As much of a struggle as it can be to convince a practitioner to write for estrogen and progesterone, I get even stranger responses when my recommendations include testosterone for women. All hormones are important to our wellbeing. It is like a conductor directing a symphony, or a contractor making sure the trades all come together to build a house. This sounds like what DNA does, you might say. Well it just so happens that hormones speak to the cells they bind to from the receptor on the cell membrane to your DNA in the nucleus of the cell. This is a lot of control to have. There many steps that have to take place after a hormone meets that receptor. This is why we sometimes see different symptoms between patients with the same hormone levels (high or low). It isn’t all about levels, but it’s a good place to start. Your diet and nutritional status are a huge help.

What if one of these hormones is testosterone. Testosterone is an essential hormone for both men and women and the androgen receptor is found in most tissues. What if the level of testosterone is low in the saliva or the connection between the receptor and the nucleus is broken? Symptoms would include perhaps:

• Depression
• excessive anxiety or fears
• excessive emotions
• low resistance to stress
• reduced muscle strength or tone
• dry skin
• low libido
• vaginal itching
• painful intercourse
• looking older than your age
• hesitant
• cellulite on the thighs
• varicose veins on the legs
• flabby belly
• pale face
• poor concentration or memory
• permanent fatigue

Does this explain you? A good first step is to have this level tested in the saliva. Why saliva testing? Because it shows what is free and bioavailable to reach the tissues. If I wanted to know how busy it was in my Pharmacy, I could either count the cars that drive by the store or count the customers in the store. Which one would give me the more accurate count, the second one of course. This is the difference between blood and saliva testing. The blood is the street and the saliva is the pharmacy.

When your testosterone levels are low, you are more susceptible to depression, anxiety disorders, joint disorders, osteoporosis and atherosclerosis. We often find women low in testosterone have a number on testosterone topically. It is important to note that testosterone treatment in this way takes time to work. It can take up to four months to see improvements. These changes are normally emotional or libido related in nature and take some patience to happen. The increase in muscle tone takes longer, up to eight months to occur. Diet and exercise dramatically increase results here. Eating animal protein and avoiding foods that lower testosterone (grains, sugars and alcohol) will accelerate results. Testosterone levels tend to be the opposite of cortisol. Cortisol tends to increase like insulin. Insulin increases with sugar. So if a food increases insulin rapidly then it inversely affects the testosterone levels. This is how stress (high cortisol) reduces testosterone. In the opposing manner, testosterone helps to improve blood glucose levels and fight against insulin resistance. In boosting testosterone in women, we suggest avoiding alcohol, vinegar and caffeinated drinks, sugar, soft drinks, sweets, bread, pasta, cereals (even cereal fiber) and dairy. None of our recommendations on hormone or supplements work as well without exercise.

So, documented benefits of insulin include, decreased inflammation, improved energy levels, increased bone density, decreased blood pressure, decreased cardiovascular disease, lowered LDL levels, increased HDL levels, improved muscle strength, improved brain function and decreased body fat. All proved by science.

This brings me to the best part of testosterone treatment for women, breast cancer protection. In 2004 a study that involved 100,000 women years, it was found that adding testosterone to conventional hormone therapy brought the breast cancer risk down to the level of non hormone users, quite a remarkable feat! Other studies have found the same results.

In applying testosterone, hair growth is a concern of physicians and patients. Typically it is less than 10% in the literature of this side effect. In my practice I see it as much lower. If applied in cream form to the leg(s) this is less of an issue due to normal shaving anyway. Some women do not absorb testosterone well this way and respond better to IM injections. DHEA supplementation can increase testosterone levels in women (not men) so some women may go this route as well.

If you have further questions on this popular topic, give us a call!

-Hormone Optimization in Preventive/Regenerative Medicine second ed, Ron Rothenberg, Kris Hart and Roger Rothenberg California Health Span Institute

The Hormone Handbook second ed, Thierry Hertoghe, MD, 2010, SA International Medical Books

The Hormone Makeover, Donna White, 2010, Xulon Press

BioIdentical HRT, Storey Marketing, for Stone’s Pharmasave