Testosterone for postmenopausal womenOctober 6, 2015 October 6, 2015
Listen to new research: Testosterone is an essential hormone for women. Despite the crucial role of testosterone and the high circulating concentrations of this hormone relative to estradiol in women, studies of its action and the effects of testosterone deficiency and replacement in women are scarce.
The primary indication for the prescription of testosterone for women is loss of sexual desire
The primary indication for the prescription of testosterone for women is loss of sexual desire, which causes affected women substantial concern.
That no formulation has been approved for this purpose has not impeded the widespread use of testosterone by women-either off-label or as compounded therapy.
Observational studies indicate that testosterone has favorable cardiovascular effects measured by surrogate outcomes; however, associations between endogenous testosterone and the risk of cardiovascular disease and total mortality, particularly in older women, are yet to be established.
Adverse cardiovascular effects have not been seen in studies of transdermal testosterone therapy in women.
- Clinical trials suggest that exogenous testosterone enhances cognitive performance and improves musculoskeletal health in postmenopausal women. 1 (Sept 2015)
Hysterectomy and oophorectomy
Hysterectomy and oophorectomy (the removal of ovaries) are performed to treat various diseases in women, including cancer. These procedures are accompanied not only by a decline in estrogen but also testosterone levels in the blood. Many women who have undergone surgical removal of their uterus and/or ovaries can develop symptoms of sexual dysfunction, fatigue, low mood and decreased muscle mass.
Recent research from Brigham and Women’s Hospital (BWH) has found that testosterone administration in women with low testosterone levels, whom previously had undergone hysterectomy with or without oophorectomy, was associated with improvements in sexual function, muscle mass and physical function. This research appeared in the medical journal Menopause.2
There has been emerging interest in supplemental hormonal treatment with testosterone for disrupted sexual functioning, loss of muscle mass, physical limitations and osteoporosis in postmenopausal women.
In this study, researchers sought to determine the dose-dependent effects of testosterone on sexual function, body composition, muscle performance and physical function in women with low testosterone levels who had undergone hysterectomy with or without oophorectomy. They studied 71 women over the course of 24 weeks. Participants were randomly assigned either to placebo or one of four testosterone doses given weekly. They found that the higher dose, 25mg, of testosterone tested in this trial after 24 weeks was associated with gains in sexual function, muscle mass and measures of physical performance.
Currently the FDA has not approved testosterone therapy for women because of inadequate long-term safety data. The researchers note that longer term studies are needed to determine if testosterone can be given safely to women to improve important health outcomes without inducing other health risks such as heart disease and breast cancer.
Should women use testosterone supplementation to ward off cardiovascular risk?
Research suggests that women with testosterone deficiency are at greater risk for developing cardiovascular disease than those women who suffer from estrogen deficiency. 3
The problems of obesity, metabolic syndrome, and diabetes are becoming a leading health concern because of their link to cardiovascular disease. Further, research shows an increased cardiovascular disease risk in postmenopausal women taking estrogens alone or with progestin. For the past decade research supports the use of androgens, “male hormones,” i.e, testosterone to help women battle heart disease and other problems associated with aging.
“Aging is, often, accompanied by a decrease in free testosterone levels, a concomitant reduction in muscle mass and an increase in fat mass. Furthermore, numerous studies showed that total serum testosterone levels were inversely related to the atherosclerosis disease incidence in postmenopausal women. New therapeutic targets may, therefore, arise understanding how androgen could influence the fat distribution, the metabolic disease onset, the vascular reactivity and cardiovascular risk, in (men and women).” 4
the development of cardiovascular disease after menopause is due not only to estrogen decline but also to androgen decline
In other words, as other research has pointed out, “the development of cardiovascular disease after menopause is due not only to estrogen decline but also to androgen decline.” 5
Testosterone for postmenopausal women
At the Magaziner Center for Wellness, we use bio-identical hormones (BHRT). Bio-identical hormones are different than synthetic hormones because they are structurally and chemically the same as the three estrogens naturally produced by the body – Estriol, Estradiol and Estrone and natural progesterone, testosterone and others, depending on the needs of the patient. Synthetic hormones – namely conjugated estrogens feature a manipulated form of the three estrogens while Medroxyprogesterone Acetate (MPA), which is found in Provera, is a synthetic form of progesterone.
Before formulating a treatment plan, the doctors at the Magaziner Center for Wellness analyze each patient individually.
We use a self-scoring system each time a patient comes in so that we can further customize and assess the success of her treatment as it progresses. This allows us to tweak the dosages so that we can optimize the patient’s results.
We have successfully treated thousands of menopausal and perimenopausal women and continue to be recommended by actress, author and women’s health activist Suzanne Somers, who refers to the doctors at the Magaziner Center for Wellness as leaders in the use of bio-identical hormone therapy.
1. Davis SR, Wahlin-Jacobsen S. Testosterone in women-the clinical significance. Lancet Diabetes Endocrinol. 2015 Sep 7. pii: S2213-8587(15)00284-3. doi: 10.1016/S2213-8587(15)00284-3. [Epub ahead of print]
2. Huang G, Basaria S, Travison TG, Ho MH, Davda M, Mazer NA, Miciek R, Knapp PE, Zhang A, Collins L, Ursino M, Appleman E, Dzekov C, Stroh H, Ouellette M, Rundell T, Baby M, Bhatia NN, Khorram O, Friedman T, Storer TW, Bhasin S. Testosterone dose-response relationships in hysterectomized women with or without oophorectomy: effects on sexual function, body composition, muscle performance and physical function in a randomized trial. Menopause. 2013 Nov 25. [Epub ahead of print]
3. Barrett-Connor E. Menopause, atherosclerosis, and coronary artery disease.
Curr Opin Pharmacol. 2013 Jan 23. pii: S1471-4892(13)00009-X. doi: 10.1016/j.coph.2013.01.005. [Epub ahead of print]
4. Montalcini T, Migliaccio V, Ferro Y, Gazzaruso C, Pujia A. Androgens for postmenopausal women’s health? Endocrine. 2012 May 12. [Epub ahead of print]
5. Montalcini T, Gorgone G, Gazzaruso C, Sesti G, Perticone F, Pujia A. Endogenous testosterone and endothelial function in postmenopausal women Coron Artery Dis. 2007 Feb;18(1):9-13.