Can Women benefit from Male Hormones in Menopause?
Do women make male hormones? Yes. They are called androgens. The major androgens in women are dehydroepiandrosterone sulfate (DHEA-S), dehydroepiandrosterone (DHEA), androstenedione (A), testosterone (T), and dihydrotestosterone (DHT).
As expected, the production of all of these androgens decreases as women age. After menopause, male hormone production is the main role of the ovary. What role do androgens play in females? We really don’t know. The assertion that low androgen levels play a role in female sexual function is based upon the known role of androgens in male sexuality. In studies that measure serum hormone levels and sexual function in women, the correlation between male hormone concentrations and sexual function is very weak.. Women with low androgen syndromes such as removal of both ovaries surgically, adrenal insufficiency (the adrenal gland does not work well), or with hypopituitarism (the pituitary gland does not work well), do not necessarily have poor sexual function or libido. The levels of androgens in women are much lower than in men, and there are no clear lab values for this because of a lack of validated tests in the female range. Should we give women testosterone? It is a good question and very hard to answer. Blood androgen levels do not correlate with sexual function in women or men. However, testosterone therapy has been shown to improve sexual function in some post-menopausal women when given in high enough doses to get blood concentrations to levels that are higher than normal for women. The long term consequences of these relatively high serum testosterone levels are unknown. There are no FDA approved testosterone products for women in the United States. This means that the FDA does not think that it is safe to use testosterone in women. Those women who would like to try testosterone to increase their libido must be willing to take the risk of testosterone supplementation. When a physician gives testosterone to a woman, it is an “off-label” (not FDA approved) use. It seems to increase the sense of well-being, energy, and libido in men; therefore, it seems like it would have the same effect in women.
There is a 300 mcg testosterone patch for post-menopausal women which is available in some other countries. It is not approved for use in the United States.
Androstenedione (an androgen precursor that is widely used and promoted as “Andro” in bodybuilding magazines) increases serum testosterone concentrations in some men. When given to women, androstenedione increases serum testosterone and estrone concentrations. However, the impact of regular use on sexual function or its potential androgenic side effects in women are unknown. DHEA replacement therapy appears to be effective for improving the sense of well-being. It helps your insulin work well to metabolize sugars, and prevents bone loss at the hip or femoral neck in women with low adrenal androgen levels.