Menopause and the Effects of Testosterone

When we think of testosterone, we usually think of it as a male hormone, a marker of men’s inherent masculinity. But testosterone is actually one of six hormones produced by the female reproductive organs as well. It is often not until women enter menopause, however, or experience dissatisfaction in the bedroom, that they start to look more closely at their testosterone levels.

Back in 1999, researchers appearing in the American Journal of Obstetrics and Gynecology recommended the addition of androgen (testosterone) to estrogen for all women undergoing surgical menopause.

Today, it’s still a treatment that healthcare providers offer to women struggling with the natural effects of menopause. And some research has shown that testosterone can, in fact, provide the following benefits to women:

• improved relief of vasomotor symptoms of menopause
• increased energy levels
• enhanced feelings of well-being
• decreased breast tenderness
• improved sexual desire
• increased sexual sensitivity
• increased frequency of coitus
• enhanced orgasms

But though androgen therapy has been around since 1936, many women are still wary about it. In the past, there have been reports of side effects such as hoarseness or other voice changes, or the development of facial hair, acne, or hypersexuality. And longterm safety information on testosterone/androgen therapy is lacking. Then came the results of the Women’s Health Initiative, a multi-year study on the long-term use of hormones to prevent chronic diseases such as cognitive decline or cardiovascular disease. One study from as recently as 2002 found that combination progesterone and estrogen therapy caused an increased risk for invasive breast cancer, which is likely to be the reason the FDA has been slow in approving other hormones like testosterone for women.

Symptoms of Testosterone Deficiency

Still, healthcare providers continue to prescribe its usage off-label, and the pharmaceutical industry certainly hasn’t discouraged them from doing so. Among the symptoms they cite are:

• diminished sexual pleasure
• decreased sensitivity of breast and genital tissues
• decreased orgasmic response
• decreased libido
• low energy
• depression

If you have been experiencing any of these symptoms over a long span of time, and it has been causing you personal distress, you should certainly talk to your gynecologist or primary care healthcare provider. If they can’t help, they may be able to refer you to another medical practitioner who specializes in female sexual functioning, or to another sexuality professional.

Testosterone replacement, however—available in oral estrogen-androgen combinations, injectable, and implantable forms, and in compounded testosterone creams – may not be the answer. And the truth is, there is no actual metric by which healthcare providers can measure and determine whether or not your testosterone levels are “low.”

Luckily, there are so many options these days. And the North American Menopause Society has even put together a free app called MenoPro that looks at a woman’s health history and offers guidance for what women can do.

In the end, the best thing you can do is due diligence. Do your own research. Talk to your healthcare provider. Consider all of the risks and benefits.

And then choose the option that’s best for you.