Women's Health: The Role of Testosterone | San Francisco Womens Journal

Testosterone…for Guys Only? Ask the Menopause Maven

Dr. Sandra Altman SF Bay Area OB-GYN

Dear Dr. Sandi,

I thought testosterone was a “guy thing”. But lately I have been hearing that women have testosterone too. I have to admit this is a scary thought to me! If it’s true, can you tell me what testosterone does for me and why I need it?

E. W.

Dear EW,

It is true. Women have testosterone. We don’t have as much as males do, but we have some. In fact, the first thing that happens in puberty for girls is the production of testosterone by the adrenal gland resulting in armpit hair, pubic hair, acne and attitude. Several months later the ovary comes on line producing estrogen and testosterone.

From that point on, half the testosterone in the female is produced by the adrenal gland and half by the ovary. During our 40s, the adrenal gland stops producing testosterone, and only the ovaries continue to produce. So by the time we’re in our 40s our testosterone level is down 50 percent .

According to my text books, the ovaries are supposed to continue producing testosterone for 10 years after they have stopped making estrogen Unfortunately, many ovaries never got that particular email and they poop out during our 40s and early 50s.

The question is, what happens when we lose our small amount of testosterone?

Some women experience many changes and others experience none. The most common symptom is that libido diminishes, but reduced libido is just one result of the loss of testosterone. Other symptoms include fatigue, lack of a sense of well being, lack of motivation, diminished muscle strength and loss of mental sharpness.

The studies we have on giving women testosterone, all involve postmenopausal women already receiving estrogen. For some of these women, adding the testosterone makes them feel like themselves again.

Because current lab tests and available testosterone products are geared for males, the existing studies and statistics aren’t very accurate at our low range and the doses of the drugs are way too high for us.

Last year the testosterone patch for women was approved in Europe, but the U.S. FDA asked for more safety data before granting approval.

Keep in mind that any use of testosterone for women is “off label” and involves a compounding pharmacy or using small amounts of the gels and creams made for men. Using testosterone can have side effects such as oily skin, acne, facial hair, feeling too assertive, increased appetite and male pattern hair loss. When taken orally it can lower good cholesterol.

In other words, this is a very individualized process and a woman needs to work with a doctor who has experience with this area of hormone management.

Dr. SandiDr. Altman is a Board Certified Ob-GYN and has been in private practice since 1983. She is aka The Menopause Maven and has been in high demand as a speaker and teacher on menopausal and hormonal topics since 1992. To learn more, please visit her website, Menopause Maven.

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