breast cancer in women.
Testosterone for Women
Testosterone (in both sexes) fires libido, well-being, confidence, and zest for life.
Contrary to many medical texts, it has been shown that the main source of young women’s testosterone is from skin, muscles, body fat, and brain. These areas manufacture more than the ovaries and adrenals combined.
Part of natural aging is a steady decline in all hormones. However when the testosterone level in females is considered, only a small amount is present pre-menopausally (0.5-2.6nmol/L being the normal range), and thus when levels drop they do not have to fall far before deficiency signs are there. Testosterone levels normally start to fall in the decade before menopause but drop dramatically when surgical menopause (hysterectomy) is performed.
The periods of depression, associated with both of these, is often directly related to the low testosterone levels, as this hormone is a natural anti-depressant, especially in females as only a low-level is present optimally. When small amounts of testosterone are reintroduced this black cloud of depression is often lifted dramatically.
It is of interest to consider that the loss of libido associated with low levels of testosterone are often put down to advancing age as the common belief that women do not need testosterone is still held, as there are no menopausal regimes available commercially that contain testosterone. Thus, the loss of libido manifests itself as depression as part of the zest for life and associated confidence and well-being is no longer apparent. Current medical treatment is often by way of differing tranquillising drugs to treat effect rather than cause. Statistics show that menopausal women on these classes of drugs are much higher than their younger sisters. Wouldn’t one think that in older years worries and stress should be reduced?
Apart from physically feeling better testosterone plays an important part in the maintenance of bone mineralization and in protection against heart disease and atherosclerosis. Some evidence suggests that testosterone replacement can reduce the risk of serious heart disease. It has also been shown that testosterone actively decreases cholesterol levels and improves circulation.
Aging is primarily due to tissue breakdown, which is a catabolic process, and as testosterone is an anabolic hormone it helps to, if not reverse it, at least slows down this process. It promotes the building up of body tissues like muscle and bone, and a lot of research has been done in the role of testosterone in osteoporosis. It has not yet been established if testosterone acts directly on bone, via receptors, or as precursors for oestrogen biosynthesis, but either way it is known that its presence is essential.
In my experience treating menopause and pre menopause over the last 10 yrs I have to say that clinically around 70% of women experience an improvement in libido and energy levels when prescribed a low dose of Testosterone. Around 30% of women seem to have no change in their libido.
Most common side effects relating to Testosterone therapy are increase in facial hair and sometimes acneiform rash in the face and scalp. These side effects occur rarely and are reversible in stopping the Testosterone.
With thanks from Dr MacGeachy.
Testosterone therapy in women: a review.
Department of Medicine, Internal Medicine, Endocrinology, Cedars-Sinai Medical Center, Plaza Level, Los Angeles, CA 90048, USA.
Female sexual dysfunction is a complex problem with multiple overlapping etiologies. Androgens play an important role in healthy female sexual function, especially in stimulating sexual interest and in maintaining desire. There are a multitude of reasons why women can have low androgen levels with the most common reasons being age, oophorectomy and the use of oral estrogens. Symptoms of androgen insufficiency include absent or greatly diminished sexual motivation and/or desire, that is, libido, persistent unexplainable fatigue or lack of energy, and a lack of sense of well-being. Although there is no androgen preparation that has been specifically approved by the FDA for the treatment of Women’s Sexual Interest/Desire Disorder or for the treatment of androgen insufficiency in women, androgen therapy has been used off-label to treat low libido and sexual dysfunction in women for over 40 y. Most clinical trials in postmenopausal women with loss of libido have demonstrated that the addition of testosterone to estrogen significantly improved multiple facets of sexual functioning including libido and sexual desire, arousal, frequency and satisfaction. In controlled clinical trials of up to 2 y duration of testosterone therapy, women receiving androgen therapy tolerated androgen administration well and demonstrated no serious side effects. The results of these trials suggest that testosterone therapy in the low-dose regimens is efficacious for the treatment of Women’s Sexual Interest and Desire Disorder in postmenopausal women who are adequately estrogenized. Based on the evidence of current studies, it is reasonable to consider testosterone therapy for a symptomatic androgen-deficient woman with Women’s Sexual Interest and Desire Disorder.
