Testosterone

Testosterone and other related hormones in the body (also known as androgens) play important physiological roles in women.

It is generally known that androgens are important for muscle and bone strength and for growth of normal body hair. But androgens may also have important positive effects on mood, wellbeing, energy and vitality in women.

The most well-known and potent of the androgens is testosterone. This hormone is produced by the ovaries and the adrenal glands, and in other parts of the body from hormones made by the adrenal glands and the ovaries, particularly from a hormone called DHEA which also circulates in the blood as DHEA-sulphate.

There is a major fall in oestrogen and progesterone over 3-4 years at menopause; however, testosterone levels start to drop in women in their younger reproductive years. This means that a woman in her forties has on average only half of the testosterone circulating in her blood stream as does a woman in her twenties, however this can vary between individual women. There is almost no change in testosterone levels at the time of natural menopause. There is only a very gradual decline in testosterone after a woman has reached her sixties. If a woman has her ovaries removed by surgery, however testosterone levels can fall afterwards by up to 50 per cent. Blood levels of the hormone DHEA-sulphate also fall during a young women’s reproductive years and continue to fall across a woman’s life span.

Testosterone and libido

Libido and sexual function are complex and relate primarily to lifestyle and relationship issues; however some studies have shown that for women at menopause who are experiencing a loss of sexual interest, various aspects of sexuality may be improved with testosterone therapy, with or without oestrogen. One small study also indicates that testosterone therapy will improve sexual interest and wellbeing in premenopausal women presenting with low libido, but further research is needed.

A study of Australian women recruited from the community, and without any complaint about their sexual function, has now shown that low sexual desire, arousal, responsiveness and other aspects of female sexuality recorded in the questionnaire are not significantly related to low testosterone levels. However women who are distressed by their low sexual function may be found to have low testosterone levels for their age.

Summary

There are further research questions to be answered on the use of testosterone therapy in women. In the meantime, any woman considering testosterone therapy should have her blood hormones checked to ensure that her testosterone level is not above a level that would increase the risks of treatment side effects and needs talk to their health practitioner to gain a clear understanding of what is, and is not, currently known about this therapy.

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