While many women know the value of replacing estrogen and progesterone in menopausal therapy, many wonder if testosterone should be replaced as well.Marzell

Do we really need this hormone? What benefits does it really provide? What forms are best to take? A recent article in the International Menopause Society’s journal explored these questions.

Testosterone is naturally produced in women in the ovaries and adrenal glands. Interestingly, estrogen can be produced from testosterone or its precursors in fat tissue, bone cells, cartilage cells, blood vessels and the brain. Testosterone is vital for healthy musculoskeletal tissue, blood vessels and brain function. It is also helpful for stimulating the remodeling of bone, which produces thicker and stronger bones.

Testosterone receptors have been identified in the vaginal mucosa and muscular walls. A recent study by Witherby found that when testosterone was applied intravaginally, normalization of damaged cells resulting from low hormones in menopause occurred. It was also found that pain with intercourse, experienced by many menopausal women, decreased. Some researchers feel that the vaginal atrophy (dry and damaged cells associated with hormone deficiency) cannot be corrected without the use of testosterone or its precursor, DHEA.

One of the most interesting new areas of study is the effect testosterone has on brain cells of women. Levels of testosterone in premenopausal women are actually several times that of estrogen. Testosterone provides a protective effect on the brain against oxidative stress and damage from amyloid, which can form plaques in the brain leading to mental dysfunction. Recent studies are revealing beneficial effects for women with verbal learning and memory.

I have personally noted positive mood benefits for women. I describe these as estrogen being a stimulant, pep-up type of hormone. Testosterone seems to give women the courage to take on challenges and help with decision making.

I have joked that on one visit to a local restaurant, several women were having lunch, discussing, of course, men. The subject appeared to be what a man said to one of the women, what it really meant and what she should do about it. The conversation extended for at least 30 minutes. I wished to have a little testosterone dust to throw in the air to help with the apparent need to make a decision about the situation.

Last but not least is the very important role that testosterone has in sexual response and libido in the menopausal female. A wise woman doctor pointed out that when men complain of erectile dysfunction, they are given hormones or Viagra, but when women complain of decreased desire for sex or ability to achieve orgasm, they are given antidepressants, which can further cause loss of interest in sex. Testosterone can restore sexual function as it did in premenopausal days.

Can we get too much testosterone? The answer is, of course, yes. It can cause irritability, impatience and hair growth where we do not want it. But we may be doing a disservice to our patients if we ignore a hormone vital to their health. Keeping things in balance, as nature does, should be our goal.

Dr. Laurie Marzell is a naturopathic physician and certified menopause practitioner with the North American Menopause Society. She has an office in Lake Grove on Boones Ferry Road.

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