Testosterone replacement therapy is a controversial subject regarding men and it is almost taboo to discuss testosterone replacement therapy in women. Women, like men, produce testosterone, but to a much lesser extent (about 1/10th) than men do.
Why do women take testosterone?
Women may choose to take testosterone to restore a healthy sex drive, increase energy levels or improve an overall feeling of well-being. It has been shown that women who do not produce sufficient testosterone are likely to experience a dramatic increase in libido (sex drive) when testosterone replacement therapy is given. In fact, one study of women who had undergone a hysterectomy (removal of uterus) with a bilateral oophorectomy (removal of the ovaries), the women who were given supplemental testosterone showed an improvement in overall mood, well-being and sexual function (1).
What if I'm a woman and haven't had one of the surgeries mentioned above?
Dr. Susan Davis is one of the world's leading experts on testosterone replacement therapy for women. Dr. Davis provided a report in the Journal of Clinical Endocrinology and Metabolism summarizing the positive effects post-menopausal women had with testosterone supplementation. The report cited that women who were postmenopausal or had oophorectomies and were treated with testosterone therapy, had produced a direct and sustained improvement in sexual drive, arousal, and frequency of sexual fantasies (2). To further the point, Dr. Davis recently wrote in a published article that testosterone appears to be important in maintaining a woman's energy level and sense of well being, regardless of her age (3).
How do I know if my testosterone is low?
If you are experiencing symptoms of low sex drive, low energy and low mood, you could be a victim of low testosterone. The best way to find out if your testosterone levels are low is to have your physician test your blood. It's critical to ask your doctor for a free testosterone check and not just a total testosterone. Total testosterone includes testosterone, which is bound to sex-binding globulin hormone and albumin. Bound testosterone is not biologically available and thus will not exert the positive effects.
The free testosterone range for women is very wide
The free testosterone range for females is 0.0- 7.0 (depending on the lab). Women who are on the high end of normal (5.0-7.0) generally have a more fulfilling sex life than women who are on the low normal end (0.0 -2.0). However, lab values are only a guide and treatment should be based upon the patient's symptoms. Some women may experience a high sense of well-being and healthy libido with a low normal testosterone while women who are in the high normal range may have a poor sense of well-being and low libido. Each individual is different and should be treated accordingly.
What can I do to increase testosterone naturally?
There are several ways to naturally increase testosterone that I have written about before. In addition to the suggestions made in the blog above, strength training has been shown to increase a woman's testosterone. A study done on young females (age 19-25) demonstrated that squatting could boost a woman's total and free testosterone levels (4). Another study in 2002, examined the effects of endurance and resistance exercise on hormonal levels, including testosterone, in women 19-69 years of age (5). As in the previous study, testosterone levels increased significantly in women who did either endurance or resistance exercises, regardless of age.
What are the side effects of testosterone replacement therapy in women?
Testosterone replacement therapy has the potential to have side effects, like any other hormone. Side effects from excess testosterone include hirtuism (unwanted body hair), increased aggression and clitoral hypertrophy. These side effects are generally seen in women who abuse testosterone for bodybuilding or performance enhancing reasons. If testosterone is prescribed by a physician and blood tests indicate that you're in the normal range, you are unlikely to experience the side effects listed above.
Testosterone is not a hormone only for men. Every healthy female in the world produces testosterone for a reason; it contributes to basic functions in the female body. Testosterone should be viewed just as any other hormone in the female body. Treat the patient safely and effectively based upon blood tests and symptoms. If you're looking to increase your testosterone, begin by incorporating a strength-training program and other lifestyle factors that can contribute to boosting testosterone. If you don't achieve the results you're looking for through lifestyle and dietary factors, consider testosterone supplementation from a physician. I hope this clarified many of the misconceptions surrounding the importance of healthy testosterone levels in females.
1. Shifren JL, Braunstein GD, Simon JA, et al. Transdermal testosterone treatment in women with impaired sexual functioning after oophorectomy. N Engl J Med. 2000 Sep 7;343(10):682-8.
2. Davis S. Androgen replacement in women: a commentary. J Clin Endocrinol Metab. 1999 Jun;84(6):1886-91.
3. Davis SR. Androgens and female sexuality. J Gend Specif Med. 2000 Jan-Feb;3(1):36-40.
4. Nindl BC, Kraemer WJ, Gotshalk LA, et al. Testosterone responses after resistance exercise in women: influence of regional fat distribution. Int J Sport Nutr Exerc Metab. 2001 Dec;11(4):451-65.
5. Copeland JL, Consitt LA, Tremblay MS. Hormonal responses to endurance and resistance exercise in females aged 19-69 years. J Gerontol A Biol Sci Med Sci. 2002 Apr;57(4):B158-65.