Listen in to my Primal Diet – Modern Health podcast on this topic on the player above or on iTunes.
There are three kinds of Testosterone: the hormone we make in our body from cholesterol and DHEA, and prescription Testosterone (either bio-identical or non bio-identical). Since Testosterone is an androgen, it acts as a form of growth hormone just as Estrogen does.
Testosterone has many functions in women, but, like Estrogen, it’s best kept in a “normal” range. It plays a role in muscle mass, cognition, energy and libido, to name a few.
How do you measure Testosterone?
Two ways… by blood or by saliva. Neither are 100% accurate.
Blood measures Total Testosterone, and/or Free Testosterone. Total T is a general measurement of the Testosterone in the body, whether it is available for use (free) or not. Free T measures the much smaller amount available for use. If you’re testing by blood, you should test both but doctors rarely do. Blood tests should be run in the morning when testosterone is highest (especially in men). Many men get prescribed Testosterone they don’t need because their blood tests are run at the wrong time, nor at the same time consistently.
Saliva testing measures only Free Testosterone and can affordably measure the important downstream metabolites DHT and Androstenedione. Elevated DHT is the hormone that can cause male pattern hair loss in men and women and prostate problems in males. Saliva testing is a “pooled” value and can be run any time of day.
Free Testosterone, whether by blood or saliva, is found in only tiny amounts. One big issue with prescribing Testosterone is that all tests are somewhat unreliable because the amount of testosterone is so small. And most people on RX Testosterone don’t test it as often as they should (every 3 months).
What are normal levels of Testosterone?
If you’re asking one of the thousands of new “Anti-Aging” Doctors, you’ll be told you should have the same T at 50 as you did at 20. Wouldn’t that be great? The Fountain of Youth?
Testosterone declines gradually in all men and women starting in our 20’s. This is normal and the body has its own reasons for doing this. I have a strong objection to this fad of anti-aging docs who charge huge amounts of money to put women (and men) on large amounts of hormones to “prevent and reverse aging”. I frequently see clients in my clinic who have paid thousands of dollars for doctor visits, blood tests and hormones I suggest they stop.
I run inexpensive saliva hormone tests (as well as do muscle-testing and blood tests) and invariably find their doses are too high.
Sometimes dangerously so…
I feel that Saliva testing is more accurate, cheaper and more extensive. And I prefer to try to FIX any low hormonal issue at the root cause. WHY are the adrenals tired and not producing Testosterone, Cortisol or Progesterone? Why use a Band-Aid to cover up a symptom?
Dangers of Testosterone for Women
- Elevated Testosterone is strongly associated with PCOS (cysts on the ovaries) as well as Endometriosis. PCOS can be a serious health risk. If ovarian cysts get large enough they can rupture, leading to internal bleeding and a 911 call for the ICU. I have a client who, under the care of an “anti-aging” doctor, almost died of a ruptured ovary.
- Testosterone creams or gels WILL rub off onto sheets, towels, hands, spouses, kids and pets.
- I don’t like the infection rate of subcutaneous hormone pellets (or the cost). Injections are the safest way to dose this super volatile hormone and get the correct dose (if needed). But the dose is so tiny for women that most docs use creams.
- Hair growth on the face is a common sign of high T. If you have a persistent dark moustache, see your Ob-Gyn ASAP to be tested for ovarian cysts. Don’t wait!
- Oily acne
- Hair loss
- Edema and fluid retention
- Deepening of the voice
- Changes in menstrual cycle
- Can raise Cholesterol
- Potential for elevated Insulin and Insulin Resistance
- Potential for increased risk of female hormonal cancers such as breast, ovarian and uterine
- Some studies warn of blood clots, strokes and increased risk of heart disease in women taking testosterone
What is the real cause of low hormones?
I see low Cortisol on perhaps 50% of the saliva tests I run. Perhaps 75%. Adrenal Fatigue is often the real issue.
