Due to certain misconceptions, very little is known about the importance of testosterone in women.
Testosterone is an incredibly misunderstood hormone. It is generally attributed to masculinity and virility, and even perceived as the cause of violence and rage in men.
Women, in particular, are wary when testosterone is mentioned because we tend to think that testosterone is the source of all the “problematic” characteristics in men.
Testosterone therapy also has a bad reputation and is often thought to be illegal and dangerous. This is partly because many people confuse the idea of medical testosterone therapy with the abuse of steroids by athletes and bodybuilders.
Due to these misconceptions, very little is known about the importance of testosterone in the body – and in women, even less.
Many studies are now showing that normal testosterone levels are not only crucial in maintaining men’s health, but for women as well.
In this article, I will look at the role of testosterone in the body, and how it can help to improve women’s well-being.
The ‘sex’ hormone
Testosterone is known as a male sex hormone because it is produced in the reproductive system (specifically, the testes), and is responsible for ensuring the development of male sexual characteristics.
What many women do not know is that they produce testosterone as well, in their ovaries and adrenal glands. Previously, little was known about the role of testosterone in the female body, as many scientists and doctors thought that the female hormones like oestrogen and progesterone were more important.
However, more research is starting to point to the fact that testosterone is a very important hormone for women, especially in terms of staying fit, lean, and sexually active.
Just like in men, women’s testosterone levels will peak when they are in their 20s and decline thereafter. Problems start occuring when testosterone levels go down, as low testosterone can reduce motivation, cause fatigue, and contribute to low sex drive.
In contrast, normal testosterone levels are believed to help maintain a woman’s libido, energy level and sense of well-being.
Benefits of testosterone
One of the strongest arguments – backed by scientific evidence – for the use of testosterone replacement therapy in men is that it greatly contributes towards improving a man’s sex drive, as low testosterone causes low libido in men, leading to depression and extremely low self-esteem.
Now, testosterone therapy may do the same for women too, especially those who have gone through hysterectomies or menopause.
A detailed report in 1999 by Dr Susan Davis, a researcher of women’s health issues, showed that appropriate testosterone therapy in women who were post-menopausal or had had their ovaries removed produced a direct and sustained improvement in sexual drive, arousal, and frequency of sexual fantasies.
What about women who have not gone through menopause, and still have their uterus and ovaries intact?
Some women may have low testosterone because they are taking contraceptive pills, which can reduce testosterone levels. Dr Davis postulates that testosterone supplementation can also benefit these women, although no testosterone studies have been carried out on such a group of women.
Improving libido and sexuality has long-ranging effects in a woman, as it will have an impact on her mental and emotional health, quality of life, and her relationship with her partner.
The other significant benefit of testosterone therapy in women is in maintaining a healthy body composition (amount of fat and muscles in the body).
Similar to what is seen in men, testosterone has an effect on fat and muscle cells in a woman’s body. Testosterone has the ability to act on muscle cells, making them stronger and more defined.
At the same time, it also transforms certain types of cells (primitive cells which are capable of changing to fat, muscle or bone cells) into muscle cells instead of fat cells. Lower testosterone levels mean that more fat is accumulated, usually around the abdomen.
Some studies, including one reported in the Journal of Clinical Endocrinology and Metabolism, show that obese women given low doses of synthetic analogues of testosterone lost more body fat and abdominal fat, and gained more muscle mass, compared to women given a placebo.
Other potential benefits of testosterone
There are also exciting new developments in research that are being carried out on the effects of testosterone in women. For instance, there is a possibility that testosterone deficiency contributes to heart disease in post-menopausal women or women who have had their uterus and ovaries removed (hence stopping the production of testosterone).
Scientists suggested this link because they noticed that cardiovascular disease is the leading cause of death in post-menopausal women, while women who have hysterectomies are three times more likely to develop cardiovascular disease compared to women who have not had the procedure. Menopause and hysterectomy cause testosterone levels to decrease in a woman, although there is still not enough evidence to confirm this link yet.
Another potential consequence of low testosterone is breast cancer. It is widely believed that high oestrogen levels are one of the risk factors for breast cancer, but current research is also looking at the possibility that testosterone may protect against the cancer.
A study carried out in 2000 looked at the effects of testosterone and an anti-cancer treatment, tamoxifen, on breast cell stimulation. The study found that breast cells exposed to oestrogen showed cancer-like rapid growth, but cells exposed to testosterone had less significant growth.
This study correlates with another piece of research in 2003, which also showed that testosterone significantly inhibits breast cell growth, suggesting that testosterone could protect against the abnormal multiplication of cells that leads to cancer.
How to take testosterone therapy
Like any form of medical therapy, especially hormone replacement therapy, this is not something that you should rush into.
There are a few things that you need to know about testosterone therapy for women.
Firstly, testosterone therapy is only approved for use in men, so any use of it for women with low testosterone is experimental. However, methyltestosterone, an oral form of testosterone therapy, can be prescribed for menopausal women to improve their sexual desire.
Women should not take any form of testosterone therapy if they are planning to, or could potentially, get pregnant. Taking testosterone during pregnancy can cause a female foetus to develop male characteristics.
Women who have breast or uterine cancer, high cholesterol, heart disease or liver disease also should not be given testosterone therapy.
If you are wary of taking testosterone injections or supplements, you can try to improve your testosterone levels through natural methods first. Resistance exercises are the best way to do this.
Resistance exercises are those that force your body muscles to resist an external force, for instance, repetitive motion squats, lunges, crunches, pull-ups and push-ups. These are the most accessible types of resistance exercises because you do not need gym equipment; instead, you are resisting your own body weight.
Evidence shows that resistance exercises increases the levels of free and total testosterone in both men and women, at any age.
If you think that you may have low testosterone levels, especially if you have gone through menopause or a surgical procedure to remove your uterus and/or ovaries, talk to your doctor about the role of testosterone therapy.
It is still a new concept for many doctors and patients to grapple with, but do not be afraid to explore the idea, as well as discuss the pros and cons with your doctor.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). For further information, visit www.primanora.com.