Testosterone: A Major Breakthrough for Menopausal Women

Just as men's bodies manufacture small amounts of estrogen, women's bodies produce testosterone through the ovaries and adrenal glands. A multitalented hormone, testosterone boosts both libido and energy, maintains muscle mass, strengthens bone and ensures the nipples and clitoris are sensitive to sexual pleasure.

As we age, our bodies produce less androgen (testosterone), estrogen and progesterone. By age 40, women produce about half the testosterone we did in our twenties. These levels drop further still with the onset of menopause or for women who have had their ovaries removed. Many clinicians believe that the diminished energy, decreased sexual desire and "flatness" of mood that some women experience during and after menopause are directly related to declining levels of testosterone.

Doctors traditionally respond to menopausal complaints by dispensing prescriptions for estrogen and progesterone, traditional "female" hormones that address some of the discomforts of menopause and provide the added advantage of protecting against heart disease, Alzheimer's disease and osteoporosis. But although estrogen can quench hot flashes and ease vaginal dryness, it does little to enhance libido or energy.

Several studies suggest, however, that small amounts of androgen added to estrogen replacement therapy can restore sexual desire, improve energy and promote a sense of well-being. And that's not all. Testosterone also helps prevent bone loss, improves body composition (building lean mass and reducing body fat) and supports cognitive function.

Clinicians such as Dr. William Regelson, M.D., author of "The Superhormone Promise," argue that testosterone is the missing link in hormone replacement therapy. "For many women who feel they are not quite themselves," he says, "the ingredient missing from the blueprint is testosterone." He has found that adding testosterone to the hormonal "cocktail," even for a short period of time, duplicates our "normal hormonal state" and helps women better tolerate estrogen and progesterone.

Researcher Dr. Barbara Sherwin, a professor of psychology at McGill University, conducted a study on women who had their ovaries removed (ovaries produce nearly half of a woman's testosterone) and found that when given a combination of testosterone and estrogen, these women were more interested in sexual intercourse.

They also experienced more orgasms and greater pleasure. Dr. Sherwin suggests that short-term therapy is sufficient for some women, while others may need longer-term dosages.

Still, some members of the medical community have not embraced androgen therapy for women. Many physicians are reluctant to prescribe androgen because there are relatively few studies on women and testosterone. The long-term effects are unknown.

Critics point out that without long-term studies to support its efficacy and safety, testosterone should be used cautiously, if at all. That's because it can have unfavorable effects on cholesterol levels, primarily decreasing HDL "good" cholesterol. This in turn tends to negate the positive effects of estrogen on the cardiovascular system.

Some also argue that fatigue and low libido can stem from any number of nutritional, medical or psychological conditions. Even androgen's most fervent advocates agree that the hormone should be prescribed on a case-by-case basis to menopausal women who are otherwise healthy. They caution that this therapy is not appropriate for women of childbearing age. Not only do younger women produce sufficient androgen, but also excess levels can cause serious damage to a developing fetus.

The key, agree doctors, is to tailor dosages to the individual needs of women rather than providing a "one size fits all" prescription. This ensures that women can reap the benefits of this therapy without experiencing unwanted side effects such as masculinization, facial hair or acne.

Testosterone is available in pills, lozenges, patches, gels and injections. Although there are advantages and disadvantages to each, most clinicians will not prescribe pills, which can increase the risk of liver toxicity and lower levels of HDL (the "good" cholesterol).

A slightly "milder" alternative to testosterone is DHEA (dehydroepiandrosterone). This steroid hormone is a precursor of testosterone, meaning that the body converts DHEA into testosterone. Supplementary DHEA, which is available in pill or cream form, increases testosterone levels by one-and-a-half to two times. So it's not surprising that DHEA provides many of the same therapeutic benefits, including increased sexual interest and enhanced physical and mental satisfaction.

If both testosterone and DHEA levels are depleted, women's health pioneer Dr. Christiane Northrup, M.D., recommends replenishing DHEA. If DHEA, which can require about four months to work its magic, is insufficient, she recommends switching to testosterone. For those who choose testosterone, Dr. Northrup favors a natural version over those made from equine estrogens and methyl testosterone.

Formulary, or compounding pharmacies create natural hormones that are customized to individual needs. To learn more about natural hormones, call the Women's International Pharmacy at (800/279-5708 begin_of_the_skype_highlighting            800/279-5708      end_of_the_skype_highlighting). To locate a formulary pharmacist in your area, contact the International Academy of Compounding Pharmacists at (800/927-4227 begin_of_the_skype_highlighting            800/927-4227      end_of_the_skype_highlighting). Their Web address is www.iacprix.org.

If you think you might be a candidate for androgen therapy, here's what to do:

If you begin androgen therapy, be sure to report any side effects to your doctor so he or she can monitor your progress and adjust your dosage as necessary.

Although it is not for everyone, emerging research may reveal androgen to be one of the most promising therapies available to menopausal women. Sexuality and vitality need not be passing pleasures of youth.