What Women Need to Know About Testosterone Deficiency
Women ≠ Estrogen
I know I know… that statement might sound bold or even shocking, but there's some fascinating science behind it that you should hear about.
A healthy 20-year-old female has 15-20 times more testosterone than estradiol, the most potent type of estrogen. In women, testosterone levels typically start to decline around the age of 35. In fact, by the time a woman reaches 35-40, she has half the testosterone of a 20-year-old.
It is not a coincidence that around this time, many women begin noticing significant changes in their psyche, body composition, mood, sex drive, and cognition. Symptoms such as breast tenderness or depression may set in, but these are not necessarily related to estrogen levels as commonly thought.
A diminished sense of well-being, low energy, physical fatigue, lack of motivation, waning self-confidence, increased fear, bone loss, decreased muscle strength, hot flashes, and insomnia are all issues that we see with androgen (testosterone) deficiency in women. Simply giving a woman estrogen and progesterone is not enough and can leave her feeling sub-par and not optimal.
Here's something your doctor may forget or might not even be aware of, but it's crucial to understand: Ladies, you have testosterone receptors ALL OVER your body! These receptors are in your bones, muscles, brain, heart, blood vessels, ovaries, breasts, vaginal tissue, skin, bladder, and even lungs and intestines. Testosterone has incredibly wide and beneficial effects on your entire body. It’s not just about sex drive and libido—far from it!
Still with me? Great! Here’s the last crucial piece of information: There is an enzyme in your body called aromatase that converts testosterone to estrogen. This enzyme is present in every cell that has an estrogen receptor.
Why is this so important? It means that when we give testosterone to a woman, the cells that need estrogen can and do readily convert testosterone to estrogen.
In my practice, I rarely need to give estrogen to a woman because of this key point. Administering testosterone alone (my favorite form is hormone pellets) is often enough to relieve menopausal symptoms and improve body composition, libido, memory, bone density, urinary complaints, and mood without the risk of causing unwanted side effects related to excess estrogen.
Every doctor who treats hormone deficiencies in women knows that if a woman has issues with any hormone, it's almost ALWAYS estrogen. Women rarely have testosterone issues, especially when administered by an experienced and well-trained provider using testosterone pellet therapy or is knowledgeable enough in alternative delivery mechanisms.