Testosterone in women is vital for hormone balance, normal levels of libido and general well-being.
- I couldn’t care if I never had sex again!
- Iâ€™m too tired!
- Forget the sex, I just wish I had some energy!
- I do it for him, not for me!
- I love him, but I just donâ€™t want to have sex with him!
These comments are repeated by thousands of women every day, sometimes to doctors, sometimes to friends and sometimes to partners.
Women provide a far more complex sex-hormone picture than men, with three hormones contributing to the overall makeup of their hormonal balance.
Women produce oestrogen, progesterone and testosterone. The ovaries produce the bulk of oestrogen during the years leading up to menopause and substantially less post-menopause.
During the menstrual years, progesterone is produced once ovulation has taken place. Progesterone ceases to be produced when ovulation stops at menopause. In some females, progesterone production stops even before menstruation ceases.
Testosterone in women is produced by the ovaries and adrenal glands on a continual basis. Testosterone blood levels are at their highest around age 20 and decline steadily with time. At the age of 40 a womanâ€™s serum testosterone levels are approximately half what they were at age 20. This level continues to fall with age.
Testosterone in women is vital in the preservation of bone, for its positive effect on libido and for maintenance of energy levels.
Reduced libido, unexplained fatigue, depression, lack of concentration and emotional mood changes typify the symptoms of testosterone deficiency in women.
Supplementing small amounts of testosterone in women experiencing symptoms of testosterone deficiency usually results in increased energy, libido and sexual response for the patient.
In the last decade there has been an increasing interest in administering low doses of testosterone to pre and post-menopausal women, particularly to help with loss of libido. The use of testosterone to manage low libido in women has extensively been reviewed in medical literature for decades.
What exactly is Testosterone?
Natural testosterone is a term used to describe the hormone testosterone that is naturally produced by the testes in men and the ovaries and adrenal glands in women.
Testosterone is not produced anywhere in the plant kingdom.
Testosterone has, for over 80 years, been recognised as exerting a significant effect on the human body.
With the advent of pharmaceutical chemistry, pure testosterone was first manufactured synthetically in the late 1930s. Today, natural testosterone and synthetic analogues with testosterone-like actions are manufactured for pharmaceutical purposes from soya and wild yam substrates.
Testosterone is classified as an androgen. Androgens are a group of hormones controlling sexual characteristics. They play a role in theÂ maintenance of systemic anabolic effects particularly metabolism ofÂ salts, fluid balance and bone growth.
Testosterone has significant effects on libido, mood, sexual function
Both sexes produce testosterone. Men produce far greater quantities of testosterone than women. The amount secreted by women is small and it does not have a strong masculinising effect.
Women produce 5 – 10% of the quantity of testosterone produced by
Even though the amount secreted by women is small compared to males, it plays a pivotal role in the sexuality and metabolic functioning of women.
The History of Testosterone Use in Females
There is universal acceptance amongst reproductive endocrinologists, gynaecologists and those specialising in the area of womenâ€™s health that female sexual dysfunction (FSD) affects a substantial proportion of women.
FSD has significant psychological ramifications and can adversely affect social and personal relationships. Various studies indicate 30 – 43% of women aged between 18 to 59 years experience some degree of sexual dysfunction. Of these women, 18 – 22% list low libido as their primary symptom.
Classifications and the defining of criteria for sexual dysfunction in women have been established over a decade ago. Validated assessment scales and questionnaires, such as the Female Sexual Function Index (FSFI), have been developed to assist with the diagnosis and monitoring of management regimes for sexual dysfunction.
Female sexual dysfunction is a multifactorial condition requiring careful evaluation. Treatment may involve several management strategies. The hormonal profile of the subject is part of the assessment to determine the origins of sexual dysfunction.
The greatest influence on human sexual function is the hormoneÂ testosterone.
Testosterone is a vital component of female sexuality, enhancing desire to initiate sexual activity and intensifying the response to sexual stimulation. It is associated with greater well-being and increased energy and vitality. Testosterone also plays a part in reducing anxiety and depression.
Surgically menopausal women (hysterectomised women with ovaries removed) and women with premature ovarian failure (early menopause) are among the populations most likely to experience a testosterone deficiency. This syndrome is characterised by blunted or diminished motivation, persistent fatigue and lethargy, decreased sense of
personal well-being, low-circulating blood testosterone levels and low libido.
In contrast to oestrogen, serum androgen levels do not fall precipitously at the time of menopause, but rather decline with age.
Early scientific evidence from the 1940s and 1950s showed testosterone
was the libido-enhancing hormone in the human female.
In the mid-1970s, the vital role of the ovary in testosterone production was established. Subsequent research has recognised sexual function declines following oophorectomy (surgical removal of the ovaries). Additional research has found administration of testosterone reverses the decline in sexuality experienced after an oophorectomy.
Prior to 2000, the majority of medical research conducted regarding testosterone use in women had centred on testosterone implants and injections. While therapeutically effective these dose forms have significant shortcomings when used in women.
Testosterone implants and injections produce extremely high serum levels in women even when administered in reduced doses. This can often result in levels 10 times higher than normal. At high levels, testosterone has the potential to cause significant side effects including masculisation, hirsutism (body hair growth), acne and voice changes.
Many women who suffer from loss of libido date their problem to removal of their ovaries (oophorectomy) and/or uterus (hysterectomy). Removal of the ovaries in both pre and post-menopausal women results in an immediate 50% reduction in circulating serum testosterone levels.
Standard medical practice over the past 40 years has been to supplement women with oestrogen after removal of the ovaries, but ignore the hormones testosterone and progesterone.
Oestrogen therapy alone usually does not restore lost libido in oophorectomised women. Medical studies comparing oestrogen alone versus oestrogen plus testosterone have shown a significant improvement in energy and libido with the combined treatment. Combination therapy did not show an increase in side effects. Additional medical trials have also shown testosterone has an additive effect on bone density when combined with oestrogen Â – a very important consideration for prevention of osteoporosis.
The problem of reduced libido and unexplained fatigue is not confinedÂ to women who have undergone surgical removal of the ovaries.
Pre and post-menopausal women with intact ovaries can also have low testosterone levels and experience the same symptoms of low sexual desire and lethargy as oophorectomised women. Small doses of testosterone can result in significant improvements in quality of life and sexual fulfilment for these women.
In the USA, Europe, Asia and South America no testosterone product has been government-approved for the treatment of poor libido in women. As a result, testosterone products approved for use in men are often given to women in reduced doses. This is commonplace by doctors around the world – a practice called off-label! usage.
The most popular options used in women off-label are injectable short acting testosterone depots, testosterone implants or compounded creams or troches from compounding pharmacies.
There are no published trials using injectable testosterone in this way for testosterone therapy in women.
Testosterone implants were discontinued world-wide in 2012.
The situation in Australia is distinctly different with a 1% testosterone cream for women available. It’s calledÂ AndroFeme.
The cream is a popular testosterone option for use in women because it involves no surgery, no pain, has no adhesion or visibility problems and the dose is flexible and accurately controlled.
Understand more on testosterone in women:
The information in this article has been taken with permission from the official Lawley booklet onÂ Understanding Testosterone for Women.