Testosterone — it’s not just for men

The moment I read about this study on testosterone replacement in women, I knew I had to share it with you.

Why? Because in my medical practice, I use bioidentical hormone replacement therapy a lot. Especially testosterone replacement — even in women.

While this may come as a surprise to some, men and women have both testosterone and estrogen in their bodies. And they’re both necessary, too — of course, one is simply more dominant, depending on whether you’re a man or a woman.

And despite the controversy over testosterone therapy, my experience has me convinced of its safety. Plus, if you look at the science, there’s really no reason to doubt its safety. Still, I’m always happy to have more data back up my point…

Relief for menopausal women

This systematic review only looked at three studies — but the takeaways have some pretty important implications for older women.

Namely, that transdermal testosterone (which is administered through the skin through an adhesive patch) is effective in treating low sex drive in a postmenopausal population. And just as importantly, this treatment comes with no increased risk of breast cancer.

I also frequently prescribe women testosterone to manage general menopause symptoms. And trust me, it works — and the results of these recent studies are reassuring, to say the least.

The first study featured nearly 650 women who entered menopause as a result of surgery. They were treated with transdermal testosterone and estrogen therapy. And four years of follow-up showed no increase in adverse effects, including rates of breast cancer.

The second study was a randomized, placebo-controlled trial featuring approximately 270 menopausal women. (This time, due to natural age-related hormone changes.) They received either transdermal testosterone therapy or a placebo for six months.

There were no breast cancer diagnoses, heart attacks, or deaths during the study. But there was quite a boost in sexual satisfaction among the testosterone group.

The third study was also placebo-controlled — only this one lasted a full year and featured more than 450 postmenopausal women with low sex drive. There were only a handful of incidents of cancer in the testosterone group, but researchers were able to attribute all of them to outside factors.

And again, there was a significant surge in sexual satisfaction among this group when compared with placebo.

Find a doc who knows the ropes

As I mentioned earlier, I use bio-identical hormone replacement therapy in a lot of my patients — both male and female. And for postmenopausal women, I’ve seen it work on anything from fatigue and insomnia to mood swings.

Estrogen typically dominates any conversation about standard hormone replacement therapy (HRT). But this research is a good reminder that the other hormones matter — both to balance estrogen levels and to restore sex drive.

Women, like men, should always ask to test for total and free testosterone. Total testosterone levels should generally fall between 20 and 80 ng/dl. (Though I find closer to 80 is usually ideal.) And all my HRT protocols start with at least 1 mg of testosterone.

That’s just a starting dosage, though — you’ll know you’ve hit the sweet spot when all of your menopause symptoms disappear. And at that point, I’ll generally test hormone levels three times a year to help maintain them.

There is, of course, an exception to every rule. And the one case where I’m quite reluctant to introduce testosterone to a female patient is if she has had triple-negative breast cancer that’s positive for androgen receptors. In these unique cases, the extra testosterone could contribute to the disease.

Otherwise? If you’re an older woman with low libido, trouble losing weight, or dealing with diminishing workout returns, testosterone replacement could be the solution you’ve been looking for.

The first step is working with a doctor who knows what they’re doing. To find a knowledgeable holistic practitioner familiar with natural hormone replacement therapy, contact the American College for Advancement in Medicine at www.acam.org or call 1-800-532-3688.

The International and American Associations of Clinical Nutritionists (IAACN) can also be a good resource. You can contact them through their website at www.iaacn.org or by calling 972-407-9089 between 9 a.m. and 4 p.m. CST, Monday through Friday.

The bottom line is this: Testosterone therapy has over 75 years of science behind it. Time and time again, it’s been proven safe and effective. In fact, I wrote about this at length in my June 2015 Logical Health Alternatives newsletter (“Safety of testosterone therapy backed by 75 years of science”). And the most important thing to remember is that any treatment should be individualized.

(To learn more about my monthly Logical Health Alternatives newsletter, or to subscribe today, simply click here.)


“No Breast Cancer Risk for Testosterone Use in Menopausal Women.” Medscape Medical News, 12/14/18. (medscape.com/viewarticle/906606)