Susan Merenstein, Pharmacist/Owner

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Testosterone for Women

March 5, 2022

  • Women make one-tenth as much testosterone as males.
  • Normal, healthy women make testosterone in ovaries (stimulated by LH from the pituitary), adrenal glands, skin, muscles, and body fat.
  • Research has shown daily production is approx. 50ug from ovaries, 50ug from adrenals, and 150ug from other tissues.(1)
  • At perimenopause production drops slightly from ovaries, but adrenal testosterone by 40-50%, production in other tissues by 60% or more.
  • Testosterone is a precursor to Estradiol.
  • Low salivary testosterone has been associated with low bone mass.(2) Testosterone is an anabolic hormone essential for building and maintaining the integrity of structural tissues such as skin, muscles, bone and brain.
  • Symptoms of low testosterone include low libido, incontinence, vaginal dryness, fatigue, memory lapses, depression, and bone loss. (NOTE: low testosterone and high cortisol levels-associated with stress-over a prolonged period of time can lead to excessive bone loss).
  • Some researchers believe that the conversion of testosterone to androstenedione is critical for improved libido.

    IMPORTANT- increasing the level of testosterone above the normal ranges does not stimulate a further increase in libido.

  • Testosterone delivered through the skin as a cream or patch is expected to be 10-50 times more potent than testosterone taken orally, most of which is destroyed in the GI tract before absorption.
  • In a recent clinical study of surgically menopausal women (hyst/oophor), 300ug of transdermal (patch) testosterone was shown to significantly improve sexual function and psychological well-being. This dose would likely give a saliva testosterone in the range of 30-60pg/ml. (3)
  • Elevated testosterone levels in women may be due to the following: Menopausal transition, Polycystic Ovarian Syndrome, Insulin Resistance, Testosterone supplementation, or DHEA supplementation (In one study, DHEA raised testosterone levels 50-100% from baseline in women). (4)
  • Estrogen dominance increases Sex Hormone Binding Globulin (SHBG)-binds 10x tighter to Testosterone than Estradiol.
  • We recommend doses not exceeding 1mg topically a day for women. Dose may be applied topically to inner arms thighs, backs of arms, buttocks, or vaginally to clitoris and labia.

References:
Journal of Clinical Endocrinology and Metabolism, Vol. 82, No.5, p. 1945.
Oronzo et al. Eur J Epidemiology 2000:16; 907-912.
N Engl J Med 2000: 343; 682-88.
Morales and Yen. J Clin Endocrinol Metab. 1994:78; 1360-67.