Testosterone is primarily produced by the testicles in men and the ovaries in women. Testosterone levels start to decline in the late 20s/early 30s and continue to decline at a steady rate over time. For women with ovaries, blood levels of testosterone are half the amount by age 50 and surgical removal of the ovaries results in an immediate 50% decline in testosterone production. Testosterone deficiency has been shown to increase the risk of obesity, diabetes, heart disease, thinning of the bones, and depression.
What Causes Low Testosterone?
- Natural aging
- Surgical removal of the ovaries
- Birth control pills or oral estrogen
- Pain medication/narcotics
- Being overweight or obese
Testosterone and Women
Several clinical trials suggest that testosterone is a safe treatment for women and a good alternative to estrogen in women with blood clotting disorders or breast cancer. Research suggests that testosterone replacement may have a breast protective effect and actually reduce the risk of breast cancer; further research is needed as with most off-label medical treatments.
At the present time, testosterone is an off-label treatment for women, but it has been studied in randomized controlled trials since 1990. In 2019 The Lancet Diabetes & Endocrinology evaluated 36 of these trials that included 8,480 women. This meta-analysis found that the use of testosterone therapy in women improved sexual functioning (desire, pleasure, arousal, orgasm, and responsiveness), reduced distress, and improved self-image. Testosterone therapy did not cause any serious adverse events and the most common side effects included acne, oily skin, and hair growth. In our experience, testosterone increases scalp hair growth for most women, but some experience hair loss or thinning due to an excess of dihydrotestosterone (DHT). Other causes of hair loss include weight loss, changes in diet, stress, natural aging, genetics, smoking, and anesthesia. If you experience hair loss of thinning so that we can order labs and discuss other options.
Testosterone and Men
Testosterone is primarily produced by the testciles in men. A lack of testosterone can negatively affect your health and quality of life. Take the quiz to see if you may be suffering from low testosterone. You may be a candidate for hormone replacement.
Screening for Low Testosterone:
- Do you have a decrease in libido (sex drive)?
- Do you have a lack of energy?
- Do you have a decrease in strength and/or endurance?
- Have you lost height?
- Have you noticed a decreased enjoyment in life?
- Are you sad and/or grumpy?
- Are your erections less strong?
- Have you noted a recent deterioration in your ability to play sports?
- Are you falling asleep after dinner?
- Has there been a recent deterioration in your work performance?
Did you answer YES to either question 1 or 7? Did you answer YES to at least three questions?
If so, a blood test can determine if you have low testosterone.
*Adapted from: Morley JE, Charlton E, Patrick P, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000; 49(9): 1239-1242.