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August 5, 2013

Low Testosterone In Women Is Not Healthy

low testosterone in womenOur response to this article is of course women should consider testosterone replacement therapy if their testosterone levels are suboptimal. And the article suggests that as well. Every man, woman, and child makes testosterone and replacing it is really no different than it would be for replacing more common hormones like thyroid.

Much like men, women experience a drop in testosterone levels by the time they reach their mid-30s. And, for those women experiencing symptoms of low testosterone, testosterone replacement has been shown to be beneficial. Some women remain skittish about going on estrogen and/or progesterone replacement, and for them testosterone replacement has been an excellent alternative in alleviating post-menopausal symptoms.

What are the signs and symptoms of low testosterone in women?

There are receptors for testosterone throughout the body. So low testosterone in women can have wide-spread effects on a woman’s health. Some of the signs and symptoms of low testosterone in women are similar to those in men.

  • Lack of energy and/or motivation
  • Depression/anxiety/mood swings
  • Sleep difficulty
  • Loss of muscle mass/fat gain
  • Low libido or sex drive
  • Hot flashes
  • Brain fog
  • Urinary incontinence

What conditions are associated with low testosterone levels in women?

  • Depression
  • Endometriosis
  • Chemotherapy
  • Birth control pills
  • Emotional stress
  • Statin drugs
  • Adrenal burnout

Cholesterol is needed to make our sex hormones including testosterone, progesterone, and estrogen. Lowering cholesterol too much with statin drugs can adversely affect the production of these hormones and vitamin D.

As Dr. Rebecca Glaser says, “Testosterone is our most abundant biologically active hormone. Adequate levels of testosterone are necessary for physical and mental health in both sexes.”

Women have testosterone levels that are about one-tenth that of men. A certain amount of testosterone in men and women is converted into estrogen – one reason why testosterone can be effective in the management of post-menopausal symptoms in women.  This conversion can be blocked allowing women at risk for estrogen-sensitive cancers to receive testosterone replacement. And, testosterone has been shown to be safe in women with breast cancer.

How is testosterone administered in women?

The same testosterone treatment options available to men are available to women, too. Testosterone can be prescribed in the form of daily application of transdermal creams, weekly testosterone injections, or implantation of testosterone pellets every three to four months. It is largely up to the individual.

There are pros and cons to each treatment option. In men transdermal creams sometimes fail to give adequate blood levels of testosterone. But, since women require lower blood levels this is rarely a problem in women.

Creams are relatively convenient, too. There seems to be movement towards pellets, but we do not see much upside to them. It requires an in-office procedure (adding to the expense – good for the doctor, not so good for the patient).

Activity has to be restricted for a few days. Plus, adjusting the dose to achieve optimal benefit is less flexible than it is for creams and injections. Consistent blood levels of testosterone are reported as the main advanatage of pellets.

But, all our hormones naturally fluctuate some throughout the day with levels of many hormones being higher in the morning and lower in the evening. At this point I’m not convince that having consistent levels throughout the day is desirable as it theoretically may lead to hormone receptor insensitivity (leading to ever increasing doses) – but I may be wrong.

For more informantion on testosterone use in women see this paper.



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Dr. Joe Jacko

Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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