Women with low testosterone have usually undergone surgical removal of their ovaries. Following this procedure circulating testosterone levels drop by 50%. Levels may also be reduced in women after hysterectomy when their ovaries have been conserved. This is due to the blood supply to the conserved ovaries being adversely affected by surgery. In some cases, but less commonly, medical conditions may be associated with low testosterone levels.
For this reason there has been interest in the use of testosterone to treat postmenopausal women. You may have read about testosterone therapy for women. This therapy is promoted as being able to improve your sex life, improve your skin, give you more energy and so on (I hasten to add that most of this has been said by Jane Fonda!). However, some studies have indicated improved mood and sense of well-being. Furthermore, the use of testosterone is associated with improvements in some aspects of female function and is an option some women may wish to consider. Testosterone supplementation is rightly not readily available to women in the UK in any other form apart from as part of hormone replacement therapy and in the US it remains unapproved by the FDA but is prescribed by some healthcare professionals. See types of supplementation below.
Before we look at options let’s explore testosterone, the symptoms experienced by women with low testosterone and the benefits and risks of supplementation.
Not all women are aware that ovaries produce both oestrogen and testosterone. Testosterone belongs to a class of male hormones called androgens. Testosterone is produced in your ovaries, adrenal glands and fat cells. These sex hormones are involved in the growth, maintenance and repair of reproductive tissues and influence body tissues and bone mass.
It appears that whilst there is evidence that testosterone supplementation can help some women, primarily those with sexual disorders, it is not a wonder drug and in most cases is not recommended. Furthermore, many medical professionals are cautious about recommending this therapy because of side-effects.
Women with Low Testosterone – Symptoms
Suggested Benefits of Testosterone Supplementation
- Encourages heart health
- Improves mood
- Increases energy
- Bone and muscle health
- Improves skin tone and elasticity
- Boosts libido
- Helps prevent osteoporosis
- Decreases body fat
- Increases muscle strength
Types of Testosterone Supplementation
Tablet form HRT, Tibolone, which is an oestrogen-like molecule which is coveted to progestogen and testosterone (available to postmenopausal women).
Testosterone gel – currently only licensed for use in men in the UK and is given to women in a smaller dose under specialist care.
Testosterone patch – this has recently been withdrawn in the UK
Testosterone Implant – only available is some clinics. The implant is insertion of a pellet every 6 months under the skin using local anaesthetic.
Risks Associated with Testosterone Supplementation
Testosterone replacement therapy is not advisable for women with breast or uterine cancer. It may also increase the chances of cardiovascular and liver disease.
Adverse Effects of High Levels of Testosterone
- Increase in facial hair
- Deepening of voice
- Weight gain
(These adverse effects could be minimised by monitoring the levels of testosterone in the blood but this is not really a practical proposition)
What Should You Do Next?
Consult with you healthcare professional to rule out any underlying medical problem, ie over or under active thyroid disorder.
Testosterone testing. This is important if you have features suggesting high levels of testosterone, like frontal balding or enlargement of the clitoris, but not so useful for ‘low levels’. Total testosterone and ‘free’ testosterone measures your levels of bioavailable testosterone that is not bound by blood proteins (this is the active portion).
If your testosterone levels are below the norm (normal levels for an average adult female 15-70ng/dl decreasing by 1% each year thereafter) and you are experiencing symptoms, your healthcare professional will be able to make treatment suggestions and you can weigh the risks and benefits. If you start therapy you will need to have regular blood tests to keep track of your levels. Remember that a gradual decrease in testosterone is a normal part of the aging process.
Note: The Royal College of Obstetrics and Gynaecology urge caution to the medical profession when prescribing libido-boosting treatment to women other than those who have had their ovaries removed.
A review of the use of testosterone therapy for women has been published in the Lancet. Analysis of 36 randomised trials including 8480 participants concludes that testosterone is effective for postmenopausal women with low sexual desire which is causing distress.
The findings add to growing evidence that only non-oral testosterone should be prescribed to women, as there are adverse effects with oral testosterone. Currently, only formulations for men are available which are adjusted for women and prescribed off label.
Reviewed on: 11/05/2018 by Dr Karen Morton
Next Review: 11/05/2020
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Brabaw, K. (2015) 5 Surprising Signs You Have Low Testosterone. Retrieved from http://www.prevention.com/health/women-low-testosterone
Gallenberg, M. M., MD. (2013) Does testosterone therapy help increase sex drive in women? Retrieved from http://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/testosterone-therapy/faq-20057935
Turner, N. MD. (2011) Low Testosterone: How to tell if it’s a problem for you. Retrieved from http://www.chatelaine.com/health/low-testosterone-how-to-tell-if-its-a-problem-for-you/