Menopause can be such a challenge. There’s the whole “fuzzy brain” scenario—you know, that “where is my car/my purse/my mind” experience.
Or maybe it’s your body that’s pooping out. You know exercise would help but you just don’t have it in you to work out.
And let’s not even talk about your sex drive. Right now, you feel like you have a starring role in “Sexless in the City!” You’ve lost that lovin’ feeling and you don’t know where to find it!
Is this just part-and-parcel of the whole menopause/low estrogen issue or could something else be going on—like a case of low testosterone (Low “T”)?
Dr. Michael Krychman, Executive Director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach California explains, “While estrogen is critical, it is my belief that there is interplay between lowered estrogen and lowered testosterone levels in women as they age.”
What you need to know about testosterone in women:
- It’s part of our hormonal makeup. Not just a guy thing, the steroid hormone testosterone is produced in smaller amounts by body—one place is our ovaries—and is essential for muscle tone, a healthy libido, and strong bones.
- Enter menopause abruptly and testosterone can nose-drive. While low testosterone in women can start during their menopausal journey, it may begin a decade earlier than when menstrual periods stop. This quick jump into “the change” can send testosterone levels plummeting. According to Dr. Krychman, “Many feel that surgical or abrupt menopause can cause more severe and abrupt symptomology rather than a gradual decline. It seems that when science or disease interferes with Mother Nature, she retaliates by sudden withdrawal and plunging testosterone.”
- Low-T symptoms are wide-ranging. When T levels drop, women can experience depression, fatigue, weight gain, bone and muscle loss, and cognitive dysfunction. Then there is the whole “low libido” issue, which can be dramatically decreased. As for orgasms, if we have them, they can be more “ho-hum” than “woo hoo!” if our “T” level is down, according to a report from The North American Menopause Society.
- Boosting testosterone levels can help. Supplementing with testosterone can benefit your heart, mood, energy, and bone and muscle health. Additionally, testosterone can sustain skin elasticity and tone, encourage heart health, boost libido, help prevent osteoporosis risks, decrease body fat and increase muscle strength.
You think you have low “T.” Now what?
- First, rule out other medical problems by scheduling a visit with your health care professional, or menopause specialist. Underactive or overactive thyroid, for example, can also affect your energy level, libido and general physical health or well being.
- Ask about testing your testosterone level. Typical tests will measure and calculate your total testosterone and “free” testosterone. (“Free” testosterone measures the active portion—the levels of bioavailable testosterone that is not bound by the blood proteins. Ranges vary between post-menopausal and premenopausal women, with a gradual decline as we age, says Dr. Krychman. However, he adds, “I advise treating symptoms, not lab values. A comprehensive assessment with a good differential is the rule. Testosterone supplementation is not the panacea. It is important to remember that this there is also approximately 40% placebo effect!”
- Discuss treatment options. If your testosterone levels are below norm and you have the symptoms, your health care professional may suggest an “off-label use” of testosterone, with or without estrogen. (Why “off-label? Because the FDA has yet to approve any testosterone drug for women.)
According to WebMD, oral testosterone (taken by mouth) is processed by the liver—which can result in a change of cholesterol levels. But that same effect doesn’t occur when testosterone is administered by skin patch, gel or cream (aka transdermal) or in pellet form (the size of a grain of rice) inserted under the skin. “What form to use depends on many facets including patient tolerability, patient price, side effects and clinician preference,” says Dr. Krychman.
- Weigh the risks vs benefits with your health professional or menopause specialist. Dr. Krychman has a frank and candid conversation with his patients about the benefit versus the risk – safety and efficacy are always balanced, he states. Make sure you understand the pros and cons of the treatment options, and, once you start therapy, have regular blood work to keep track of your levels. It is important to monitor your blood count and lipid panel, coupled with testosterone levels.
Bottom line? Don’t blame Mama Estrogen for all your menopause miseries. Papa Testosterone could be partly responsible for your brain fog, exhaustion and crashing libido! Get the info you need to take charge of dealing with your symptoms. Evaluate the risks and benefits, to determine what is best for your body and your quality of life.
Suffering in silence is OUT. Reaching out is IN.