The Forgotten Hormone: Unlocking the Power of Testosterone for Menopausal Women

Strategic Insights -

The menopause has often been associated with oestrogen and progesterone deficiencies, but a growing body of research suggests that testosterone may play a crucial role in maintaining women's health, particularly in perimenopause and menopause. Recent studies have shown that testosterone has a positive effect on libido, energy, and cognitive function, and may even help prevent osteoporosis and heart disease. Yet, despite these findings, testosterone prescriptions for menopausal women remain rare, with only about 8,000 women out of 13 million in the UK receiving testosterone as part of NHS hormone replacement therapy (HRT). A panel of experts from international menopause societies has called for more clinical trials on testosterone's effect on various aspects of women's health.

Key Takeaways:

  • Testosterone is the hormone women produce in the largest quantity, except during pregnancy, with levels peaking in early twenties, halving in forties, and slumping in sixties. Oestrogen and progesterone levels fall dramatically at menopause, but testosterone levels only decrease gradually.
  • Many women report a positive effect on energy, sharpness, and libido when testosterone is topped up to natural female levels after surgery or naturally at menopause.
  • Testosterone can improve sex drive, as evidenced by a 2022 Fawcett Society poll showing half of women aged 45-55 reporting low or no interest in sex. The National Institute for Health and Care Excellence (NICE) guidelines recommend considering testosterone supplementation for menopausal women with low sexual desire if HRT alone is not effective.
  • Testosterone may help prevent osteoporosis, as research has shown that when combined with oestrogen HRT, it results in better bone density in women at risk of osteoporosis after surgical menopause.
  • Low testosterone levels double the risk of heart disease; a 2022 investigation in The Lancet Healthy Longevity discovered that women aged over 70 with low blood testosterone had twice the risk of cardiovascular events than women with higher testosterone.
  • There is no evidence that transdermal testosterone increases the risk of breast cancer; a 2022 study showed that women aged 56 and over using supplementary testosterone had a 50% lower risk of breast cancer.
  • Memory may be boosted by testosterone, as a 2013 study showed that testosterone alone improves memory in postmenopausal women.
  • Testosterone may even increase resistance to Alzheimer's disease, with research suggesting that lower testosterone levels are associated with worse cognition and processing speed in APOE-4 gene carriers.

Statistics:

  • About 8,000 women out of 13 million in the UK receive testosterone as part of NHS HRT.
  • Half of women aged 45-55 report low or no interest in sex (2022 Fawcett Society poll).
  • Low testosterone levels double the risk of heart disease (2022 investigation in The Lancet Healthy Longevity).
  • Women aged 56 and over using supplementary testosterone have a 50% lower risk of breast cancer (2022 study).
  • Memory is improved by 26 weeks of testosterone therapy in postmenopausal women (2013 study).
  • Only 8,000 women out of 13 million in the UK have received testosterone as part of NHS HRT.

Sources:

  • NHS: "Women produce three times more testosterone than oestrogen before menopause"
  • Fawcett Society: 2022 poll on sex drive in women aged 45-55
  • National Institute for Health and Care Excellence (NICE): Guidelines on Hormone Replacement Therapy
  • The Lancet Healthy Longevity: 2022 investigation on testosterone and cardiovascular risk
  • Monash University: Study on testosterone and breast cancer
  • Alzheimer's Association: Research on testosterone and Alzheimer's disease
  • Times: Article on testosterone and menopause by Kate Muir