Recently in this newsletter, I discussed estrogen and progesterone and their multiple roles in our body.
Testosterone is the third of the sex hormones. It is the most prevalent in men, but also plays an important role for women.
In both sexes, it serves to maintain good quality of life, slow down the aging process, and prevent many diseases.
For most men, testosterone production begins to slow down at mid-life, the period called “andropause” – the fit man male version of menopause.Testosterone, sometimes called ‘T,’ declines slowly and steadily over 10-15 years or more. As a result, the symptoms of lowering testosterone are often associated with “getting older” and dismissed as inevitable. Things like low energy, skipping the gym, going to sleep in the Lazy-Boy in the evening right after dinner, low moods (a “life is flat” feeling with lowered motivation), weight gain often accompanied with a beer belly or breast development, the beginnings of an inability to have an erection or have it last, or declining sexual satisfaction – all these and more are common symptoms in men with declining testosterone.
And it may not just be at mid-life that testosterone declines in men. Over the years, I have treated younger men who have experienced high exposures to toxic chemicals, such as firefighters. Many of these chemicals cause endocrine disruption in the body, causing our natural hormone production to decline prematurely or displacing our hormones at the receptor site so as to testosterone prevent them from doing their job.
For women, testosterone is needed for endurance and maintaining/building muscle strength.
A female body that is leaner with less fat usually has more optimal testosterone levels. Improved balance and coordination, increased energy, mood control (including the avoidance of excessive crying) are all positive effects of testosterone in the female body. Additionally, testosterone in women does help increase the level of sex drive, sensation, and sexual pleasure.
Testosterone declines in women around peri-menopause and is usually the last sex hormone to decrease. However, if younger women are stressed a lot without periods of adequate recovery, this hormone will be lower than the optimum level and will result in the same symptoms that peri-menopausal women can have from low testosterone. Generally, women will be producing 50% less testosterone by age 50 than they did at age 20. Birth control pills have been shown to lower and/or stop woman running testosterone production in women, sometimes causing them to be unable to produce optimal levels thereafter even when they go off BCP’s.
When symptoms of decline occur for either men or women, it is wise to test testosterone levels and determine if there is a need for testosterone replacement.
Male replacement doses are substantially higher than those needed by women, so different formulas and concentrations are used for each sex. Typically, women use testosterone as a cream on the skin or the genitalia. Men generally start out with testosterone as a cream or gel on the skin, but most men eventually need intra-muscular injections to maintain appropriate levels for good quality of life and disease prevention.
Some things to remember while on testosterone:
- Regularly check your blood testosterone levels – every 3-6 months as determined by your provider
- Notice if you are developing symptoms of declining testosterone: such as changes in mood, endurance, muscle tone, strength, coordination, or memory
- Notice any symptoms of excess levels of testosterone: such as acne, facial hair growth, irritability, weight gain, or aggressiveness
Remember, testosterone needs to be maintained in an optimum ratio with estrogens and progesterone. Balance is always key.
Multiple studies over decades have shown testosterone to be preventative of heart disease, diabetes, metabolic syndrome, and osteoporosis, among others.
Two recent studies were in direct opposition to the plethora of previous findings, but on closer examination these studies have each been shown to have major flaws in their methods and conclusions.
I encourage you to talk with a clinician trained in bio-identical hormone therapy to get the best evaluation and care for testosterone therapy. When you are consistently and periodically monitored for optimal levels and associated variables, and are provided safe doses and other essential support, your health and well-being will benefit from these treatment strategies and you can feel assured that you are receiving the best care for your particular body.
Enjoy these early spring days, but hold out hope for more rain this season!
Jane Kennedy, CFNP, MN, MPH