Testosterone and The Menopause
Testosterone Replacement & Female Androgen Deficiency
Testosterone is a androgen hormone. We commonly think of it as a male hormone but it has an important role in normal female development, behavior and health; it is important for sexual function and interest, vaginal health, cognition, energy levels and bone strength and health. Half of a woman’s testosterone comes from the ovaries and half from the adrenal glands; testosterone acts on cells and tissues directly but is also converted into oestogens, particularly in fat cells. Some of the actions of testosterone are actually the effects of oestrogens.
What happens at the Menopause?
The production of testosterone declines in women from the mid-thirties onwards, thought as the menopause progresses there is no sudden drop in testosterone.
This is quite different if there is a surgical menopause – when the ovaries are removed – where there is a precipitous drop in testosterone.
After the menopause the level of oestrogen falls but the remaining small quantities of testosterone can cause some women to have male type symptoms such as excess hair growth (hirsutism) and sometimes even male pattern hair loss.
Female Androgen Deficiency Syndrome (FAD) & Hypoactive Sexual Desire Disorder (HSDD)
The lack of testosterone can cause tiredness, lack of energy, difficulty concentrating and a low libido. Together this can be Female Andogen Deficiency Syndrome (FAD), and the loss of libido can be termed Hypoactive Sexual Desire Disorder (HSDD).
How is FAD or HSDD diagnosed?
Usually the patient’s story is enough to make the diagnosis, a blood test is not always necessary, though sometimes one might be done if there is any uncertainty.