Women — Don’t Live One Third Of Your Life In A State Of Sex-Hormone Deficiency
As we age our bodies natural level of testosterone drops. What you can do to get this essential hormone back in balance.
I’m a guy. Why am I writing about balancing testosterone for women? Well, it started as research for my own health. I am not a doctor or medical professional, so why listen to me? While I am not a doctor, I am an expert in researching, distilling my research for into understandable and usable information.
As my research bears out, if a woman has symptoms of low testosterone or the symptoms of menopause are caused by low testosterone, it is most likely to be under diagnosed. Doctors will typically look for other causes first.
My original article covered testosterone for both men and women, but it was a bit convoluted jumping between the two sexes, so I split the article into two. One article focused on men and this article focuses on women.
Testosterone is a hormone present in both men and women’s bodies. For men, it is the main hormone responsible for our masculine characteristics. In both men and women, testosterone affects sex drive, muscle mass, fat composition, lethargy, and mood. For women, testosterone therapy has been used successfully to combat symptoms of menopause.
The biological effects of testosterone on men have been known since antiquity. The reason we learned this so early in our history is that the testes, where 95% of the man’s testosterone is secreted, are external to the male body and are easily removable. Say it with me, Ouch!
Aristotle (384–322 BC) observed and reported the effects of castration. However, the castration of males has been documented as early as 1300 BC, as the country of China performed the practice to create eunuchs. Castration was also performed on slaves and defeated soldiers, in addition to being used as punishment for those who committed various crimes.
What is Testosterone?
Testosterone is an anabolic steroid. I know, sometimes the words anabolic steroid is a Pavlovian dog whistle suggesting negative associations to athletes and body builders. However, we ought not label steroids as being “bad.” The human body uses many steroids every day to stay alive and function.
Testosterone is the first anabolic steroid found. Anabolic steroids increase protein production, what we common lay-folk think of as muscles and bone. However, the few athletes who abuse anabolic steroids rarely do so with plain old testosterone. Designer steroids are available that are more potent than testosterone. And if they are abusing testosterone, it is in dosages that far exceed what a normal replacement (physiological) dose of testosterone used in replacement therapy (HRT).
The focus of this article is to restore your youthful levels of mental and physical fitness by balancing women’s most neglected hormone, testosterone, to an optimum level.
Women’s Natural Testosterone Production
Women in their twenties will produce between 0.25 to 1 milligram of testosterone per day. That’s between 1/10 and 1/20 of the amount of testosterone produced by men.
While testosterone is thought of as a male hormone, women produce testosterone in both the ovaries and adrenal glands. Testosterone levels decrease with age in women, as it does with men. By the time a woman reaches age 40, her testosterone levels have decreased by fifty percent.
Low testosterone in women mimics similar symptoms in men; lower sexual drive, lethargy, depression, weight gain, loss of bone density, and loss of muscle mass. Women under 50 years old with a testosterone level of 20 ng/dL is (in some ranges) considered low. (study), (study)
Nonpregnant women between the ages of 20 and 29 have an estrogen level that varies between 20 and 150 pg/ml. Estrogen levels vary depending upon where a woman is in her menstrual cycle. While I’m sure testosterone levels in women vary also during the month, I haven’t found any supporting data on this. Therefore, I am using a static average testosterone value. I estimate a woman’s testosterone level at a midlevel value of about 40 ng/dL. If we convert her testosterone unit of measure from ng/dL to pg/ml, 40 ng/dl converts to 400 pg/ml of testosterone.
Women have 2–20X more testosterone than estrogen in their blood.
Now it becomes interesting, and I believe it’s a fact few people know. Well, at least I didn’t know this beforehand. A woman between 20 and 29 years of age has two to twenty times more testosterone in her system than estrogen. This ratio changes when a woman becomes pregnant, as pregnancy elevates a woman’s estrogen and testosterone levels.
