Aging in Davie is difficult enough for women without having to deal with declining hormones. Women in Davie often complain of a diminished sense of well being, chronic fatigue, and a loss of libido just to mention a few symptoms of hormone imbalance.
For many women there is a tremendous void in treatment of menopausal symptoms. Hot flashes, mood swings and low or no sex drive are just the tip of the iceberg. Some earlier hormone imbalance symptoms of estrogen deficiency are frequent waking at night. Many others are present, including “mental fogginess.” A woman’s short-term memory retention may be dwindling and her concentration and focus isn’t as good as it used to be. Frequently, women may experience some loss of energy to the point that they actually slide into symptoms of chronic fatigue. In addition, women may experience some mood swings and irritability, and at the extreme may actually develop feelings of depression. With the loss of energy and chronic fatigue, females find themselves unable to exercise as much as in the past, or to recover as quickly when exercising. Women often find themselves increasing weight gain in spite of attempts at exercising. One hormone imbalance symptom that is not frequently discussed is the loss of sex drive and diminished libido. Not only is energy level and sense of well being diminished, but anticipation and enjoyment of sexual activity is waning as well.
Weight Loss Consequences, Physical or Emotional?
There's a growing interest in testosterone hormone replacement for treating symptoms related to aging. You've probably seen advertisements of virile, muscle bound men in their 60's and 70's.
Along with the growing interest there's also a growing amount of information. But much of it is anecdotal stories, misleading data and flat out, unproven myths. Especially as it relates to testosterone replacement therapy for women.
The fact is that medically administered, testosterone therapy is also used to successfully treat symptoms of hormone deficiency in pre and postmenopausal women. And two physicians-Dr. Rebecca Glaser and Dr. Constantine Dimitrakakis-are dispelling the misinformation about it through scientific research.
Dr. Glaser and Dr. Dimitrakakis focus on subcutaneously implanted, bio-identical hormones (human identical molecule) and not oral, synthetic androgens or anabolic steroids.
With that in mind, here are the 10 myths of testosterone replacement therapy for women.
Myth #1: Testosterone is a "male" hormone
Although men have a higher circulating level of testosterone than women, from a biological perspective, men and women are genetically similar. Both sexes include functional estrogen and androgen (testosterone) receptors. And while estrogen is popularly considered the primary female hormone, throughout a woman's lifespan, testosterone is actually the most abundant, biologically active hormone with significantly higher levels than estradiol. And as early as 1937, testosterone therapy was reported to effectively treat symptoms of the menopause.
Myth #2: Its only role in women is sex drive and libido
There's a lot of hype about testosterone's role in sexual function. But in reality, it's a fraction of the overall physiologic effect testosterone plays in women. That's because testosterone governs the health of almost all tissues including the breast, heart, blood vessels, gastrointestinal tract, lung, brain, spinal cord, peripheral nerves, bladder, uterus, ovaries, endocrine glands, vaginal tissue, skin, bone, bone marrow, synovium, muscle and adipose tissue.
The function of these tissues declines as testosterone declines. The result of this deficiency in both men and women includes dysphoric mood (anxiety, irritability, depression), lack of well-being, physical fatigue, bone loss, muscle loss, changes in cognition, memory loss, insomnia, hot flashes, rheumatoid complaints, pain, breast pain, urinary complaints, incontinence as well as sexual dysfunction. And just like for men, these symptoms are successfully treated in women through testosterone therapy.
Myth #3: It masculinizes females
Testosterone therapy has been safely and successfully administered in women for over 76 years. Rather than decrease a woman's femininity it increases it. Testosterone stimulates ovulation, increases fertility and safely treats the nausea of early pregnancy without adverse effects.
Sure, large doses of supra-pharmacological synthetic testosterone are used to treat female to male transgender patients to increase male traits like body hair. But this requires high doses over an extended period of time. Even then, true masculinization is still not possible. And these effects are reversible by simply lowering the dosage.
Myth #4: It causes hoarseness and voice changes
Hoarseness is most commonly caused by inflammation due to allergies, infectious or chemical laryngitis, reflux esophagitis, voice over-use, mucosal tears, medications and vocal cord polyps. Testosterone possesses anti-inflammatory properties. There is no evidence that testosterone causes hoarseness and there is no physiological mechanism that allows testosterone to do so.
Although a few anecdotal case reports and small questionnaire studies have reported an association between 400 and 800 mg/d of danazol and self-reported, subjective voice 'changes' an objective study demonstrated the opposite.
Twenty-four patients received 600 mg of danazol (synthetic testosterone) therapy daily and were studied for 3 and 6 months. There were no vocal changes that could be attributed to the androgenic properties of danazol. These conclusions are consistent with a one year study examining voice changes on pharmaco-logic doses of subcutaneous testosterone implant therapy in women by Glaser and Dimitrakakis.
