Testosterone in Women
Testosterone therapy is not a men’s only club. We see lots of low testosterone (T) treatments, or “Low t treatment,” clinics – but the emphasis is on men. Testosterone replacement therapy (TRT) can be a low testosterone cure for both men and women. Testosterone has many important functions in female physiology. When the levels of testosterone drop, those important functions can suffer. This article will serve to explain what low testosterone treatments are available for women.
While it may seem like an unlikely treatment for menopause, low testosterone medication is used safely and effectively as one of the natural remedies for low testosterone and menopause symptoms. T treatment can be a beacon of hope for many women who feel blindsided when they step into peri- and menopause.1-4
As we age into our 30s, the natural hormonal decline is gradual but relentless. Because it is typically a slow decline, women can be wooed into complacency about feeling – terrible. Unfortunately, women and even their healthcare providers often don’t recognize that their exhaustion, aching bones, weight gain (~ over 20 lbs), brain fog, and painful sex are caused by low estrogen, progesterone, and testosterone. TRT can help relieve all of these testosterone-related symptoms quickly and safely.
Symptoms of Low Testosterone in Women
When it comes to sex hormones, most people associate estrogen and progesterone with women, and men are all about testosterone. But that is not accurate. Both men and women produce and need all three hormones.
Men make testosterone, progesterone, and estrogen in their testicles and adrenal glands. It is similar to how women naturally make progesterone, estrogen, and testosterone in their ovaries and adrenal glands. When your estrogen and progesterone levels start to drop, testosterone drops too. Maintaining appropriate levels of hormones is critical to both women’s and men’s overall health.
Testosterone levels peak in a woman’s ’20s and by the time she is 50, her testosterone levels have likely decreased by about 50%.1,2,3 Testosterone drops in your 20s and instead of leveling off, it only accelerates its downward momentum every year. When women’s testosterone levels fall, it can lead to a number of distressing symptoms such as:3
Low sexual desire, arousal, orgasm
Reduction in general quality of life
Tiredness & Fatigue
Mood Changes & Depression
Skin dryer and thin
Loss of muscle mass
Changes in breast tissue
Treatment for Low Testosterone in Women
Menopausal symptoms such as hot flashes and night sweats can dramatically reduce a woman’s quality of life. Hormone replacement therapy (HRT) is used to ease these symptoms. Research has shown that giving testosterone (T) supplements may ease menopausal symptoms, including hot flashes, sleep problems, irritability, and fatigue.3
You’ve probably seen those ads targeted to men with “low T,” a drop in testosterone level that occurs with age. Women’s bodies also suffer from the drop in T, and yet you won’t see the same “low T” sales pitches directed to women, in part because no testosterone product is FDA-approved for women.
Still, women deserve the right to choose to replace testosterone, not only to enhance their sex drive, but also to improve their muscle strength, bone density, or mood. Studies of postmenopausal women have found that taking T increases sexual desire and pleasure.3
There are currently no testosterone products for female use licensed in the US. So, some women will try to use products licensed for men, but there is a better way to have your testosterone replaced. Taking DHEA is a preferable method to add T overusing products designed for men and cutting the dose. Taking a man’s prescription is not legal and could lead to taking too much testosterone.
DHEA or Dehydroepiandrosterone (also known as androstenolone) is a chemical that can be broken down to become testosterone. DHEA, a steroid precursor (also called prohormone), is a natural substance that your body can convert into testosterone and is one of the most abundant circulating steroids in humans.
DHEA is naturally produced in your adrenal glands, ovaries, and brain.5 By providing DHEA to women who are low in T, they can increase their T levels by adding DHEA which converts to T. We use DHEA, sometimes in combination with anastrozole, to gently and safely return testosterone to normal levels. DHEA is a testosterone precursor that the body naturally breaks down into a combination of estrogen and testosterone.
Anastrozole is a medication that can block the conversion of DHEA to estrogen. By adding anastrozole, more of the DHEA ends up as testosterone. This can give a slightly higher testosterone boost for women that need a bit more testosterone.
Other Possible Ways to Increase T Levels:13
Exercise Regularly and Lift Weights.
