Testosterone – Essential for Both Men and Women
Testosterone is a hormone that is essential for ideal function in both men and women. In men, the hormone is produced in the testes (95%) and the adrenals (5%). In women, it is primarily produced in the ovaries and adrenals.
In men, lower testosterone levels cause hypogonadism or andropause. The hallmarks of this disease process include fatigue, depression, erectile dysfunction, decreased libido, sarcopenia (muscle atrophy), functional weakness, and a loss of confidence/drive. These patients also have an increased risk of heart disease, osteoporosis, cholesterol elevation, mental decline, and Alzheimer ’s dementia. Optimizing levels of testosterone typically treat this combination of issues and protect against chronic diseases and health problems that increase health costs and increase the risk for disability. It also limits the need for treatment of high blood pressure, cholesterol disease, erectile dysfunction, osteoporosis, depression, and dementia. This also serves to limit polypharmacy, reduce costs, minimize side effects and cross-reactivity of these drugs, and improve function. Think about it, one hormone with multiple benefits limits the need for multiple expensive drugs with questionable efficacy and potential negative side effects. This is a trade I am definitely willing to take and so should YOU!
The hormone may be taken in three different forms. The first is a daily or weekly injection of testosterone which is typically self-administered after education from myself or one of our other practitioners. The second is a topical cream that is placed on the scrotum twice a day which maximizes absorption. The third is a pellet that inserted into the skin and soft tissues above the buttock on either side. All of these approaches are well tolerated and ideal for reaching optimal levels. Blood work is typically done after the initial consultation to obtain baseline levels. Once treatment begins, then levels are commonly checked every six weeks until optimal levels have been reached and/or symptoms have resolved. At that point, levels are then done every six months to confirm ideal levels and/or to adjust dosages. This pattern is similar for the other hormones that are replaced.
In women, testosterone is vital for a number of functions and it is equally as important for them as it is for men. Testosterone is described as the “feel good”hormone as it improves mood, energy, libido, and an overall sense of well-being. Testosterone is important for sexual function including clitoral sensitivity, lubrication, energy, and desire. It is helpful as an aesthetic agent as it prevents wrinkles and skin thinning from collagen loss. It also benefits musculoskeletal health limiting muscle loss and atrophy, maintaining strength and function with a concomitant exercise routine, and preventing osteoporosis and potential vertebral, hip, and wrist fractures (along with estrogen/DHEA/ growth hormone). The testosterone and estrogen combination also has been shown to have beneficial effects on the cardiovascular system including vasodilation and improvement in HDL levels (good cholesterol) and triglyceride levels (decreases visceral fat). Testosterone replacement is also vital in treating the hot flashes and night sweats associated with perimenopause (pre-menopause) and menopause.
Testosterone treatments are also helpful in women that have been treated for breast cancer as they are apoptotic (kill cancer cells) and diminish the stimulation of breast tissue. Progesterone has a very similar effect and should be given concurrently with testosterone in these patients. Testosterone may be provided to women in four different forms. The first is injection on either a daily or weekly basis. The second is a cream placed on the vagina/labia on a daily basis which may also help with lubrication, vaginal atrophy, urinary incontinence, and clitoral sensitivity. The third is a pellet that is inserted in the soft tissues of the buttock. The fourth is a micronized capsule formulated by a compounding pharmacy. Laboratory studies are performed the same as those outlined above.