Ageless Forever Anti-Aging News Blog

Testosterone - Women (5)

Testosterone in women - is it physiological and clinically important?

Testosterone is popularly known as the "male" hormone. While it is true that men have much higher levels of testosterone than women, and that testosterone contributes to secondary sex characteristics that physiologically distinguish men from women (increased muscle mass and facial/body hair), this does not mean that testosterone isn't important in women.
 
In the same way that men need estrogen, aka the "female" hormone, for optimal health, women need testosterone for optimal health. This article will describe testosterone physiology in women and its importance for women's health, and refute the two prevailing myths that "testosterone is un-physiological in women", and that "there is no research or clinical experience supporting the use of testosterone therapy in women".... you may be surprised...!
 
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Testosterone Therapy vs. Estrogen Therapy in Surgically Menopausal Women - effectiveness comparison

In a previous article I outlined a study showing the effectiveness of testosterone therapy on menopausal symptoms in pre- and post-menopausal women. Here I will present and comment on an insightful study that compared head-to-head the effectiveness of testosterone therapy and estrogen therapy in surgically menopausal women who had their ovaries removed.[1]
 
STUDY DESIGN:
Before the surgical removal of both ovaries (bilateral ovariectomy) women were randomly assigned to either a testosterone alone, estrogen alone, or placebo groups. There were 10 patients in each group.
 
Mean age of the women was 46 years. They had underwent bilateral ovariectomy due to having uterine fibroids (aka myoma), which are non-cancerous (benign) tumors that develop in the womb (uterus).
 
HORMONE TREATMENTS:
 
The testosterone group received injectable testosterone (enanthate); 200 mg/ml.
 
The estrogen group received injectable estradiol; 10mg/ml.
 
The testosterone/estrogen group received injectable testosterone (enanthate) 150 mg + 8.5 mg estradiol/ml.
 
All groups received 1 ml intramuscular injections every 28 days for 3 months.
 
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Beneficial effects of testosterone therapy on menopause symptoms and quality of life

Testosterone levels in women decline steeply with age during the reproductive years; by the time women reach their late 40, their blood testosterone levels are approximately half what they were in their 20s.[1, 2] 
 
Symptoms of androgen deficiency, including a reduced sense of well-being, dysphoric mood (sadness, depression, anxiety, and irritability), fatigue, decreased libido, hot flashes, bone loss, decreased muscle mass and strength, changes in cognition and memory, and insomnia may occur prior to cessation of menses.[3] Pre-menopausal women frequently report "menopausal symptoms", most of which are not related to estradiol levels.[4]
 
In the past, post-menopausal women with menopausal symptoms have been treated with estrogen, and more recently with bio-identical estrogen. However, new research shows that menopausal symptoms can be treated safely and effectively with testosterone.[5] It has even been shown that testosterone therapy may be more effective than estrogen therapy for treating menopausal symptoms and improving wellbeing.[6] This is great news for women with a family history of breast or emdometrial cancer, who fear taking estrogen.
 
A notable study "Beneficial effects of testosterone therapy in women measured by the validated Menopause Rating Scale" investigated the effectiveness of a 3 month continuous testosterone therapy, delivered by subcutaneous implant, on the relief of somatic, psychological and urogenital symptoms in both pre- and post-menopausal women.[5] This study also investigated long-term efficacy and safety in a sub-group of women who were treated for 2-3 years.
 
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Beneficial effects of testosterone therapy in women on menopause symptoms and quality of life

Testosterone levels in women decline steeply with age during the reproductive years; by the time women reach their late 40, their blood testosterone levels are approximately half what they were in their 20s.[1, 2]

Symptoms of androgen deficiency, including a reduced sense of well-being, dysphoric mood (sadness, depression, anxiety, and irritability), fatigue, decreased libido, hot flashes, bone loss, decreased muscle mass and strength, changes in cognition and memory, and insomnia may occur prior to cessation of menses.[3] Pre-menopausal patients frequently report ‘menopausal symptoms’, most of which are not related to estradiol levels.[4]

Adding testosterone to estrogen therapy in postmenopausal women has beneficial cardiovascular effects[5] and also results in meaningful improvements in sexual function in women not taking estrogen.[6]

Testosterone supplementation in both pre- and postmenopausal women has been shown safe, even in higher doses[7, 8], and shown not to affect the menstrual cycle.[9] It is increasingly used as part of postmenopausal HRT (hormone replacement therapy) regimens.[10] Contrary to old beliefs, testosterone can actually protect against breast cancer. It has been shown that addition of testosterone may counteract breast cell proliferation induced by estrogen/progestogen therapy in postmenopausal women.[11-15]

A notable study investigated the effectiveness of a 3 month continuous testosterone therapy, delivered by subcutaneous implant, on the relief of somatic, psychological and urogenital symptoms in both pre- and post-menopausal patients using the self administered Health-Related Quality of Life (HRQOL) questionnaire called the Menopause Rating Scale (MRS).

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Low testosterone levels predict all-cause mortality and cardiovascular events in women

A study in a large primary care patient population shows that low baseline testosterone in women aged 43-72 years is associated with increased all-cause mortality and cardiovascular events. This association was found to be largely independent of traditional risk factors, and supports the notion that the hormonal status in middle age and older women might impact morality outcomes.

The objective of the study was to determine whether baseline testosterone levels in women are associated with future overall or cardiovascular morbidity and mortality.

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Dr. Pierce's Medical Organization Affiliations

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