Everything You Need to Know About Testosterone for Women
Looking for testosterone for women because your sex drive took a nosedivewhen you started menopause? Don’t know where to start?
Here you will find the information to help you with a decision.
Testosterone replacement for women is a complicated issue. Understanding at least a little about it is important because this hormone can have some risks and potentially nasty side effects.
Testosterone and Libido
Most women are looking for a replacement because of problems with low sex drive in menopause. But women’s sex drive and libido is a much more complicated issue than just low hormone levels.
During perimenopause when hormone levels are totally out of balance the libido problems are most acute. Post-menopause, when levels balance out at a lower amount, the libido problems may actually get better – but don’t expect a sex-drive like you had when you where 20!
In any case, plenty of menopausal women have a very satisfactory love life despite their low hormone levels.
And higher testosterone levels do not guarantee satisfaction
in the bedroom.
Symptoms such as vaginal dryness due to low estrogen levels, stress or emotional factors are sometimes more important.
Several attempts have been made to produce a female hormone replacement for testosterone but to date no treatment has been approved by the FDA in the US.
One of the problems is that we don’t have reliable data about how much of this hormone is “just enough”. Missing are:
- Standard dosage recommendation for women
- Tests to reliably indicate a surplus or a deficiency of testosterone for women.
Testosterone for women is very complicated on so many levels or we would have an approved and readily available supplement for women by now.
Most doctors advise women to try estrogen therapy first (plus progesterone)and to add testosterone only if the low sex drive does not improve.
What Options do Women Have for Testosterone Replacement?
The most common replacement uses methyltestosterone, a synthetic hormone prescribed mostly in pill form. It does not work like the body-generated testosterone but probably frees up some of the natural hormone. This will lead to symptom improvement.
If the hormone is taken orally, it is metabolized by the liver which can lead to side effects such as heart disease and high cholesterol levels, especially a drop in HDL (good cholesterol). Transdermal applications (cream, patch etc.) do not show the same side effects.
Estratest is a combination of estrogen with testosterone, originally developed for the relief of hot flashes. Some doctors prescribe it off-label for low libido. However, ever since the drug was introduced in the U.S. several decades ago, it has come under a lot of scrutiny and still has not been approved by the FDA.
Proctor and Gamble has a testosterone patch called Intrinsa, which showed clinical evidence for improved sexual activity in women. However, the FDA rejected the approval for the patch in 2004 because of concerns for off-label use.
Natural testosterone is available in cream, gel, pellet or patch as well as by injection.
Gel and creams are readily available through compound pharmacies. If you use a cream or gel, vary the application site to avoid that hair begins to grow in this area. If you use a topical form of the hormone, make sure that children are not exposed to it when you put it on your skin (see sidebar).
Doctors specializing in bioidentical hormone replacement often use pelletsbut this treatment form is more expensive. The pellets are inserted under the skin, usually in the hip, and the hormone is slowly released into the bloodstream over time. Should side effects develop, they are difficult to control until the testosterone levels drop after 6 weeks or so.
Injections are also available from your health care provider, but again, dosage is tricky because the injections are developed for men and not women. The effects of testosterone injections last about 6 weeks.
If you are concerned about the use of testosterone, boost your hormone level naturally by using either maca, licorice root or chaste tree berry. All of these are hormone balancing herbs that have stimulate the endocrine system to produce more of your natural hormones.
How does Testosterone Work for Women?
A little goes a long way when it comes to testosterone for women. Testosterone plays an important role for muscle and bone health, mood, memory and cognitive function. And let’s not forget its major role for a healthy libido and sexual function.
Testosterone for women is produced in theovaries and the adrenal glands. Levels are highest for women in their 20s and drop rapidly after that. Women in their 40s have only about half of the testosterone they had in their 20s.
Have you heard the term “free testosterone”? It is a very complicated biochemical reaction but in a nut-shell here is what this means:
- A specific protein (Sex Hormone Binding Globulin or SHBG) binds itself to the sex hormones circulating in the body. This means thatonly about 1% of the hormone in the body is “free” testosterone, meaning the body can actively use it.
- Estrogen supplements, especially oral estrogen, interfere with the testosterone metabolism. The higher the estrogen levels, the higher the SHBG which can bind to the testosterone, causing the levels to fall.
- With declining estrogen levels in menopause, SHBG levels fall as well. This causes the amount of free testosterone to rise, leading to symptoms such as an increased growth of coarse hairs on the face and other parts of the body, thinning scalp hair and acne and oily skin.
You see, it is not only about the total amount of the hormones in the body. The ratio of the hormones to each other is more important for your symptoms.
Because of the relationship between the estrogen and testosterone for women, you can think about it as a see-saw. But actually the see-saw has a third player that messes up the balance - progesterone. Low progesterone levels interfere with the production of testosterone.
This shows again that the levels of all female hormones are important for a healthy libido. It also explains why the search for a “little blue pill” (like the men have it for their plumbing problem) is so elusive and complicated.
Risks and Side Effects
No matter what kind of hormone is used, synthetic or bioidentical, all testosterone replacement to date is designed for men.(At least in the U.S.. Women in Europe, Canada and Australia have standard treatments available.)
Women how might become pregnant are strongly advised to avoid testosterone as it can lead to birth defects.
So if you and your doctor are considering it, you have to be guided by you symptoms.
If you develop acne or oily skin, a deeper voice, hair growth on face and body and a receding hair line, the dose is too high.
One of the risks of testosterone replacement is a drop in HDL (the good cholesterol) and an increased risk of heart disease.
This is a problem for women in menopause anyway because with declining estrogen levels, HDL levels decline. This is one of the reasons that the risk for heart disease increases so dramatically after menopause.
Additionally, your personality may change dramatically. Testosterone increases not just sexual desire, it also stimulates the drive to become more dominant and aggressive.
And even if your sex drive does not improve, this may or may not be due to low testosterone levels.
A Final Word
Having said all that, testosterone for women is still a good option if it is donecarefully and guided by your symptoms.
Given the high level of demand, it is certainly only a matter of time before a testosterone for women will be approved in the US.
In the meantime you can get bioidentical testosterone through a compound pharmacy. If you think that the potential for side effects is too high, try one of the herbs we have mentioned in this article.
After all, today’s menopausal women are not ready to fade into the sunset and if safe and effective hormone therapy or herbs can help – more power to them.
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