Yes testosterone is now considered part of HRT (Hormone Replacement Therapy) for women.
Many people think of testosterone is a ‘male’ hormone. This is true, but women produce testosterone too.
In fact, women produce x3 times as much testosterone than estrogen before the menopause. Levels of testosterone in your body drop more sharply around the time of the perimenopause and menopause and stay low thereafter.
This fall in testosterone can lead to a lack of energy, brain fog, lack of a general sense of wellness (feeling flat and experiencing reduced or no joy in life) and reduced libido (sex drive).
What does testosterone do in your body?
Testosterone plays an important role in maintaining muscle strength and tone, bone strength and well functioning joints, a healthy cardiovascular system(heart and blood vessels), memory, concentration, and your overall energy levels and quality of sleep.
Testosterone also influences your level of interest in sex, and the amount of pleasure you feel from it. When your levels of testosterone reduce, you may find that you desire sex less often and when you do have sex, it’s not as enjoyable as it used to be, (even when you still desire and love your partner).
Benefits of testosterone
Majority women find that taking testosterone as part of their HRT provides added benefit in their health and well-being than taking estrogen alone (with or without a progesterone).
Benefits you are likely to experience include:
Improved energy and stamina (getting your mojo back).
Improved muscle quality and strength
Improved sleep
Increased libido and sexual arousal
Improved concentration, and ability to think and remember things
Improved confidence
A general sense of wellbeing
Who may benefit from testosterone?
Current guidelines only recommend testosterone if you have severely reduced libido otherwise called ‘Hypoactive Sexual Desire Disorder’. However, there is good evidence to show that the benefits of testosterone could help many more women in their perimenopause and menopause for the reasons listed above. Menopause specialists, and increasingly GPs, are realising the widespread benefits of testosterone replacement for most women.
Testosterone can be considered soon after the onset of peri/menopausal symptoms. You need a testosterone blood test before starting testosterone and 6 weeks after starting. Although the testosterone avdikable on prescription in Australia is specifically manufactured and licensed for women. It is important to monitor for overuse, or underuse. We aim to keep a measure called free androgen index at <6.
How is testosterone given?
Testosterone is usually given as a cream, in Australia, it is available as AndroFeme®1 cream. AndroFeme®1 is body identical; this means that it is the same molecular make up as the testosterone we produce naturally in our ovaries. It is derived from tank, a Mexican root vegetable. It is rubbed into your skin like a moisturiser, and it then becomes absorbed directly into your bloodstream. The AndroFeme®1 is made for women and is a regulated preparation. It should be rubbed onto clean, dry skin on your upper outer thigh or buttocks, it usually takes about 30 seconds to dry. You should wash your hands thoroughly after using it.
Apply the cream in the morning at roughly the same time each morning. Avoid swimming or showering until around 30 minutes after application and initially avoid using perfume, deodorant or moisturising creams on the area.
After you start testosterone
There are usually no side effects with testosterone treatment as it is given to replace the testosterone that you are otherwise lacking. Very rarely women notice some increased hair growth in the area in which they have rubbed the cream, this can be avoided by rubbing it into places with few hair follicles (upper outer thighs and buttocks are the recommended sites) and regularly changing the area of skin on which you rub it in.
As the dose is so low, testosterone used in this way does not usually increase your risk of developing facial hair, voice deepening or skin changes.
It is important to have regular blood monitoring. This is before starting testosterone, 6 weeks after starting and 6 weeks after every change of dose. Once the levels are good twice a year bloood test is recommended. It can sometimes take a few months for the full effects of testosterone to work in your body. It takes about 6 months for a visible improvement in muscle mass. If you are carrying extra weight or not exercising, you may not notice the toning. That's why it's important to commit to improving your physical exercise experience.
Remember, exercise doesn't have to be stressful and hard. . Keep it simple! Your goal is enjoyment of exercise and consistency. So keep it so simple that you can't say no to it! (See my NEWSTART blog on exercise).
AndroFeme®1 contains almonds extract. It should not be used if you have an allergy to almonds.
Testosterone can be taken safely alongside estrogen HRT and vaginal estrogen.
Long term use of safely prescribed testosterone replacement is not associated with any adverse health risks and is shown to be beneficial for the health and strength of your muscles, bones, cardiovascular health and brain health.
Dr Purity Carr
GP and Menopause Doctor