Testosterone is the male hormone produced in the testicles that is responsible for sex drive or libido. Women also make testosterone in their ovaries. After menopause the amount of testosterone is decreased and will affect a woman’s sex drive and libido.
Testosterone, widely and misleadingly understood to be the “male” hormone. Men produce 10 times more testosterone than women, but in their early reproductive years women have 10 times more testosterone than estrogen coursing through their bodies. And many experts now believe that it’s the loss of testosterone, and not estrogen, that causes women in midlife to tend to gain weight, feel fatigue and lose mental focus, bone density and muscle tone — as well as their libido. Testosterone is a woman’s most abundant biologically active hormone. Adequate levels of testosterone are necessary for physical and mental health in both sexes.
Benefits for Women
Women, before, during and past menopause, and sometimes as early as in their mid-30s, invariably have low testosterone levels. Not all women will experience its wide variety of symptoms, like low libido, hot flashes, fatigue, mental fogginess and weight gain. For those who do, and who seek to avoid taking synthetic oral hormones (shown by National Institutes of Health findings to pose an increased risk for breast cancer, heart attack, stroke, blood clots and dementia), bioidentical testosterone (whose molecular structure is the same as natural testosterone) has been shown to be safe and effective.
Some testosterone is converted by the body into estrogen — which partly explains why it is useful in treating menopausal symptoms. For those at high risk for breast cancer, or who have had it, that conversion can be prevented by combining testosterone with anastrozole — an aromatase inhibitor that prevents conversion to estrogen. Nonetheless, testosterone has been shown to beneficial for patients with breast cancer. Preliminary data presented at the American Society of Clinical Oncology have shown that, in combination with anastrozole, testosterone was effective in treating symptoms of hormone deficiency in breast cancer survivors, without an increased risk of blood clots, strokes or other side effects of the more widely used oral estrogen-receptor modulators tamoxifen and raloxifene.
Other benefits cited for testosterone therapy include:
Relieving symptoms of menopause, like hot flashes, vaginal dryness, incontinence and urinary urgency.
Enhancing mental clarity and focus. Researchers at Utrecht University in Holland recently found that testosterone appears to encourage “rational decision-making, social scrutiny and cleverness.”
Reducing anxiety, balancing mood and relieving depression combined with fatigue. Dr. Stephen Center, a family practitioner in San Diego who has treated women with testosterone for 20 years, says the regimen consistently delivers “improvement in self-confidence, initiative and drive.”
Increasing bone density, decreasing body fat and cellulite, and increasing lean muscle mass. Testosterone is the best remedy available for eliminating midlife upper-arm batwings.
Offering protection against cardiovascular events, by increasing blood flow and dilating blood vessels, and against Type 2 diabetes, by decreasing insulin resistance.
Countering the Myths
Some women believe, also incorrectly, that testosterone therapy will produce “masculinizing” traits, like hoarseness and aggression. While the hormone may cause inappropriate hair growth and acne in some women, those side effects can be remedied by lowering the dose.
Testosterone therapy has been approved for a variety of conditions in women as well as men in Britain and Australia. But while the U.S. Food and Drug Administration has approved of testosterone for use in men whose natural levels are low, the agency has not sanctioned it for women, for any reason.
How Treatment Works
Women can take testosterone as a cream, through a patch or in the form of pellet implants, which have the highest consistency of delivery. Synthesized from yams or soybeans, and compounded of pure, bioidentical testosterone, the pellets, each slightly larger than a grain of rice, are inserted just beneath the skin in the hip in a one-minute outpatient procedure. They dissolve slowly over three to four months, releasing small amounts of testosterone into the blood stream, but speeding up when needed by the body — during strenuous activities, for example — and slowing down during quiet times, a feature no other form of hormone therapy can provide.
To determine a patient’s dosage, some doctors measure testosterone levels in the blood.
Side effects of the insertion procedure, which are rare, include infection, minor bleeding and the pellet working its way out or being extruded. Some patients notice improvements within a day or two; others do not perceive benefits for a couple of weeks.
Bottom Line: Since implantation is a surgical procedure, and the pellets are manufactured by a variety of pharmaceutical compounders, who may have varying safety standards, it’s important for women to consult with an experienced, board-certified physician about treatment. Ask your doctor if you feel you are having symptoms related to low testosterone and see if testosterone replacement would be right for you