Do women truly need to supplement testosterone levels?

Posted by Liz on Jun 13, 2014 in testosterone | 3 comments

Testosterone is a hot topic for men. But evidently, it’s an equal opportunity hormone, designed to boost low libido one woman, one cream application at a time. But what is it about testosterone that makes its use in menopausal women questionable if downright unhealthy?

The levels, that’s what.

I’ve written about testosterone before and you can look up the archives via this link. The upshot is that for both men and women, testosterone therapy is oversold as a panacea for just about everything from distress about aging to sexual desire to bone, heart and mental health. Wow! Quite the Fountain, no?!

However, while transdermal (through the skin) testosterone is preferable (it avoids metabolism by the liver and promotes steady blood levels of the hormone), the patch has gotten the boot both in this country and overseas, and implants are no longer available. LibiGel, a topical cream was also denied market entry by the FDA. The result has been frequent prescribing of compounded testosterone in both genders.

Mind you, Allopathic practitioners for the most part shun compounded products, claiming safety issues and the lack of regulation. And in some cases, they are absolutely correct (do you recall the New England compounding crisis?). More recently, the North American Menopause Society (NAMS) issued a press release knocking compounded prescriptions, noting that they may deliver excess levels of testosterone thereby “producing untoward effects.” For example, too much testosterone may lead to depression, promote unwanted acne and hair growth, enlarge the clitoris, deepen the voice, produce aggression and boost cholesterol levels. The answer? According to NAMS, the answer may lie in an Australian formulation — AndroFeme — that was recently tested in seven healthy, postmenopausal women.

In a study published ahead of print in the journal Menopause, the researchers report that this 1% testosterone cream, applied 5 mg daily for 21 days and then immediately thereafter, 10 mg daily for 21 days, resulted in peak blood levels of testosterone that were in the normal range; while the 5 mg dose raised blood levels only slightly above normal, the 10 mg dose raised it to a higher level (double the upper limit). Moreover, apparently neither dose level had an impact on estrogen levels or sex-hormone binding globulin, a protein that binds to the sex hormones and determines how much of them remain available.

So, what’s the lowdown? Theoretically, the Australians have arrived at an acceptable testosterone dose for women with a safe delivery system. They report that it was well tolerated but did not qualify what this means. If you read the NAMS press release, the organization is basically promoting a pharmaceutical grade product over compounded agents even though the study was conducted in a mere seven women. Seven women do not a conclusion make…ever.

How much testosterone is too much for women after menopause? As of today, any amount might be too much until more data are available. Buyer, beware. T is for thwart and the time to put low T to bedis now.