I dont like the way the testosterone makes me feel.

Hi Catherine,

I am on a very small dose of progesterone cream that I apply every evening and a small dose of estiril cream that I apply vaginally once to twice a week and a small amount of testosterone gel I apply every morning. What does the testosterone gel do for me and do I need it? Can I just use the progesterone and the estiril cream on their own? I dont like the way the testesterone makes me feel.

Thank you,

Judi

Dear Judi,

Testosterone has long been considered a “male only” sex hormone due to the dominant role it plays in men both physically and mentally. Women provide a much more complex sex hormonal picture with three hormones contributing to the overall makeup of the hormonal balance.

Women produce oestrogens, progesterone and testosterone. The ovaries produce the bulk of the oestrogens during the years leading up to the menopause and substantially less post-menopause.

Progesterone is produced once ovulation has taken place during the menstrual years. Progesterone ceases to be produced when ovulation stops at the menopause.

Testosterone in women is predominately produced by the ovaries. It is produced on a continual basis and levels rise slightly around the time of ovulation. With a decline in ovarian function testosterone production similarly will decline.

Testosterone is vital in the preservation of bone, for its positive effect on libido and maintenance of energy levels.

Testosterone is recommended for use when ovarian function declines and especially in young women who have had surgical removal of the ovaries.

Ovarian function can decline from as early as the mid-thirties and is not necessarily related directly to the menopause.

Reduced libido, fatigue, depression, lack of concentration and emotional mood changes typify symptoms of testosterone deficiency.

Supplementing small amounts of testosterone in women experiencing symptoms of deficiency can result in improved energy levels, enhanced feeling of well being, increased libido and sexual response.

Blood levels of between 2-4 nmol/L is the normal range for the total testosterone level in women. By contrast the level varies between 10-35nmol/L in men.

The diagnosis of androgen levels in women should be determined by measuring the levels of testosterone and sex
hormone binding globulin (SHBG) and the free androgen index (FAI). Your doctor will usually order these blood tests before prescribing testosterone replacement.

Low total testosterone, mid level total testosterone with high SHBG or low FAI are all results that may warrant testosterone replacement. Your doctor can advise you of your options.

A medical practitioner must closely monitor supplementation with testosterone. Provided blood levels are maintained within normal ranges side effects do not occur. Continual and high dose supplementation of testosterone in women may induce side effects.

Regardless of the strength and type of testosterone gel that you are using your doctor should regularly check you teststerone blood levels. The testosterone may be making you feel unwell if the dose is too high. You will only know this by having your blood levels tested.

Another question that I would ask is “Is it pure testosterone in the gel or is it an synthetic androgen with testosterone like effects?” This is important because if it is a synthetic it will act in a different fashion to bio-identical testosterone.

To learn more about testosterone use in women I would recommend you view www.lawleypharm.com.au and click on ‘Female Testosterone’ link.

The use of testosterone in women in a rapidly emerging area of female healthcare, but the use of “male” testosterone products in women is potentially fraught with problems due to the higher doses required by men relative to what is needed in women.

Thank you,

Michael