Testosterone Therapy in Women

Testosterone Therapy for Women

A woman's hormone levels fluctuate throughout her lifetime.  Levels can change hour to hour and day by day.  However, it is well known that during the normal aging process a woman's hormone levels will begin to decline with age.  A multitude of clinical research studies have shown that by increasing testosterone levels in women their quality of life can improve because they are essentially being restored to a more youthful state and are able to experience enhanced health benefits.

At Weight Loss & Vitality and in my own clinical practice I have witnessed first-hand the positive life changing effects of testosterone replacement therapy has had on our patients.

Below we’ll look at some of the health benefits associated with testosterone replacement therapy in women: 

1. Bone strength
2. Protein synthesis
3. Prevention of heart disease
4. Skin health
5. Brain function
6. Fat distribution
7. Libido
8. Red blood cell production

Bone Strength and the Prevention of Osteoporosis

Bone remodeling is controlled by 3 main bone cells: osteoblasts, osteoclasts and osteocytes. These cells control bone-formation, bone-reabsorption and bone cell monitoring mechanisms.  These bone forming cells and their regulation greatly depend on proper hormone levels, minerals and cytokines in order to receive the messaging required to form new bone. The simplest explanation is osteoblasts (cells responsible for generating new bone) are greatly affected by testosterone hormone which directly upregulates androgen receptors on osteoblast cells. The process is complex and not yet completely understood. However, many studies show that testosterone is not only involved with formation of new bone by stimulating osteoblasts; testosterone also indirectly influences bone health by stimulating other key hormone players including growth factors, interleukins-6, parathyroid hormone and even fibroblasts. 

Protein Synthesis and Muscle Composition

Protein is responsible for nearly every function carried out in the body. It is also the building block for structure, development, function and regulation of all tissues and organs in the body.  This especially holds true for muscle development and recovery.  As in bone formation - testosterone indirectly influences many of the same factors that lead to improved protein synthesis which directly results in improved muscle composition.  If there is any doubt about the importance of having muscle remember – muscle is the largest organ group of the body.  The better muscle composition you have the more carbohydrates and fatty acids your body will burn.  Muscle matters in the pursuit of healthy longevity.

Prevention of Heart Disease

From 1999 to 2017 over twenty studies have been completed examining the effect of testosterone on the cardiovascular health of patients.  Rather than getting into a long and drawn explanation for why testosterone protects your heart health – I will just refer you to the latest study coming from the Mayo Clinic. The study can be found at:

https://www.mayoclinicproceedings.org/article/S0025-6196(17)30824-8/fulltext   

The final sentence is important and holds a lot of significance. It can be found on pg. 97 “The benefits of treatment of low testosterone levels with testosterone therapy in men and women substantially outweigh any risks, according to the current data.”

Improved Skin Quality

Would you like slow down and decrease the signs of aging and improve overall skin health?  Many factors make up skin health. Sebaceous glands, fibroblasts, sweat glands cells, subcutaneous fat cells, keratinocytes, collagen, hyaluronic acid (HA) and elastin. Hormones, including testosterone, play an important role in maintaining the health of skin. Hormones act at specific receptor sites throughout our skin which stimulate a chain reaction for maintaining healthy skin.

Three factors of interest related to maintaining healthy, youthful looking skin include collagen, hyaluronic acid and elastin. These 3 items make up much of the skin’s structure and repair mechanisms; and provide the ability for skin to stretch and contract. All 3 factors require proper protein synthesis and amino acids.  As mentioned earlier - protein synthesis relies heavily on adequate hormone levels in the body - including testosterone, estrogen, progesterone, growth hormone(s), growth factors and more.

Improved Cognitive Function

Most studies show that testosterone effects mental function and behavior.  The exact mechanism of action is not well defined; however it is well understood that androgen receptors (AR) are in the brain, skin, fat, muscles, etc… Simply stated AR’s must bind to hormones in order for the body’s intended functions to occur.  Literature states and supports that when testosterone replacement therapy is used properly it can support an improved mood, anxiety compensation and increased energy & spatial awareness.

Decrease Body Fat

Decreased testosterone levels in women can lead to decreased muscle mass.  Having a healthy metabolism is critical to decreasing body fat and improving muscle composition. Your body is designed like an engine – and in order for your engine to burn those extra calories versus storing them as fat – you must have an adequate supply of testosterone. Being estrogen dominant can also be a result of low testosterone.  Estrogen and testosterone compete for similar receptors on the body and both hormones have a very different function.  Estrogen will commonly increase body fat storage. Therefore, keeping your testosterone/estrogen ratio balanced is crucial for maintaining normal functioning body fat storage and muscle composition. 

Improved Libido

It’s a well documented fact that testosterone therapy increases sexual desire and arousal in women who have low testosterone levels. Check out this link from the lancet that shows the clinical results when studied Lancet Clinical Study

Enhanced Red Blood Cell Production

Both a benefit and a risk of testosterone therapy is the stimulation of erythropoiesis (also known as red blood cell production). This results in elevation of hemoglobin and hematocrit.  As hemoglobin and hematocrit levels rise – this improves and encourages increased oxygenation of vital organs and muscles leading to improved overall function. However, hemoglobin and hematocrit levels should not rise above normal. Therefore, it is important to be properly monitored by an expert healthcare provider when receiving HRT (hormone replacement therapy).

Symptoms of Low-Testosterone

Symptoms vary from patient to patient but can include some of the following: 

• Loss of muscle strength & weakness
• Decreased ability to recover after exercise
• Fatigue & sluggishness
• Sleep disturbances
• Reduced sex drive
• Weight gain
• Irregular menstrual cycles
• Vaginal dryness
• Loss of bone density
• Depressed mood

Multiple medical conditions can cause the exact same symptoms listed above so a proper evaluation is often necessary to in order to establish if low-testosterone is a contributing factor to symptoms. A simple blood test can often establish this.

If interested in learning more about testosterone replacement and hormone therapy for women, please call (571) 550-9000 to schedule an appointment.

Author

David J. Bauder, PA-C David Bauder, PA-C, is a certified physician assistant and the assistant medical director at Weight Loss and Vitality in Manassas and Alexandria, Virginia, Washington, DC; and Gaithersburg, MD. He enjoys helping patients optimize their physical and mental health to improve their overall well-being. He earned his physician assistant degree from the University of Texas Health Science Center at San Antonio. Afterward, he gained admission into the reputable graduate program for physician assistant studies at the University of Nebraska Health Science Center in Omaha. David has over 26 years of experience working as a physician assistant. He’s practiced in podiatry, family medicine, emergency medicine, general surgery, urgent care, and functional medicine.