Eat More Beans, Protein, and Nuts that can stimulate T production (eggs, lentils, almonds, coffee).
Get Some Sun and/or Take a Vitamin D Supplement.
Take Vitamin and Mineral Supplements.
Taking amino acid supplements may help raise T levels, but evidence in women is lacking.
Keeping a Healthy Weight is always a good idea.
Sleep 7-8 Hours Every Night. Sleep deprivation affects all hormones including testosterone.
Have Sex. Some research indicates that having sex helps raise your testosterone levels.
Manage Stress Hormone Cortisol Levels. High cortisol can block T production.
Reduce Alcohol Consumption. Alcohol decreases the rate that testosterone is made.
Testosterone’s Important Roles
Let’s take a look at some of the most significant roles testosterone plays in women:
Personalized hormone treatments. For you.
Sex & Vaginal Health
Testosterone regulates the desire to have sex. Testosterone levels in women help drive libido, sexual response, orgasm, and overall sexual satisfaction.5 While decreased sex drive or libido can happen due to lots of reasons, when you are a woman over the age of 40, it is the low testosterone levels that have been found to be a major risk factor in low libido.5 Studies have shown that by replacing T to normal youthful levels you can return your normal sexual desire.
Beyond just desiring sex more, low testosterone levels can reduce the size and sensitivity of your clitoris which can make it more difficult to reach orgasm or even lead to loss of orgasm potential. Replacing testosterone to normal levels can reverse these changes. T helps with the resilience of the vaginal and the natural lubrication which can further improve the experience and decrease associated pain. Women who replace testosterone levels report increased overall sexual satisfaction and increased quality of life.
Testosterone is important for maintaining lean muscle mass.5,6 Lean muscles are muscles that do not have a lot of fat around or within them. You want to maintain your lean muscle because it will reduce the risk of injury, strengthen your core, and protect your bones.
If your T is low, you can exercise the same amount (or more) and will see less improvement in lean muscle mass than a woman with normal testosterone. When you improve your body’s response to exercise by increasing T, you will likely notice the benefits.
Because testosterone is responsible for increased muscle mass and a leaner body mass, you can better control your weight and increase your energy levels. Research studies show that T treatment can decrease overall body fat and increase muscle tone and strength.
By increasing your muscle mass, you are increasing your metabolism. Weight loss occurs when the amount of calories consumed is less than the amount of calories burned. As T drops with age, we require fewer calories. Returning testosterone to normal levels can reverse this trend.
Replacing low testosterone to normal levels can also improve energy and decrease fatigue.6,7 Women with low testosterone are more prone to experience low energy and fatigue. Returning testosterone to normal levels will help to increase overall energy levels and can help you feel better. Think about how much energy you had when you were in your 20s.
One of the unfortunate parts of aging is the loss of energy and the body’s ability to refresh itself. One of the reasons we lose so much energy as we age is because of falling testosterone levels. Testosterone stimulates red blood cell production and can stabilize your iron levels.11 Red blood cells and ironwork together to carry oxygen to your cells. When you aren’t able to carry enough oxygen you can start feeling easily fatigued. Returning testosterone to normal levels will increase the body’s ability to refresh and increase overall energy levels.4,6
Returning normal energy levels via testosterone replacement can have a profound impact on your quality of life. Decreasing fatigue can improve mood, boost confidence, and allow for activities that increase happiness.
Normal testosterone levels in women are key to brain health. Clarity of thought, improved concentration, and overall cognition come with normal T levels. When T levels drop brain fog can be the result. Low T levels in women are also associated with significant mood changes including anxiety, depression, and irritability. Replacing testosterone and returning levels to youthful numbers can reverse these symptoms and return women to a state of good mental health.5
Loss of bone mineral density is associated with increased bone-breaking and fracture risk and is an important health concern for women as they age. Osteoporosis is responsible for loss of height, fractures of the vertebrae, back pain, abnormal curvature of the spine, and even nerve damage.1,5
Low testosterone levels in women have been found to be an important risk factor for bone mineral density loss in women. Replacing testosterone to normal levels in women can be an important part of maintaining bone mineral density.
