Yes, we have testosterone in our bodies as women! We have about 3-5x more testosterone than estrogen, so it is clear that testosterone plays an important role in our bodies. As women approach menopause, hormone levels change and testosterone becomes a part of the equation.
What is testosterone used for?
The ovaries produce about half of our testosterone, while our adrenal glands (which sit above our kidneys) produce the remaining 50%. Because testosterone is a masculine hormone, we tend to talk about it in terms of men. It is often associated with the strengthening of bones and muscles and maintaining sperm (sex drive) and testosterone. But testosterone plays a similar role in women. It is a chemical messenger that increases testosterone levels and is important for sexual function, libido and sexual arousal. It also plays a role in the development of the reproductive system at younger ages. It is also implicated in the maintenance of bone and muscle mass. Low testosterone levels are linked to depression and low mood.
What happens to testosterone levels in women over time?
If a woman is still fertile (still experiencing her period), the testosterone levels will peak in menstruation in a similar fashion to estrogen. This is because testosterone plays a crucial role in the development and maintenance of follicles, which is where eggs are formed during ovulation. The baseline testosterone levels will drop to the same level as estrogen at the end of menstruation.
The estrogen and testosterone levels will also change drastically during menopause. Because 50% of testosterone in our bodies comes from our ovaries, this is why it is so important to understand. All hormones produced by the ovaries will decrease if the reproductive cycle slows down. While estrogen will remain the most important hormone to increase, testosterone will also be affected. The decreasing estrogen levels will directly affect testosterone levels, which will cause them to drop more.
Premature ovarian dysfunction or surgical menopause can have a greater impact on testosterone and cause it to decrease more than during natural menopause. Low testosterone can have a greater impact on the body.
What does testosterone do during menopause
Menopause has the greatest impact on testosterone levels. A decrease in testosterone can lead to menopausal symptoms. The body must adjust to changes in testosterone levels, just as it needs to adjust for decreasing estrogen and progesterone.
Low testosterone can lead to a decrease in sex drive and sexual arousal, which is the most common symptom. However, it is important to remember that symptoms related to testosterone can overlap with those associated with estrogen or progesterone. It is not possible to simply attribute specific symptoms to a decline in testosterone. Menopausal symptoms are often caused by a combination of all reproductive hormones declining together. However, if you have symptoms that persist despite being on HRT, it may be time to assess your testosterone levels. Low testosterone can lead to symptoms such as:
- Low libido
- Concentration is difficult
Low testosterone could also be caused by other factors
Stress. The adrenal glands also produce testosterone, which is the stress hormone cortisol. Our adrenal glands can produce more cortisol if we are stressed out. This will decrease testosterone production. The end result will be a decrease in testosterone production if you are under constant stress.
How do we measure the testosterone levels in our bodies?
You can measure your body's testosterone levels to get an idea of your testosterone levels. If you're looking for additional testosterone, this can be particularly important. A blood test is required before you begin any testosterone replacement medication. This will give you a baseline. Before making any decisions, consult your doctor.
A simple blood test can determine your testosterone level. It is important to know that testosterone can bind to a protein in the blood when it travels. This protein is called sexhormone binding globulin (SHBG). The testosterone becomes inactive when it is bound to the protein. This hormone is not available to your body and therefore does not have any effect. The hormone will not have any effect unless it is free testosterone, which isn't bound to a protein. Low levels of free testosterone can lead to symptoms. It can be costly to get a direct test for testosterone. You can also use a calculated measurement. The SHBG and total testosterone readings can be used to calculate your free testosterone. Total testosterone and SHBG both are fairly inexpensive tests. This is the Free Androgen Index (FAI).
What can you do to increase your testosterone levels?
There are currently no testosterone products licensed for female use in Britain. This is something we hope will change, and there are many amazing campaigners working to make it happen.
NICE and the NHS recommend that systemic hormone replacement therapy (with estrogen and/or progesterone), be used primarily to treat menopausal symptoms. Unlicensed testosterone products are available that can be used by women if HRT fails. They meet safety and efficacy requirements and are approved for use by doctors. These can be in the form of creams or gels.
- Androfeme - Testosterone cream
- Testogel - Testosterone gel
- Tostran - Testosterone gel
If you are unable or unwilling to take medication, lifestyle changes can be used to combat low testosterone.
- Weight loss and strength training - An excess weight can affect your body's natural hormone production.
- You need to be cautious when you are trying to lose weight. Extreme diets can also affect hormone production. It is best to eat a healthy and balanced diet.
- Reduce alcohol consumption
It can be difficult to decide on the right treatment for you menopause. It isn't often that testosterone is discussed as a possible treatment option. A baseline blood test and consultation with a doctor experienced in testosterone prescribing are required.