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By David M. Odom, MD

Testosterone for Women

Testosterone Is a Female Hormone

The ovaries make three hormones:
● Estradiol● Progesterone● Testosterone

Ovarian production of all 3 hormones decline with age and ceases at menopause. Some very minor production continues in the adrenal glands after menopause, but not enough to produce the health benefits associated with them.
It is interesting to note the relative abundance in the female body of the various steroidal hormones. Throughout reproductive life, the adrenal hormone, DHEA, is 10,000 times more abundant than Estradiol. Progesterone is 1,000 times more plentiful than Estradiol during the week before period. And Testosterone is 10 times more available than Estradiol.

So, then, what is the female hormone? Is it the estrogen, which is the least common?

Testosterone Provides Health Benefit

What are the health benefits to women of youthful ovarian levels of Testosterone?

Early on, it was noted that Testosterone effectively treats the symptoms of menopause [1]. We now know that Testosterone therapy after childbearing, but before menopause benefits mental clarity, libido, and muscle tone. Continued supplementation allow these benefits to persist after menopause, but also preventing the frailty, osteoporosis, heart disease, breast cancer, and cognitive decline that typically occur within several decades after menopause.

When I started treating women for hormone imbalance in the late ‘90's, an effective treatment for low Testosterone in women, as in men, was the daily application of a Testosterone containing cream to the skin of the inner thighs. Of course, Testosterone cream for men was typically 100 mg per gram of cream, that for women was 20 mg per gram or less. At that time, female patients were instructed to apply a small dab to the labia. And some patients did this, even though the resultant blood levels were not any better than application to the skin of inner thighs. Most women, however, refused to comply. They did not like the whole idea of using the cream. They would enthusiastically take the thyroid supplement, place BiEstrogen beneath the tongue every morning and swallow the Progesterone capsules at bedtime. But, they would avoid using Testosterone cream regardless of my protestations. Blood levels would continue to measure low.

I suppose this resolute failure on the part of patients and me was because of the reputation that Testosterone is a “male hormone”. Perhaps they thought that the Testosterone cream was only for libido. And if that was not important to them, they wouldn’t use it.

The libido issue was probably the same reason that caused my male patients to faithfully use the Testosterone cream, thereby preventing heart attacks and prostate cancer. So my male patients obtained health benefit, but their reasoning for using the Testosterone cream was to enhance sexual function.

Sometimes I wonder if people really ever listen to what I tell them.

Pellet Therapy for Testosterone Supplementation in Women

What has made the difference in recent years regarding Testosterone supplementation for women is the advent of pellet therapy. Ladies would arrive at the clinic to receive subcutaneous “hormone pellets”, which, of course, were mainly Testosterone. And, they would come back faithfully for re-pelleting every 3 to 4 months. Why? Because they felt so good! And why did they not get this same benefit from use of the Testosterone cream? Because they never gave it a chance.

The simple technique of using Testosterone pellets injected subcutaneously for slow systemic release has revolutionized hormone replacement therapy for women.

Pellet therapy is preventing breast cancer [2], osteoporosis, heart disease, and Alzheimers.

That is correct! Testosterone is the second most powerful hormone after Progesterone for prevention of breast cancer. (Progesterone has a general cancer preventive effect. So-called “vitamin” D3 or cholecalciferol is also important for prevention of cancer.)

What blood levels do we seek in women supplementing Testosterone?

We want to see the same blood levels naturally occurring in 20 to 25 year old women.

Testosterone Myths

Since there are so many benefits to Testosterone supplementation as women age, why would women not use it? The answer is that there are misunderstandings in a time when bio-identical hormone replacement therapy (BHRT) is still not accepted by conventional medicine.
BHRT is not beneficial to pharmaceutical companies that need to sell new, patented drugs. BHRT suffers from myths, which I am repeating from an excellent review article by Glaser and Dimitrakakis [1], which I suggest that you read:
Testosterone is not just for libido. Testosterone does not masculinize women when properly dosed. Testosterone does not cause hoarseness or vocal cord changes. Testosterone increases scalp hair growth in women. Testosterone protects the heart. Testosterone does not damage the liver. Testosterone does not cause irritability or aggression. Testosterone protects against breast cancer. The safety of Testosterone supplementation in women is well established.

​Bibliography:
1. Glaser R, & Dimitrakakis C. Testosterone therapy in women: myths and misconceptions. Maturitas. 2013 Mar;74(3):230-4. http://www.ncbi.nlm.nih.gov/pubmed/23380529
2. Glaser R, & Dimitrakakis C. Reduced breast cancer incidence in women treated with subcutaneous testosterone, or testosterone with anastrozole: a prospective, observational study. Maturitas. 2013 Dec;76(4):3429.