Most people go through life thinking estrogen is for women and testosterone is for men, but things aren’t that simple. For example, men need estrogen. And when men lack estrogen there is a genetic irregularity. This leads to health problems. There’s a lot of good research on men and estrogen. But there hasn’t been much research done on women and testosterone. But that’s changed over the last 10-15 years.
At Protea, we run lab work to figure out why women may need testosterone. In this blog we’re going to cover why we treat some women with testosterone, symptoms of low testosterone in women, and the risk and benefits associated with testosterone in women.
In women, testosterone is produced in the ovaries. Testosterone is produced all month long, with a little spike sometime around ovulation. Testosterone binds to muscle tissue to help fortify muscle tissue, including your heart.
Currently, the most common use of testosterone in women has been for anti cancer treatments. Testosterone helps mitigate the pain caused by breast cancer, and inhibit breast cancer growth. But testosterone also has a profound effect on brain chemistry.
In the brain there is the limbic system. It’s a deeper part of the brain, and it has centers associated with confidence, assertiveness, aggressiveness, libido, risk taking and boundary setting. These are deep drives within the human brain. Then there is the cortex, the upper part of the brain.
A young man (around 17/18 years old) may exhibit a lot of these traits: abnormal libido, they take too many risks, and they have over abundant confidence. This is because a young man has a very thin cortex. I.e., he doesn’t have a lot of judgement. If you have a thin cortex you feel those drives more intensely, this is only compounded by the amount of testosterone a young man has.
Women have much thicker cortexes than men. Especially adult women. Adult men have tick cortexes as well, but cortexes develop slower in men. Your cortex is where your experiences live: your upbringing, your values, friends, beliefs, spirituality and etc.
Healthy amounts of testosterone filtered through a woman’s thicker cortex means they have a healthy level of risk taking/risk management. They don’t act aggressively in a harmful way, but they are aggressive in regard to pursuing their dreams and what matters to them. Women with healthy levels of testosterone can more easily set emotional boundaries and adhere to them. This all allows women with healthy testosterone to be able to be more confident, more assertive and also have an increased libido.
A lot of women want these traits. A lot of books are written telling women how to be more assertive and take more risks in their lives. But the issue with being told “how” to be more confident and assertive is that it’s an external “solution.” When you read a book and intellectually process that information it lives in your cortex. The info you just absorbed is not rooted deep within your limbic system. So you may be aware of these concepts, but it’s harder to act on them because they are merely concepts in your cortex. We want to stimulate the actual centers of confidence and assertiveness which live deep within your limbic system. Testosterone in women helps to do that. Let’s look into this some more.
Why would women have low testosterone? Well, women aren’t supposed to have a lot of testosterone. A man’s level of free testosterone is at 20-25, for women it’s four. Four is a good number. Now, when we say “free testosterone” we mean testosterone that is unattached to anything in your blood. One of the reasons women can have low testosterone is because of sex hormone binding globulin — a protein made by the liver.
Sex hormone binding globulin is like a magnet. It looks for testosterone that’s in circulation and binds it to the protein. Any testosterone bound to that protein becomes inert. Anytime a woman has too much sex hormone binding globulin, she won’t have any free testosterone available to do anything in her body. Well, what could increase sex hormone binding globulin? Oral contraceptives.
So when a female patient comes and says she lacks confidence, assertiveness and drive and etc, we look at what her sex hormone binding globulin level is. We then ask if she have a history of oral contraceptives? We gauge what her testosterone levels are. We measure what amount of testosterone is bound to the sex hormone binding globulin protein. And then we look at what is her amount of free testosterone.
Giving a woman dosages of testosterone is not our ultimate goal. Our goal is to find a woman’s free testosterone that isn’t bound to the sex hormone binding globulin, and bring that testosterone to a healthy level — naturally.
You might be wondering, “what if we do have to use testosterone?” “What are the risks?” “What are the benefits?” Testosterone in women is probably one of the hardest things we deal with in our office. Because the way it’s naturally secreted by the ovaries is very slow and gentle. When we give a women an injection of testosterone, her levels shoot up, but then harshly drop after seven days. Meaning the process needs to be repeated. Which means the patient is on a tumultuous cycle of hormone dosing. That’s a roller coaster. Some women don’t notice that roller coaster, and everything is fine. But some women do notice it, and that roller coaster ride of testosterone can be immensely difficult to deal with.
In most cases we’ll insert a sub-dermal pellet that lasts for four months, and releases very slowly and steadily. This is our preferred method of treatment. This does not spike testosterone levels. After the four months, it dissolves and leaves the body. This is far gentler on the endocrine system than injecting testosterone into the body.
It’s important to note that side effects of testosterone can be mitigated as long as you’re receiving a healthy dosage. As long as the dosing is healthy, any side effects can be managed and reversed. We view testosterone as a subordinate to progesterone in women. Testosterone helps progesterone do its job. Progesterone is your body’s natural anti-anxiety agent. And finding natural solutions to your health problems is what we’re passionate about at Protea.
We want to work in concert with your body, not against your body. That is our philosophy at Protea, and it has lead us to success with our patients. We invite you to contact us to learn more about how we can help you live a healthier and happier life — naturally. That is the Protea promise.