Testosterone for Women—the Most Powerful Yet Neglected Hormone

When you hear the word testosterone you may think of bodybuilders and men looking to enhance virility.  After all, there is no widely-marketed commercial testosterone product available for women—yet.  According to my female patients’ stories, when asking the family doctor about testosterone, they are often met with a shrug, a chuckle and a negative comment or simple statement such as, “I don’t prescribe testosterone for women.”  The doctor often follows that comment with, “it hasn’t been studied enough”   or “we don’t yet know about its safety.”  Men can have all the testosterone they want, but when for women, testosterone therapy and its benefits seem to be out of the realm of possibility.

Facts on Testosterone Therapy for Women

•  Testosterone has been used safely in women for decades with no evidence of adverse mental or physical consequences when prescribed and monitored appropriately.
•  Testosterone has many of the same benefits for women as men.
•  The fact that there is no commercial product available for women means that the vast majority of orthodox physicians will never prescribe it to women who need it.

 What is testosterone and why do women need it?

Testosterone is an adrenal steroid hormone, derived from the molecule cholesterol. In women who have not yet reached menopause, testosterone is produced by the ovaries in a pulsatile fashion, with the levels fluctuating up and down as many as 15 times per hour, as confirmed by salivary hormone tests. In women who have reached menopause, testosterone is largely produced by the adrenal glands, but in much smaller amounts.

Testosterone production is greatly affected by stress. When significant career or personal stressors present or if there are internal stressors, such as a poor diet and fluctuating blood sugar levels, lack of a consistent long-duration sleep pattern, inflammation or infection (often without symptoms), the body will shunt steroid hormone production toward the stress hormone cortisol and away from testosterone production. This is why many young patients have low testosterone levels on testing. They are capable of producing testosterone but they are producing large amounts of stress hormones in its place. This causes emotional problems, hunger and weight gain.

 What does testosterone do?

Testosterone exerts its powerful mental and physical benefits in two ways:

• Physical effects: It is an anabolic hormone, stimulating the production of protein. Combined with physical activity, testosterone enhances muscle development at the expense of fat, helping to reshape the body. The increase in testosterone that begins in boys and girls during the teenage years goes hand in hand with the loss of baby fat and an increase in muscle definition (especially if these individuals are exercising and not overeating). The reverse occurs with aging.  As men and women in their 40s and 50s experience a decline in testicular and ovarian testosterone production, an increase in body fat and a decrease in muscle mass often occurs.

Besides improving body shape, testosterone increases the speed of healing of injuries and also promotes improvement in organ function, especially the heart (progressive cardiologists have found that testosterone increases cardiac output for patients with congestive heart failure).

• Mental effects: Testosterone boosts the powerful neurotransmitter dopamine. Dopamine is responsible for:

• Memory
• Assertiveness
• Initiative
• Libido
• Ambition
• Positive mood
• Self esteem

For many people, correcting low levels of testosterone helps improve self-esteem, behavior, ambition, and career and family relationships. Countless patients have reported that with testosterone therapy, productivity, success, and happiness are enhanced, as well as sexual wellbeing.

Testosterone FAQs

How is testosterone administered to women and what are the costs?

•  Testosterone can be administered via a cream or gel or via small pellets that are implanted painlessly under the skin of the buttocks, usually leaving no visible mark.  Pellets are the preferred form of administration in my anti-aging and integrated medicine practice because the mimic the natural release of testosterone much more than creams, have fewer adverse reactions  (see below) and are hands down preferred by women who have tried both creams and pellets. The cost of testosterone ranges from @ $1-2 a day (creams) to @ $3-4/day (pellets) depending on dose and frequency of administration.  Health insurance generally does not yet cover testosterone treatment in women (no surprise, the health insurance industry is dominated by men, for whom testosterone use is often covered).

Are there any common side effects?

• Testosterone pellets have the fewest side effects of any form of administration.  Creams sometimes cause a slight increase in facial hair or acne.  Pellets generally don’t do this.  If any reactions like this occur they can be suppressed with topical creams or pills.  With pellets an additional compound can be added to block facial hair and acne if it is a significant problem, which is rare. Testosterone does not make women more aggressive. Instead it makes women feel more in control, so that they are far less likely to be irritable or lash out in stressful situations. Testosterone has improved the relationships and marriages of many, many of my patients.

What about safety concerns?

• Many physicians may be concerned about testosterone and possibly increasing the risk of blood clot formation (thrombosis) and may tell their female patients that using testosterone will increase their risks for a stroke or heart attack.   A recent published study,  that has been largely discredited,  attempted to associated use of testosterone with causing heart attacks in men (leading to a flurry of TV ads from case hungry lawyers).  But the reality is that testosterone is cardioprotective for most patients who use it.  Among 20,000 patients (men) who received testosterone therapy during a 5-year period (2009–2014) at Low T Centers nationwide (www.lowtcenter.com), the risk for MI was 7-fold lower and the risk for stroke 9 times lower compared with samples from the general population. Further, there was no evidence of worsening of preexisting cardiovascular disease in patients treated with testosterone.  There are 4 published studies looking testosterone delivered by subcutaneous implants, which bypass the liver, that showed that testosterone does not affect clotting factors and does not increase the risk of thrombosis (clots).  However if a woman does have a history of deep vein thrombosis or pulmonary embolism we would definitely recommend clotting studies and approval by their doctors before starting them on testosterone therapy.

Will testosterone increased breast cancer risk?

• Studies using testosterone implants have shown less stimulation of breast tissue and lower rates of breast cancer compared to to women who are untreated.  So testosterone implantation appears to exert protective effects for women.  Testosterone pellet implantation has actually been used therapeutically for patients with breast cancer as it it has been shown to reduce the rate of recurrence or metastasis. That is because testosterone appears to block the stimulatory effects of estrogen on abnormally dividing breast cells.

How can I get started on testosterone?

As it is a cutting edge form of treatment, requiring special training and experience concerning forms of administration, dosing and monitoring,  women who are interested in receiving testosterone should have it prescribed and managed by a physician who is fellowship trained in the use of bioidentical hormones.  My colleagues with BodyLogicMD and I have received this type of specialized training and each of us have managed hundreds of women with testosterone therapy successfully over many years.   To find out more about becoming a patient, please contact CenterMD today.