Low T has been shown to increase both stresses and urge incontinence in women. Stress incontinence is when urine leaks out when your bladder is under pressure; like when you cough or laugh. Urge incontinence occurs when urine leaks as you feel a sudden urge to pee. As the pelvic muscles weaken with low T, incontinence increases.12
Replacing T, back to normal levels, has a beneficial effect on breast tissue. T can help protect the breast from cancers. You can further enhance the protection testosterone provides by giving an additional ingredient with the DHEA, an aromatase inhibitor, such as Anastrozole. These protective effects on the breast are even more pronounced than with testosterone alone.
Quality of Life and Feelings of Wellbeing
Women feel better when they get their T levels back to normal youthful levels. Why? Sexual health improves, lean muscle mass returns, weight loss becomes easier, and energy levels increase. All these positive changes lead to improved feelings of well-being and enhanced quality of life. Women tend to feel more confident and relationships improve.9
Replacing testosterone to your normal youthful levels has an anti-aging component for skin, hair, and nails.8Without adequate levels of T, you can slowly slip into complacency about ageing and can become less of who you want to be both physically, emotionally, and mentally.
Here is a full list of the roles testosterone can play in a woman’s health:
Energy and Metabolism
Mood and Quality of Life
Brain Health and Cognitive function
Muscle health and strength
Bone health and strength
Sexual arousal, libido and orgasm
Vaginal health, decrease vaginal atrophy
Fat distribution and reduction
Red blood cell production
May help cardiovascular health
Testosterone Side Effects
Clinical trials have demonstrated that as long as appropriate levels of testosterone are maintained and levels don’t exceed the normal physiological dose, adverse androgenic effects are not problematic. Possible side effect includes:
Increased body hair at the site of the application is occasionally a problem if the cream is applied to the same location and too thick (uncommon)
Alopecia, male pattern hair loss (uncommon)
Acne and greasy skin (uncommon)
Deepening of voice (rare)
Enlarged clitoris (rare)
Myths associated with testosterone replacement in women:
Testosterone replacement will make me look like a man. This is false. Replacing testosterone to normal levels has very few, negative side effects. Some women may experience mild acne or hair growth but most have no detrimental side effects.
Testosterone replacement will give me huge muscles. Another falsehood. Women who take huge doses of testosterone and train to increase muscle mass can transform their bodies into the stereotypical 1970’s athletes. This will not occur in normal replacement doses.
Testosterone replacement will change my personality and make me aggressive. Also not true. Replacing testosterone to normal levels will not adversely impact a woman’s moos. Rather, it can help improve mood by helping you to feel better and improve the quality of life.
Testosterone replacement is dangerous for my liver. Another false myth. Testosterone is indeed metabolized by the liver. Women who have pre-existing liver disease should not take hormone replacement. In healthy women, replacing testosterone with normal levels will not hurt the liver.
Who shouldn’t use testosterone?
During pregnancy or breastfeeding
Active liver disease
History of hormone-sensitive breast cancer
Women with upper normal or high baseline testosterone levels
The benefits of low testosterone replacement treatments, or low T treatments, for women are numerous. TRT can be an important part of hormone replacement therapy (HRT). You can use natural remedies for low testosterone like DHEA which can serve as a low testosterone cure. Women on T replacement therapy can improve their libido, have more energy, and have a sense of improved wellbeing.
Winona offers low testosterone medication for symptoms of low testosterone in women in a natural way that replaces falling T to normal levels without risking going too far and ending up with high testosterone levels.
When considering hormone replacement in women, TRT benefits should not be discounted. Ask your Winona physician about how adding testosterone to hormone replacement therapy can be a safe and important part of helping women feel young.
“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”
Glaser, Rebecca, and Dimitrakakis, Constantine, “Testosterone Therapy in Women: Myths and Misconceptions.” Maturitas, Vol 74, issue 3, 2013, 230-234
MF. Sowers, et. al., “Testosterone Concentrations in Women Aged 25 – 50 Years: Associations with Lifestyle, Body Composition, and Ovarian Status,” American journal of Epidemiology, Vol 153, Issue 3, 2001, 256-264
S Bolour and G Braunstein, “Testosterone Therapy in Women: a Review,” International Journal of Impotence Research, 17, 2005, 399-408