Doing what it takes to restore the adrenals is the key to balancing your hormones
When we are under stress, we steal from DHEA, Testosterone, Estrogen and Progesterone to send the raw hormone to make Cortisol. If we drag down our Cortisol, the rest can follow. Here’s one of my many articles and podcasts on the adrenals.
Here’s a typical Cortisol pattern I see in saliva testing. Note the difference between the normal level in black and this client’s results in pink.
Getting your progesterone to cycle normally again will reduce ovarian cysts and the output of Testosterone. Read up on my adrenal articles, and take a peek at this tried and true PMS supplement. I’ve sold this in my clinic more than 30 years.
Benefits of Testosterone for Women
Testosterone can thin the fat under the skin, making muscles more visible and cheekbones more prominent. Fat will rearrange itself however and may go to the abdomen.
Studies do show possible improvement in bones, mood and libido.
A side note on Libido: If a post-menopausal woman has less desire than she remembers having when younger there are several factors to consider. 1). Women in their 50’s are OUT of the gene pool and evolution does not drive them to procreate. 2). Some may just not be attracted to their mate any more for a huge variety of reasons. 3). Sex can be painful as vaginal tissues dry up. Make coconut oil suppositories to help alleviate discomfort during sex, or weekly as a general comfort support. These have Vitamin E if you don’t want to make your own. 4). Exhausted women might just prefer to try to sleep!
Repair the adrenals to function and feel better. Consider having some Consults in my San Antonio Clinic or by phone to review your diet, lifestyle, symptoms, and run some Salivary or Blood lab tests.
Boosting Testosterone naturally
If we are chronically stressed, anxious and tired, our DHEA levels fall and therefore our testosterone and estrogens fall. Should we take Testosterone rather than fix the problem at the source? We can take DHEA or Pregnenolone (at low doses please) and work on our stress and anxiety levels by taking a good Adaptogen or Passion Flower and getting our lives under control.
Taking Progesterone or the precursors of Progesterone (such as Chaste Tree Berry) can help balance all the hormones, including Thyroid. But beware!! Don’t take more than a tiny amount of Progesterone. Much less than labels suggest, and regularly test by saliva, not blood, to see where your levels fall. Trust me on this!
If you are truly low in Testosterone (which I rarely ever see), the herb Maca will raise it. As an Adaptogen, it works on the Pituitary and allows hormone levels to stabilize. Don’t take too much and always TEST your levels frequently.
Types of Prescription Testosterone
Use bioidentical testosterone. Synthetic testosterone (methyltestosterone) or oral testosterone pills show an increased risk of breast cancer and heart disease.
A starting dose might be .5 mg transdermal testosterone daily. If side effects occur (hair growth on the face or arms, hair loss on the head, acne, deepening of the voice, irritability, irregular menstrual cycles) the dose can drop to 0.15 mg. Even better, fix all the adrenal, estrogen, progesterone and testosterone levels by fixing the adrenals and getting stress and sleep under control.
If your doctor insists on prescribing Testosterone, insist right back that Total T, Free T, and saliva testing all be done, and ask if the dose is more than .5 mg. per day.
Does the FDA approve Testosterone for women?
NO! There is no FDA approved prescription Testosterone for women.
It’s not FDA approved but is widely used “off label” anyway. As the precursor of Estrogen it can help raise low Estrogen (that’s good or bad depending on your level of Estrogen Dominance). There are no studies on the use of Testosterone longer than 6 months in women and the studies that exist show conflicting outcomes.
Here’s the FDA warning for heart attacks and strokes due to Testosterone use. It is only suggested for use in true, rare, medical emergencies or genetic flaws.
What to do with elevated Testosterone levels
If your blood or saliva test show high T, get evaluated for PCOS right away. Polycystic ovaries produce excess testosterone and insulin resistance. These are common causes of infertility, PMS and other menstrual irregularities. The supplement DIM may be useful to break down high Testosterone and Estrogen while working on the underlying cause.
I offer Virtual Consults to test and discuss these and other hormonal issues. Let’s talk.