Testosterone (T) in women is an advocate of physical and mental power: it makes us assertive, confident, and quick in decision-making.
Essential for a woman's health, for her brain so that it does not succumb to the signs of aging, for her vitality and sexuality.
In women, testosterone peaks at 18-20 years of age: this is why desire is at its peak. By the age of 40, it is already reduced by 50%: this explains the decline in libido.
If a woman has had her ovaries removed, her testosterone level drops by 80%
The ovaries produce half, and the rest comes from the adrenal glands where it is produced in the reticular zone along with the other androgens (DHEA and androstenedione).
Testosterone has many functions, some of which include influencing the various stages of puberty and the sexual sphere.
Other functions are also affected, such as bone density, muscle mass, mood, and energy reserves.
Around 35 to 40 years of age, androgen deficiency syndrome may occur, and the woman feels insecure, anxious, hesitant, there may be hysterical reactions, she loses control quickly, has no sexual desire, and no orgasm. Also if testosterone is low, the woman may be very depressed. Appearance is pale, muscle and tissue laxity (watch out for varicose veins!), sarcopenia, accentuation of kyphosis, in the vulva there is atrophy of the labia majora.
Skeletal muscle correlates significantly with T. T increases lean mass in women, reducing abdominal, gluteal, and total fat leading to weight reduction in postmenopausal women.
EFFECTS OF Testosterone
Effects on the cardiovascular system
Adequate levels of testosterone reduce intimal thickening of arteries.
In postmenopausal women low T levels increase the risk of CIC.
Bones
T is a powerful stimulator of bone mass at the level of the femoral neck and lumbar spine.
Rheumatic diseases
T reduces pain in postmenopausal women with RA
Dysmenorrhea and menorrhagia + fibroids
T improves menstrual pain and reduces the abundance of flow in cases of menorrhagia, acting like progesterone.
It also stabilizes uterine fibroids or reduces their size.
Lichen sclerosus of the vulva
It significantly reduces symptoms even though histologically there are no significant changes.
Particular symptoms of lichen are painful intercourse, painful defecation, intense vulvar itching co excoriation of the vulva, loss of vulvar structure up to the fusion of the labia and covering of the clitoris.
Urinary incontinence
T is undoubtedly the best treatment for urinary incontinence, especially stress incontinence. Great to spread it at the entrance of the urethra 2 x a day doing at least 10 contraction exercises.
Flushes
Good effect in reducing them. T is converted to estradiol.
Mood
Improved mood, increased energy and vitality. Synergistic action with estradiol
Libido
T doubles in number of orgasms compared to estradiol alone. At menopause, the woman must also be replaced by T.
Longevity
T has a positive effect on life length.
How to diagnose androgenic deficiency in women?
| Hormone | optimal values |
| E2 | 70-160 pg/ml |
| T | 350 pg/ml |
| SHBG | 65 pmol/ml |
| DHEAS | 2800 pg/ml |
| (androstenedione) | 2,8 |
| DIT | 3 ng/ml |
Therapy of androgenic deficiency in women
The goal is to find a balance and associate T with E2, E3 and P.
If administering T you should ALWAYS combine estrogen/progesterone.
The best form of administration is liposomal gel at a concentration of 0.5%, which corresponds to a dosage of 5 mg. It is better in that it avoids hepatic passage (hepatic first pass), is more natural and physiological, and induces less suppression of inogenous T and LH production.
The dosage can vary from 5 to 10 mg/day.
Possible disadvantage.: possible increased conversion after 3-12 months to DIT (Dihydrotestosterone) due to the presence of the 5-alpha-reductase enzyme in the skin.
Therapy contraindicated in women with hirsutism.