- [PubMed – indexed for MEDLINE]
Maturitas. 2013 Feb 1. pii: S0378-5122(13)00012-1. doi: 10.1016/j.maturitas.2013.01.003. [Epub ahead of print]
Testosterone therapy in women: Myths and misconceptions.
Millennium Wellness Center, 228 E. Spring Valley Road, Dayton, OH 45458, USA; Wright State University Boonshoft School of Medicine, Department of Surgery, 3460 Colonel Glenn Highway, Dayton, OH 45435, USA. Electronic address: email@example.com.
Although testosterone therapy is being increasingly prescribed for men, there remain many questions and concerns about testosterone (T) and in particular, T therapy in women. A literature search was performed to elucidate the origin of, and scientific basis behind many of the concerns and assumptions about T and T therapy in women. This paper refutes 10 common myths and misconceptions, and provides evidence to support what is physiologically plausible and scientifically evident: T is the most abundant biologically active female hormone, T is essential for physical and mental health in women, T is not masculinizing, T does not cause hoarseness, T increases scalp hair growth, T is cardiac protective, parenteral T does not adversely affect the liver or increase clotting factors, T is mood stabilizing and does not increase aggression, T is breast protective, and the safety of T therapy in women is under research and being established. Abandoning myths, misconceptions and unfounded concerns about T and T therapy in women will enable physicians to provide evidenced based recommendations and appropriate therapy.
Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
- [PubMed – as supplied by publisher]
Maturitas. 2002 Apr 15;41 Suppl 1:S25-46.
The impact of testosterone imbalance on depression and women’s health.
Department of Gynecology and Obstetrics, Gynecological Oncology, University Hospital, Hufelandstrasse 55, D-45122, Essen, Germany. firstname.lastname@example.org
Women suffer more often from depression than males, indicating that hormones might be involved in the etiology of this disease. Low as well as high testosterone (T) levels are related to depression and well-being in women, T plasma levels correlate to depression in a parabolic curve: at about 0.4-0.6 ng/ml plasma free T a minimum of depression is detected. Lower levels are related to depression, osteoporosis, declining libido, dyspareunia and an increase in total body fat mass. Androgen levels in women decrease continuously to about 50% before menopause compared to a 20-year-old women. Androgen levels even decline 70% within 24 h when women undergo surgical removal of the ovaries. Conventional oral contraception or HRT cause a decline in androgens because of higher levels of SHBG. Hyperandrogenic states exist, like hirsutism, acne and polycystic ovary syndrome. Social research suggests high androgen levels cause aggressive behavior in men and women and as a consequence may cause depression. Higher androgen values are more pronounced at young ages and before and after delivery of a baby and might be responsible for the “baby blues”. It was found that depression in pubertal girls correlated best with an increase in T levels in contrast to the common belief that “environmental factors” during the time of growing up might be responsible for emotional “up and downs”. T replacement therapy might be useful in perimenopausal women suffering from hip obesity, also named gynoid obesity. Abdominal obesity in men and women is linked to type 2 diabetes and coronary heart diseases. Testosterone replacement therapy in hypoandrogenic postmenopausal women might not only protect against obesity but also reduce the risk of developing these diseases. Antiandrogenic progestins might be useful for women suffering from hyperandrogenic state in peri- and postmenopause. Individual dosing schemes balancing side effects and beneficial effects are absolutely necessary. Substantial interindividual variability in T plasma values exists, making it difficult to utilize them for diagnostic purposes. Therefore a “four-level-hormone classification scheme” was developed identifying when estradiol (E) and T levels are out of balance. (1) Low E-low T levels are correlated with osteoporosis, depression, and obesity; (2) high E-low T with obesity, decreased libido; (3) high T-low E levels with aggression, depression, increased libido, and substance abuse; (4) high E-high T with type II diabetes risk, breast cancer and cardiovascular risk. Testosterone delivery systems are needed where beneficial and negative effects can be balanced. Any woman diagnosed for osteoporosis should be questioned for symptoms of depression.
- [PubMed – indexed for MEDLINE]