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Testosterone in Women

Donald Aulds, M.D.

When most people think of testosterone, they think of it as the “male” hormone. Their thoughts seem to run to testosterone producing unwanted hair, deepening of the voice and other side effects. There is also a bad connotation with testosterone being used as a muscle and power enhancing drug.

Testosterone is an anabolic steroid just like estrogen is an anabolic steroid, but estrogen in women does not have the bad connotations that are associated with testosterone. The simple fact is that a woman can not have a satisfactory life without hormones, and testosterone is one of the hormones needed for a satisfactory life. Studies have shown that testosterone, along with estrogen, plays a major role in the development of the female sexual organs as a fetus and in puberty. When a girl reaches puberty, testosterone brings about the development of pubic and underarm hair, as well as the breasts, and aids in the growth of the clitoris. Testosterone continues to be produced in the ovaries and later in the adrenal glands throughout most of a woman’s life.

What benefits does testosterone give to a woman?
Studies about the benefits of testosterone in women have been done since the early 1950’s. The studies have shown that testosterone reaches its peak in the early 20s, and there is a slow decrease until the woman goes through menopause – whether it’s brought about naturally or following the removal of the ovaries. In the first several years after menopause, the levels rapidly decrease by approximately 50 percent. Not only is the decline affected by the decrease in ovarian function with menopause but also the decrease in production of DHEA and androstenedione in the adrenal glands as the woman ages. The benefits that testosterone gives to the woman include:

  • Greater sense of well-being – The sense of well-being in a person can drive the entire mechanisms of success verses failure in family life, interpersonal relationships, and work.
  • Bone health – Studies have shown that testosterone places a role in the maintenance of bone strength and bone density.
  • Depression – Testosterone, when added to regimens, have been shown to aid in the relief of mild depression.
  • Vasomotor symptoms – The severity and frequency of hot flashes and night sweats have been reduced with the use of testosterone.
  • Vaginal atrophy and dryness – Recent studies have shown improvement in both areas with the addition of testosterone.
  • Sense of personal power – Testosterone helps to restore a sense of accomplishment to personal and work life. It helps to improve a person’s self-worth.
  • Sexual drive and satisfaction – Although this is a multifactor response in the body, the loss of testosterone has been shown to decrease the response and the return of testosterone in many cases can improve the response.

Are there side effects to testosterone?
There is not a chemical known to man that might not give some type of side effect when used inappropriately. When testosterone is administered in too high of doses to women, hair loss, increased facial hair, acne, or deepening of the voice may possibly occur. As long as the testosterone is being prescribed by an experienced physician and the levels are monitored, the likelihood of side effects is rare.

How is testosterone administered?
Testosterone can be obtained by prescription and under present laws it must be represcribed every six months. The available ways that testosterone can be prescribed presently include:

  • Commercially prepared tablets – presently available as Syntest, Covaryx, or Estradiol/methyltestosterone. These are a combination of estrogen and testosterone.
  • Sublingual tablets – prepared by a compounding pharmacist as testosterone alone or in combination with estrogen or progesterone
  • Topical gel – prepared by a compounding pharmacist to be applied on the skin usually on the perineal body between the vaginal opening and the rectum prior to bedtime
  • Pellets under the skin – dissolves over a period of a month. Studies have shown that there is a high level of testosterone after the insertion that decreases over the course of the month.

Ask your physician for testing of testosterone, DHEA and estrogen. These tests can be done through blood tests or through saliva. If a deficiency is shown, then discuss whether you are a candidate for testosterone therapy. Eating a well-balanced diet and exercising can also help you maintain your hormone balance and general health.

More about Dr. Aulds

Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.

Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.

Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.