A woman in menopause experiences a drop in her hormone levels and may experience the same symptoms of low testosterone as men. Typically, a doctor starting treatment using Hormone Replacement Therapy (HRT) will prescribe estrogen and progesterone but most will not include testosterone. If HRT treatment doesn’t ease the symptoms of menopause, it is possible that testosterone needs to be included.
Many doctors will say no to this course of treatment. But other doctors, some of whom are women, say yes. One such doctor began treating her own symptoms and wrote books on the need to include testosterone in women’s HRT.
Kathy Maupin MD is a board-certified obstetrician and gynecologist who went through her own hormone hell in her early 40s. Her symptoms, loss of sexual interest, exhaustion, increased body fat, lack of mental clarity, and others, were not alleviated until she began adding the hormone testosterone. This affected her so deeply, she became an anti-aging physician who has dedicated herself to treating midlife women with testosterone. In her book, The Secret Female Hormone, she describes the debilitating hormone imbalance she experienced before menopause and how she is helping other women.
Here is another case, where two married doctors discovered the advantages of optimizing their testosterone levels. An OBGYN discovered testosterone therapy for both himself and his wife. She was only 39 years old when she started testosterone therapy. He presented an interesting TED talk describing the events, you can view on Youtube here:
Testing Testosterone Levels
For an accurate measurement of your testosterone level, you need a blood test. A complete testosterone test will give three numbers associated with your testosterone measurement; Total Testosterone, Bioavailable, and Free.
Total Testosterone is the accumulated number of all the different forms of testosterone in the body.
About 45% to 65% of testosterone is strongly bound to the Sex Hormone-Binding Globulin (SHBG) protein. The SHBG bound testosterone is biologically inactive.
Approximately 33% to 50% of testosterone is weakly bound to albumin. This percentage of testosterone is called bioavailable testosterone. This form of testosterone can be converted to free testosterone, when the body runs low on free testosterone.
Finally, we have 1% to 3% of free testosterone that is biologically active. This is the amount of testosterone that is available to the cells in your body to work its magic.
Low Testosterone in Women
Women with symptoms of low testosterone are most likely under diagnosed. Doctors will typically look for other causes first. As with men, low testosterone in women is also associated with lower sexual drive, lethargy, depression, mental fog, loss of muscle mass and bone density, as well as vaginal dryness. Women experience a significant drop in hormone levels during menopause. However, drops in hormone levels can occur before menopause that developed symptoms.
If you are experiencing symptoms have a blood test to check your hormone levels, including testosterone.
Benefits of Optimal Testosterone
Women who are experiencing symptoms caused by low testosterone, may alleviate these symptoms by increasing their testosterone into its normal midrange level (35 to 40 ng/dL).
There is evidence to support that testosterone increases scalp hair growth, is cardiac protective, and helps prevent breast cancer among other values. (study)
Hormone Replacement Therapy (HRT) or Boost Testosterone Naturally
If your testosterone values are medically low, you ought to have the option of hormone replacement therapy. You may want to try increasing your testosterone naturally, and if that fails, move on to replacement therapy. In attempting to boost your testosterone naturally, you will likely improve your general health with diet, exercise, and supplements. So even if you fail at raising your testosterone levels, these steps will form a solid foundation for HRT to work.
If men with low testosterone have an issue with the non-specialized MD prescribing testosterone, the situation is compounded for women. In 2014, a task force commissioned by the Endocrine Society (report) recommended against doctors making a diagnosis of low testosterone in women due to lack of research in this area. Nonspecialized MDs are more concerned with high testosterone levels in women.
Things are improving, as a few estrogen replacement drugs also contain testosterone. Consider that unless you see a physician who specializes in anti-aging medicine, testosterone supplementation is probably off the table.
At the end of this article are resources for online anti-aging hormone specialists who can order blood tests, check results, and prescribe testosterone, as well as other hormones if needed.
Don’t be Afraid of Increasing Testosterone (Naturally or HRT)
Some women may be concerned that increasing their testosterone and exercising will make them bulky and manlike. Not likely. Barring any medical condition that may raise your testosterone to supra-female levels, a woman becoming bulky due to increased testosterone will not happen.
