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Testosterone in Women: How Important is It?

By Jan Nelson MSN, NP-C, ABAAHP

 



     Testosterone is another important hormone necessary for your personal hormonal symphony. Testosterone loss can occur at anytime in a woman’s life. Deficiencies can begin with menopause but can also occur after childbirth. Hormone levels are often ‘reset’ after childbirth, however, not always correctly. Other factors that can lower testosterone levels include: chemotherapy, adrenal stress and burnout, endometriosis, depression, birth control pills, psychological trauma, and statin drugs. Deficiencies occur earlier and initially at a greater rate in women than in men. High amounts of testosterone are consumed thereby depleting androgen levels with intense physical activity such as long distance running as well as other vigorous sports.

     An optimal level of testosterone improves mood and assertiveness, reduces depression and anxiety, improves bone density, muscle size and strength, and enhances libido. It helps maintain memory, however in a woman, effective levels of estrogen must also present. It helps stop the skin from sagging, and decreases excess body fat. Symptoms of low testosterone include: muscle wasting, weight gain, fatigue, low self-esteem, decreased HDL cholesterol levels, dry and thin skin with poor elasticity, thinning and dry hair, droopy eyelids, sagging cheeks, thin lips and anxiety. Based on known effects of androgens, it is likely that long-term testosterone deficiency predisposes women to depression, anxiety disorders, joint disorders (osteoarthritis, rheumatoid arthritis), osteoporosis and atherosclerosis.

     Approximately 20% - 25% of women have increased testosterone levels at menopause. Polycystic ovarian syndrome can also cause a woman to have too much testosterone. Symptoms of too much testosterone include: anxiety, depression, fatigue, hypoglycemia, salt and sugar cravings, agitation and anger, facial hair, acne, insulin resistance, weight gain, hair loss or unwanted hair growth, and increased risk of heart disease.

     Testosterone replacement therapy can be accomplished via transdermally or pellet therapy. With transdermal application it is important to rotate sites otherwise hair growth at that site can occur. Testosterone replacement works slowly, emotional and sexual changes are noticeable during the second, third and fourth months of treatment. Improvements in muscle mass and bone density take about four to six months. Diet changes can also help improve testosterone levels, ie., avoidance of some grains, sugars and alcohol while increasing lean animal protein. An optimal diet plan to help improve testosterone in women is the Paleolithic diet.

     Your testosterone levels should always be tested prior to initiating any kind of replacement therapy as it can influence the activity of other hormones. Continual monitoring should be done every 4-5 months to ensure all hormones are at appropriate levels. Testosterone can metabolize into estradiol which can result in higher levels, which can then cause an imbalance of the estrogen/progesterone ratio. Thyroid, growth hormone and dihydrotestosterone can also be affected.

     Each individual is unique and thus any hormone replacement therapy should be customized to that person. There is no ‘cookie-cutter’ recipe for hormone replacement, one size does not fit all. There are many variables to consider in each individual symphony.

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