The essential hormone for both men and women's health and sexuality
By Dr. Howard Liebowitz
It is well established that testosterone levels fall in men and women as they age . This becomes most noticeable from the age of about 45-50. Many times a bottoming out of sexual desire as we age is blamed on various circumstances and conditions. Without a good testosterone level the basic foundation for sexuality is missing.
Testosterone in Women
A Gallup survey of 833 women aged 45-60 conducted by The North American Menopause Society found that only 5% of the women knew that their bodies made “androgens”. Groundbreaking research in 1959 demonstrated that androgens not estrogens were responsible for sexual desire in the human female. Testosterone was found to heighten desire,increase sensitivity of the genitals,especially the clitoris, and increase sexual gratification. Symptoms and signs of testosterone deficiency in women include:Global loss of sexual desire,sexual fantasy and dreams;decreased sensitivity to sexual stimulation in the nipples and clitoris;decreased arousability and capacity for orgasm;diminished vital energy and sense of well being; and loss of muscle tone. In addition, there can also be thinning of pubic hair,genital atrophy not responsive to estrogen, dry brittle scalp hair, and dry skin. Testosterone also contributes significantly to bone density and muscle tone in both men and women.
Post-menopausal ovaries produce substantially lower amounts of testosterone. This decline often starts five or more years before menopause. Women who have had hysterectomies often suffer dramatic declines in libido after surgery, even if an ovary is spared. This is usually due to the loss of blood supply to the remaining ovary resulting in decrease in the production of ovarian hormones including testosterone. Women are commonly offered estrogen and progesterone supplementation after hysterectomy, but rarely testosterone. A similar condition can arise in women who are put into menopause prematurely by chemotherapy.
Too often women complaining of depression, loss of libido and diminished sexual energy are misdiagnosed and given antidepressants, when what they really need is testosterone. Adding testosterone to estrogen and progesterone supplementation in post-menopausal women has also been shown to improve cholesterol profiles and thus reduce cardiovascular disease risk.
Testosterone in Men
Testosterone is the dominant male hormone. Symptoms of testosterone deficiency in men are similar to that in women,but dramatically magnified. Decline of testosterone in men results in decreased libido, erectile dysfunction, difficulty achieving orgasm,diminished intensity of the orgasm,diminished penile sexual sensation, loss of muscle mass, decreased cognitive ability, depression,diminished energy, decrease sense of vitality or well being. Medical conditions that may develop or worsen after the decline in testosterone include osteoporosis,anemia, worsening of sugar metabolism, increased cholesterol and risk of heart disease.
There has been a lot of attention, but surprisingly, no long term large-scale studies done on testosterone supplementation in men to assess the health risks and benefits to date. The potential risks of using testosterone supplementation are minimal and mostly theoretical and reversible with discontinuation of use, or decreasing the dosage.
The causal relationship of testosterone and prostate disease has been studied multiple times. They have all failed to demonstrate that testosterone supplementation exacerbates voiding symptoms associated with prostatic hypertrophy.
Case reports have suggested that testosterone supplementation may unmask a previously occult prostate cancer. Multiple studies have actually correlated more aggressive high grade prostate cancers with low levels of testosterone. These studies have failed to demonstrate an association between testosterone supplementation and prostate cancer.
A landmark review article published in The New England Journal of Medicine in 2004, by Dr. Ernani Rhoden and Dr. Abraham Morgentaler, two renowned experts in the field,reported “ Despite decades of research, there is no compelling evidence that testosterone has a causative role in prostate cancer.” They went on to conclude ,” Thus, there appears to be no compelling evidence at present to suggest that men with higher testosterone levels are at greater risk of prostate cancer or that treating men who have hypogonadism with exogenous androgens increases this risk. In fact, it should be recognized that prostate cancer becomes more prevalent exactly at the time of a man’s life when testosterone levels decline.”
Based on all available research evidence it seems apparent that testosterone makes men healthier. Young men, with the highest testosterone levels have the least prostate problems, and best overall general health. As men age and their testosterone levels decline, the risk of multiple diseases including cancer and heart disease increases. If testosterone caused a worsening of these disorders we should see more young men with significant health problems. Testosterone in both men and women enhances a wide array of functions from cognitive improvement, increased muscle mass, improved sexuality,improved cholesterol, and better bone density.
Multiple studies have shown that replacing male hormones to youthful levels improves quality of life and decreases symptoms associated with the loss of hormones. There has never been any evidence to indicate that physiologic testosterone supplementation increases the risk of prostate cancer. Quite to the contrary it appears that the men with the lowest testosterone levels may actually have the highest risk of developing prostate cancer and for both men and women also heart disease and osteoporosis.
Conclusions
We are living in exciting medical times. We are the first generation with the option of supplementing our hormones with bioidentical hormones, extracted entirely from plant sources. We are also on the cutting edge of such technological breakthroughs as stem cell tissue regeneration. The abilities of modern medicine to improve health and slow the decline of the body as we age are almost mind boggling. It is wise to pursue these opportunities with caution. However, we know well how the human body deteriorates as it ages naturally. The ultimate preventive medicine approach is to slow the aging process by maintaining normal physiologic function.
The future is here now. Our parents did not have these options for their health. Every generation has been extending the human life span. Hormone replacement therapy has evolved as a very effective tool at helping achieve that. As information evolves on natural hormone supplementation it appears that this is a safe and beneficial option for maximizing quality of life, improving vitality and supporting healthy aging.
This information is for educational purposes only, and is not intended to treat or diagnose any health condition.