What Role Does Testosterone Play in Women’s Health?

Testosterone is the hormone that gives men their “manly” characteristics like strength and a deep voice. Not surprisingly, men produce more testosterone than women, about 15 to 20 times more, which is why most women don’t have a baritone voice. Yet women still produce testosterone in limited amounts and even this small amount is important for health.

While cells in a man’s testicles pump out testosterone, a woman’s ovaries produce estrogen, but females also produce small amounts of testosterone, which is released into the bloodstream from the ovaries along with estrogen. The adrenal glands, two small glands located above your kidneys, also produce minor amounts of testosterone. Even after menopause, female ovaries continue to produce and release small amounts of testosterone, although only about half as much as before menopause. Women who have their ovaries removed surgically lose this source of testosterone, making their only source of testosterone the adrenal glands.

Even prior to menopause, testosterone levels begin a slow and gradual decline. By the time a female reaches her early 40s, she only has about half the daily production of testosterone she had in her early 20s.

Some Women Have more Testosterone than Others

Although most women have low levels of testosterone relative to men, if you have a condition called polycystic ovary disease, your testosterone level is significantly higher than the average woman’s. Polycystic ovary disease, also known as PCOS, affects between 5 and 10% of women, many of whom are obese or insulin resistant. Females with this condition produce more than the typical amount of testosterone.

Extra testosterone might sound like a good thing if you’re trying to build muscle or gain strength, but if you have polycystic ovary disease, you also have to deal with other inconveniences like excess hair growth, weight gain, acne, irregular periods, infertility, and depression. A number of women with polycystic ovary disease develop other health problems, including type 2 diabetes and high blood pressure.

A situation where you might have lower than average testosterone is if you take oral contraceptives. The hormones in these pills suppress the function of the ovaries, the main producer of testosterone in younger women. Of course, having your ovaries surgically removed, for whatever reason, will lead to a drop in testosterone since the ovaries aren’t there to make it and you have to draw from the limited amount produced by your adrenal glands.

Is Testosterone Important for Women’s Health?

You don’t want your testosterone to dry up since testosterone helps maintain bone density and reduce the age-related loss of muscle tissue. Studies show women with low testosterone are more prone towards bone fractures after menopause. In addition, low testosterone is linked with reduced sex drive. In general, very low testosterone is only a problem for women who have had their ovaries surgically removed or who have lost ovarian function after taking chemotherapy or radiation.  For these women, gynecologists sometimes prescribe transdermal testosterone to help bring their testosterone level up to where it would be naturally.

As you know, the risk of heart disease in women goes up after menopause. Although the increased risk is often blamed on a drop in estrogen, some research suggests a decline in testosterone production is a contributing factor. How might this be? For one, like estrogen, testosterone improves blood vessel function. In turn, this lowers blood pressure and reduces the risk of damage to the walls of arteries. So, testosterone helps keep the lining of your blood vessels healthy.

Low testosterone in both men and women has also been linked with depression, fatigue, and lack of energy. Unfortunately, it’s also associated with an increase in body fat. It’s also possible, but yet unproven, that testosterone is important for brain health and cognitive function. Interestingly, a new study calls this into question.

In this study, researchers scanned the brains of transsexuals, using MRI, before and after they started taking testosterone therapy. Surprisingly, they found regions of the brain involved in language shrunk in size after the participants started testosterone therapy. Now, experts wonder if less testosterone explains why women tend to have better language skills.

What about Supplementation?

The problem with testosterone supplementation is the potential side effects: increased hair growth, acne, and hair loss. Not all women experience these symptoms and in ones who do the symptoms are usually mild. Usually, these symptoms only show up at higher doses.

One concern is that testosterone therapy might increase the risk of breast cancer. One large study called the Nurse’s Health Study showed a link between testosterone therapy and breast cancer but other studies have not. The reason testosterone COULD be linked with breast cancer is that fat cells produce an enzyme called aromatase that converts testosterone to estrogen, and estrogen that fuels the growth of some forms of breast cancer.

Testosterone and Strength Training

Despite the fact that females produce less testosterone, women still can develop strength and muscle even after menopause when testosterone drops. Although having more testosterone is advantageous if you’re trying to build strength and lean body mass, research suggests growth hormone may play a more important role for muscle growth in females. Plus, research shows long-term resistance training, using heavy resistance, increases serum testosterone in women. How can you take advantage of this? Maximize the growth hormone response to resistance training by lifting heavy weights, doing compound exercises, and using shorter rest periods.

The Bottom Line

Testosterone has important functions in women – it helps preserve bone density and lean body mass and enhances libido and energy level. Testosterone also seems to offer protection against depression. Most women feel better when their testosterone is not low. Whether or not it protects against heart disease and cognitive dysfunction still isn’t clear.

As far as testosterone supplementation goes, most doctors don’t recommend it unless a woman has had her ovaries removed. One thing you can do to boost testosterone is to do high-intensity resistance training and stick with it long term. Of course, you should be doing that anyway. As you can see from the problems polycystic ovary disease causes, you don’t want too much testosterone either. It would be nice to maintain the perfect balance throughout life, but life is rarely that simple.

 

References:

J Endocrinol. 2004 Nov;183(2):331-42.

Am Fam Physician. 2003 Aug 15;68(4):697-705.

Clin Med Res. 2004 Feb; 2(1): 13-27.

Expert Rev Endocrinol Metab. 2012;7(5):515-529.

Menopausal Medicine. Volume 20, No. 2. May 2012.

Harvard Health Publications. “Testosterone may improve mental function”

Bodybuilding.com. “Breaking The Myth – Increasing Testosterone In Females = Muscle Accretion And Strength Gains”

Eur J Appl Physiol,78(1). (p. 69-76).

Is Testosterone the Reason Women Have Better Verbal Skills than Men?

Arterioscler Thromb Vasc Biol. 2012 Feb;32(2):481-6. doi: 10.1161/ATVBAHA.111.232876. Epub 2011 Nov 17.

 

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