Myth #5: It causes hair loss
Hair loss is a complicated, genetically determined process and there is no evidence that either testosterone or testosterone therapy cause it. In fact, from a medical perspective, dihy-drotestosterone (DHT), not testosterone, is considered the active androgen in male pattern balding.
There are many factors associated with hair loss. For example, it's common in both women and men with insulin resistance. Insulin resistance increases 5-alpha reductase, which increases conversion of testosterone to dihy-drotestosterone in the hair follicle.
In addition, obesity, age, alcohol, medications and sedentary lifestyle increase aromatase activity, which lowers testosterone and raises estradiol. Increased DHT, lowered testosterone, and elevated estradiol levels can contribute to hair loss in genetically predisposed men and women. But so can medications, stress and nutritional deficiencies.
In studies conducted by Glaser and Dimitrakakis, two thirds of women treated with subcutaneous testosterone implants have scalp hair re-growth on therapy. Women who did not re-grow hair were more likely to be hypo or hyperthyroid, iron deficient or have elevated body mass index. And none of the 285 patients treated for up to 56 months with subcutaneous T therapy complained of hair loss.
Myth #6: It has adverse effects on the heart
On the contrary, there is overwhelming biological and clinical evidence that testosterone promotes a healthy heart. Testosterone has a beneficial effect on lean body mass, glucose metabolism and lipid profiles in men and women. It is successfully used to treat and prevent cardiovascular disease and diabetes.
Testosterone also widens blood vessels in both sexes, has immune-modulating properties that inhibit plaque and strengthens the cardiac muscle. It improves functional capacity, insulin resistance and muscle strength in both men and women with congestive heart failure.
Myth #7: It causes liver damage
High doses of oral, synthetic androgens (e.g., methyl-testosterone) pass through the digestive system, are absorbed into the entero-hepatic circulation and can adversely affect the liver. But subcutaneous implants and topical patches avoid the entero-hepatic circulation and bypass the liver. So there is no adverse effect on the liver, liver enzymes or clotting factors.
Furthermore, non-oral testosterone does not increase the risk of deep venous thrombosis or pulmonary embolism like oral estrogens, androgens and synthetic progestins. And despite the concern over liver toxicities with anabolic steroids and oral synthetic androgens, there are only 3 reports of hepa-tocellular carcinoma in men treated with high doses of oral synthetic methyl testosterone. Even the report of benign tumors (adenomas) with oral androgen therapy is exceedingly rare.
Myth #8: It causes aggression
Although anabolic steroids can increase aggression and rage, this does not occur with testosterone therapy. Even supra-pharmacologic doses of intramuscular testosterone undecanoate do not increase aggressive behavior. But as stated before, testosterone can aromatize to estradiol. And there is considerable evidence among species, that estrogens, not testosterone, play a major role in aggression and hostility.
However, in studies conducted by Glaser and Dimitrakakis, over 90% of women treated with subcutaneous testosterone therapy have documented decreased aggression, irritability and anxiety. And this is not a new finding. Androgen therapy has been used to treat PMS for over 60 years.
Myth #9: It may increase the risk of breast cancer
It was recognized as early as 1937 that breast cancer was an estrogen sensitive cancer and that testosterone acted as a counter balance to estrogen. Clinical trials in primates and humans have confirmed that testosterone has a beneficial effect on breast tissue by decreasing breast proliferation and preventing stimulation from estradiol.
However, some epidemiological studies have reported an association between elevated androgens and breast cancer. But these studies suffer from methodological limitations, and more importantly, do not account for associated elevated estradiol levels and increased body mass index. And the cause and effect interpretation of these studies conflicts with the known biological effect of testosterone.
Although testosterone is breast protective, it can aromatize to estradiol and have a secondary, stimulatory effect on the estrogen receptor. But when testosterone is combined with an aromatase inhibitor in a subcutaneous implant, it blocks testosterone from aromatizing.
This form of treatment has been shown to effectively treat androgen deficiency symptoms in breast cancer survivors and is currently being evaluated in a U.S. national cancer study. In addition, Dimitrakakis and Glaser see a reduced incidence of breast cancer in women treated with testosterone or testosterone with anastrozole implants.
Myth #10: The safety of testosterone use in women has not been established
Testosterone implants have been used safely in women since 1938. Any real concerns would be well established by now.
Long-term data exists on the successful and safe use of testosterone in doses of up to 225 mg in up to 40 years of therapy. In addition, long term follow up studies on supra-pharmacologic doses used to 'female to male' transgender patients report no increase in mortality, breast cancer, vascular disease or other major health problems.