Look at top supermodels and women who are considered the most attractive women in the world. Most of these women have more muscle mass than the average woman. Being fit and healthy is sexy. Increasing your muscle mass will make you sexier, not masculine. The benefits of improving your testosterone levels to normal female levels will help you to lose fat, build muscle, improve libido, performance, and improve mental cognition.
If you’re still worried about working out, consider that normal testosterone levels in men are 10–20X greater than the level in women and men still must work hard to build muscle mass. This is why men are always looking for something extra they can do or take to spur results.
Goal: 35 ng/dL
From my research on this topic, I reasoned that a endocrinologist (hormone specialist) will bring your T levels to mid-high “normal female range,” or about 35 ng/dL. (I base this value on the Mayo Clinic’s range for women being 8 to 60 ng/dL, although your doctor’s opinion may vary.)
Conversion of measurements
Because lab test results can provide testosterone level in different measurements, I am including a few basic conversions. With testosterone, we want a minimum total level of 35 ng/dl for health.
To convert ng/dL to nmol/l multiply by 0.034.
So a lab result of 35 ng/dL is converted to nmol/l by multiplying by .034. (35 ng/dL * .034 = 1.2 nmol/l).
To convert nmol/l to ng/dL, you multiply by 29.4.
So going back, 1.2 nmol/l * 29.4 = 35 /ng/dL (actual number is 35.28 but rounds to 35)
To convert pg/ml to ng/dL
Ten pg/ml equals one ng/dL. To convert ng/dL to pg/ml multiply by 10.
Nutrition, Supplements and Exercise
I was able to bring my testosterone levels up, from the 302 ng/dL to a healthier 540 ng/dL through the use of nutrition, supplements and exercise. It didn’t happen overnight. It took work, I also dropped a considerable amount of fat in the process. Just losing a large amount of fat, boosted my testosterone levels.
I will be writing a more in depth article on boosting testosterone using nutrition, supplements and exercise, until then here are a few tips.
Resistance exercises will help boost testosterone. The best exercises use the larger muscle groups, like in your legs. In my opinion, one of the top bodyweight exercises is squats, an alternative to squats are lunges.
The top three supplements I recommend are:
Boron: At the top of my list is the mineral boron. Extensive testing shows that boron increases testosterone in both women and men. A daily dose of 6 mg of boron has been shown to double the amount of free testosterone in women in a week. (study)
Ashwagandha: Is an adaptogen. Clinical studies show that it improves testosterone in men (study) and improves sexual function in women. (study) While the study of women didn’t directly test testosterone levels, it certainly indicates due to the increase sexual function that it had. 300mg twice a day.
The basic guideline for nutrition is simple. Reduce eating processed foods, white flour and white sugar products like, pasta, cookies, soda, cakes and pastries.
Increase eating whole foods and vegetables, eat organic if available.
Replace the use of plastics with glass in food and water storage.
The average age a women experiences menopause is 51. Of course, menopause can happen at an earlier age, but let’s assume 51 years old. The average life expectancy of women is 86 years. At the time most women experience menopause, they still have more than a third of their life ahead of them.
By addressing the symptoms caused by dropping hormone levels, and bringing them back to an optimal level will increase the quality of your life. I hope this article provided a solid foundation for you to continue learning about the value of balancing your hormone levels including testosterone.
Online Hormone and Anti-Aging Specialists
Full Disclosure: I am not in any way financially associated with, or financially benefiting in any way, with any referenced specialists below. Nor is their listing here an endorsement of their services. I know how frustrating working with non-specialized physicians can be, so they are provided as a potential source for both men and women who may not have a local anti-aging specialists in their area. These specialists offer consultations, order blood tests, interpret the blood test results, and write prescriptions if needed and desired.
Allure MD Spa & Wellness Center
Genesys Medical Institute