Testosterone Replacement Therapy

Testosterone Therapy

Testosterone for women

What is testosterone?

You may think of testosterone as a male hormone, but women make this hormone too. It is just one of the sex hormones that women produce, along with oestrogen and progesterone.

Prior to menopause, women have circulating in their blood 3 major sex hormones: oestrogen, testosterone and progesterone. The ovaries produce each of these hormones. In addition, the adrenal gland produces a hormone called DHEA which can be used by the ovaries and other cells in the body to make oestrogens and testosterone. Thus oestrogen and testosterone can be made throughout the body but particularly in body fat from hormones that are produced by the adrenal glands.

Testosterone and other related hormones in the body (also known as androgens) clearly have important roles in healthy women. It is generally known that testosterone is important for muscle and bone strength and for growth of normal body hair. But testosterone may have favourable effects on mood, well being, energy and “vitality” in women. Many studies have now shown improvements in various aspects of female sexuality with testosterone therapy. Finally, oestrogen is actually made from testosterone, and without the ability of our bodies to make testosterone we cannot make oestrogen.

Levels of testosterone in your body gradually reduce as you become older, with many women not even noticing. Others are more sensitive to the changes and sometimes benefit from extra testosterone. Young women who have surgical menopause (removal of ovaries) may notice the change in testosterone more, perhaps because they are younger and because the drop is sudden.

Low testosterone can cause one or more of the following symptoms in women:

  • sluggishness
  • muscle weakness
  • fatigue
  • sleep disturbances
  • reduced sex drive
  • decreased sexual satisfaction
  • weight gain
  • fertility issues
  • irregular menstrual cycles
  • vaginal dryness
  • loss of bone density

Why do some women have testosterone therapy?

Unlike the sudden fall in oestrogen and progesterone at menopause, testosterone levels fall more gradually with increasing age such that a woman in her forties has on average only half of the testosterone circulating in her bloodstream as does a woman in her twenties. This will vary among individual women. Testosterone levels do not change over the course of natural menopause, but after a woman has her ovaries removed by surgery, testosterone levels can fall suddenly by up to fifty percent.

Why use testosterone?

A low dose of testosterone can sometimes be beneficial at improving your energy, mood, concentration and also sex drive (or libido).

What are the symptoms of low testosterone?

In contrast to the abrupt onset of hot flushes and night sweats which occur in some women at the menopause when oestrogen levels fall, the symptoms related to testosterone deficiency develop more gradually and may go undetected. Testosterone appears to have direct independent effects in different parts of the body, and some women experience a variety of physical symptoms when their testosterone levels fall.

There is no level of testosterone below which a woman can be said to be deficient, and a “Testosterone deficiency syndrome” has never been defined. However, research studies indicate that many women reporting low sexual function (loss of libido or sexual desire) benefit with testosterone therapy.

All women should have a blood test to measure their testosterone and SHBG levels before starting any testosterone therapy. This is not in order to diagnose deficiency, but rather to ensure women with normal to high levels of testosterone are not inappropriately treated.

Do I need a blood test?

Blood tests are not able to diagnose whether or not you need testosterone but are used as a safety check to ensure you are not getting too much on top of your own natural levels. Blood tests before starting might be suggested and repeated after 3-6 months on treatment.

How do women take testosterone?

Testosterone can be taken as tablets, by injection, as an implanted pellet or via the skin as a patch, cream or spray.

Testosterone for men

Testosterone Replacement Therapy (TRT) – How can it help?

Testosterone replacement therapy (TRT) is a safe and effective treatment to combat symptoms of testosterone deficiency and restore a man’s hormonal health.

Many structures in your body require the male hormone testosterone to function. When testosterone is not available to them, either by low levels or lack of free molecules, then the effects of testosterone deficiency syndrome may be felt. Testosterone Deficiency Syndrome (also known as TDS, andropause, low T or male menopause) results in symptoms including decreased sex drive (libido), erection problems, fatigue, depression, weight gain, poor concentration, night sweats, short term memory loss and irritability.

Symptoms of Low T/Male Menopause

  • Decreased libido (sex drive)
  • Erection problems
  • Fatigue
  • Depression
  • Weight gain
  • Night sweats
  • Short term memory loss
  • Irritability

Why are healthy testosterone levels important?

Testosterone is a key hormone in men. It is vital to the development and maintenance of male sexual characteristics and function. Normal active testosterone levels help to maintain sex drive and fertility in healthy men. Research shows it even helps maintain psychological health.

The testosterone hormone is increasingly being recognised as important to a wide range of health-related areas. This includes contributing to maintaining healthy and active energy levels and preventing bone breakdown.

Research indicates that 20% of men across the USA over the age of 50 suffer from testosterone deficiency syndrome. However, only 1% have been diagnosed and are being treated.

Testosterone deficiency/low T diagnosis

Patients have a very thorough blood test before their first visit. This enables the medical specialist seeing them review not only the level and status of the patient’s sex hormones, such as testosterone, but also the complex range of factors regulating their activities, together with tests of blood fat, liver, kidney, and prostate function, and red and white blood cell counts.

At the appointment, a full assessment or “work-up” of each patient is carried out. During the appointment, as well as discussing in detail the blood test results, the doctor also reviews the patient’s symptoms, medical history and current health status and concerns.

Testosterone treatment (TRT)

TRT is usually given by testosterone gel, cream or long-acting injections for the first two to six months. Testosterone replacement therapy (TRT) has been shown to be highly effective in relieving the symptoms of testosterone deficiency – in particular in restoring energy, health and sex drive.

TRT is often needed long-term and can safely be continued in these forms if good symptom relief is maintained or changed to other types if needed.

How safe is a hormone replacement therapy for men?

Testosterone treatment including testosterone replacement therapy has been in use in the USA and other countries for over half a century and has a remarkably good safety record over that time.

To ensure the safety and effectiveness of treatment, including giving the right dosage, it is essential that the results of treatment are carefully monitored, both to establish the diagnosis and to monitor the treatment carefully, blood tests and laboratory measurements are required at regular intervals. After the initial consultation and diagnosis, detailed clinical examinations need to be carried out at 3-6 month intervals.