Many of the side effects and safety concerns attributed to testosterone are from oral formulations, or are secondary to increased aromatase activity due to elevated estradiol. This effect increases with age, obesity, alcohol intake, insulin resistance, breast cancer, medications, drugs, processed diet and sedentary lifestyle. Although often overlooked or not addressed in clinical studies, monitoring aromatase activity and symptoms of elevated estradiol is critical to the safe use of testosterone in both sexes.
Adequate testosterone is essential for physical, mental and emotional health in both sexes. Abandoning myths, misconceptions and unfounded concerns about testosterone and testosterone therapy in women allows physicians to provide evidence based recommendations and appropriate therapy
Hormone Imbalance in Women
For many women, the prospect of facing menopause brings great fear and apprehension. It is a time in life where reproduction ends, and for some women, leaves them with no way of identifying what their future life's purpose will be. Many women recall with not so fond memories the experiences of their mothers and grandmothers as they faced menopause with few of the hormone replacement help methods, which are available to females today. We have all heard the horror stories of hormone imbalance: night sweats, mood swings, etc. and are certainly not looking forward to the time when we too will be facing these unpleasant hormone deficiency side effects that often go hand in hand with perimenopause and menopause.
However, countless women today are seeking new ways to cope with the unpleasant hormonal changes, which so often accompany the onset of menopause. In the past, women have relied upon synthetic hormone replacement treatments which have been rather hit or miss in terms of their effectiveness. With the release of the Women's Health Initiative study, proving some synthetic hormones to be more harmful than good, women feared hormone replacement therapy all together. What most women didn't realize was that the WHI study neglected to disclose that their researchers did not use bio-identical hormones but only synthetic hormones. Although initial confusion about HRT was created, women are now searching for alternatives to hormone replacement and discovering a new safer solution which is bio-identical hormone replacement therapy or BHRT.
Although BHRT is an age old remedy, countless doctors and their patients are just learning of this option. If you are wondering why doctors are just learning of BHRT, there is a simple answer. Bio-identical hormones aren't patentable because they are in their natural form, thus pharmaceutical companies don't do studies on them. However, BHRT is in the forefront of anti-aging treatment and for many doctors the newest method for helping cure much that ails the menopausal woman. Different from conventional methods of hormone replacement therapy, which seeks to have women ingest synthetic or chemically altered versions of naturally occurring hormones, BHRT offers a more natural fit for the body. BHRT offers women plant based hormones that have the exact chemical and molecular structure as hormones that are produced in the human body. Unlike synthetic hormones, BHRT isn't alien to our body thus BHRT is received well with virtually no side effects.
BHRT is allowing many women to address the multiple concerns and health issues which rapidly face women who are actively going through the stages of menopause. The doses of BHRT are designed for each individual patient and are not a one-size fits all recipe. With bio-identical hormone replacement therapy, there is the recognition that each woman is different, therefore, her hormone treatment must be individualized to meet her very specific needs. Physicians who are advancing the use of bio-idientical hormone replacement therapies for their patients will first work with a woman to discover if she is actively in the perimenopause / menopause stage. Not only will the doctor need a complete physical history, but he or she will also need a patient's most up-to-date medical information which will in turn aid her in determining the specifics of each individual woman's case. At this point physicians who use bio-identical hormone replacement therapy will take blood, and from the blood results, can determine in which hormonal areas the female patient may be struggling.
Bio-identical hormone replacement therapy then calls for each hormone supplement to be compounded and dispensed in a manner which will be most effective in treating the specific hormone levels of the female patient involved. This type of customization of medicine ensures that an individual's specific concerns are addressed and that the menopause symptoms, the ones that are most bothersome to the patient, will be actively treated and brought under control.
There are many who are vocally singing the praises of BHRT. Numerous followers in the healthcare profession, particularly those who deal with women's health and their concerns, are ecstatic over these remarkable developments in the treatment of menopause. Many are finding their patients happier and healthier than they have seen them in years; furthermore, they like that bio-identical hormone replacement therapy has virtually no known side effects unlike synthetic hormones. BHRT seems to reduce the risks of blood clots and strokes, which can be so prevalent with the use of traditional hormone replacement therapy, and there are fewer concerns over cancer rates. Actually, in well known medical journals, researchers have reported that the bio-identical hormones, estrogen and testosterone, are not only safe but also have a positive impact on some diseases like osteoporosis and prostate cancer.
While many healthcare providers are still citing the lack of FDA approval, BHRT seems to be making quite a mark in the world of women's healthcare. For too long, women have been subjected to the toils and troubles that menopause can bring. With the advent of bio-identical hormone replacement therapy, the many concerns of patients and doctors are disappearing, as the hormone treatment continues to produce positive results and prove itself effective with even more patients. Numerous women are now able to approach this new stage of their lives feeling healthy and happy, ready to conquer the many unique and rewarding challenges and dreams that will come in the remainder of their adult life.