By: 15 November 2022
Do women really need testosterone?

Paaven Patel, Operations and Quality Assurance Pharmacist at Specialist Pharmacy, and Rizvan Batha, Director of Operations & Superintendent Pharmacist at Specialist Pharmacy discuss the importance of testosterone for women.

When thinking about testosterone, the dominant male character comes to mind, but testosterone plays a vital role in the bodily function of women too. Many women will experience low testosterone in the perimenopausal, and menopausal phases of their lives and it is vital that levels are topped up. Testosterone is known to help with confidence, mental health, joint health, and vitality and women do need the hormone, even if only in small amounts.

Women with testosterone deficiency may experience several symptoms including a decreased sense of well-being, loss of energy, reduced sexual libido, fatigue, joint aches, osteoporosis, weight gain, loss of muscle tone and mass, and depression.

Menopause medically speaking, is characterised by the decline in testosterone and estrogen which together with progesterone controls many elements of a woman’s life such as menstruation, sexual activity, mood, and weight fluctuations. Although menopause is a natural process associated with ageing, the force of its symptoms can result in hormonal imbalance. This imbalance can cause a variety of symptoms that often take many women by surprise and can sometimes be tricky to navigate without medical intervention such as Bioidentical Hormone Replacement Therapy (BHRT).

For any woman who is experiencing any of these symptoms, there are available treatment options including BHRT. The availability of suitable testosterone preparations for women is limited however and are mostly used off-label. Before treatment for testosterone deficiency is commenced, it is recommended that total testosterone levels are measured to ensure an optimum treatment plan.

Since 2019, the British Menopause Society (BMS) has recognised the importance of testosterone replacement in women, especially in women with premature menopause or surgical menopause (post hysterectomy), but until recently, women could only get the testosterone gels made for men which are far too concentrated. Androfemme is a licenced testosterone preparation available for women in the UK but it’s too expensive to be on an NHS formulary.

As of the 16th May 2022, The British Menopause Society supports the utilisation of Compounded Testosterone, “However, where these are absent, compounded varieties may need to be considered. If a compounded product is used, the compounding pharmacy should meet industry standards for purity of Active Pharmaceutical Ingredients and Good Manufacturing Practice.”

Although body-identical and bioidentical hormones are made with similar ‘ingredients’ there are differences between the two, including the manufacturing process, dosage, delivery, and which hormones are available in terms of estradiol, progesterone, DHEA, and testosterone. For example, body-identical progesterone is only available as utrogestan which is an oral capsule rather than a cream. Testosterone used in BHRT is known to strengthen muscles/bone density, improve mood, red blood cell production, and increase energy and libido in women.

There are, of course, nutritional changes women can make to increase testosterone levels. Nutrition can have a significant impact on testosterone levels. When experiencing unbalanced hormones, we would always advise women to reduce refined sugars, white carbohydrates, and processed food in their diet. Processed foods can contain trans fats which are known to decrease testosterone levels. It is also important to maintain a low glycaemic index (low GI) diet, as this will decrease insulin levels and hopefully aid weight loss. By losing weight, women can help to increase testosterone levels naturally.

Whole grains, good quality fats like nuts, seeds, and avocados, lean, clean protein and a rainbow plate of fruit and vegetables for a boost of phytonutrients are just some foods that can help to increase testosterone levels. Avoiding alcohol is essential, as alcoholic drinks are empty calories and a huge contributor to weight gain.

Women should also look to add the below foods to their diet to increase testosterone production:

  • Ginger
  • Oysters and other shellfish
  • Red meats
  • Poultry
  • Beans, nuts, and legumes
  • Pomegranates
  • Leafy green vegetables such as spinach and kale

For many women experiencing symptoms, it may be simply a case of tweaking lifestyle factors, but for others, treatment may be needed. If extreme symptoms are being experienced or if symptoms are disrupting a women’s quality of life a hormone specialist or GP should be consulted.