Hailed as a "prescription for passion" by some and condemned as the "rage steroid" by others, testosterone is the most celebrated, feared and misunderstood of all hormones.
Our culture lauds this substance's leading role in male virility and casts it as the villain in acts of violent crime. In truth, testosterone is neither miracle nor monster, but rather, a key player in the complex chemistry of human hormones. When balanced by other hormones, testosterone, also known as androgen, plays a lead role in the health and well-being of both sexes.
These days, many menopausal women are turning to testosterone to provide what estrogen alone cannot—renewed sexual desire. Psychiatrist Dr. Susan Rako believes testosterone therapy is a major breakthrough for midlife women. Understanding that testosterone deficiency may be to blame for a loss of interest in sex in an otherwise happy relationship, she points out, could prevent much unnecessary anguish.
Dr. Rako's book, "The Hormone of Desire: The Truth About Sexuality, Menopause and Testosterone," is one of a growing wave of publications heralding the importance of this hormone to women's health. Although androgen therapy is controversial, several small-scale studies and anecdotal evidence from women and clinicians suggest that individualized dosages provide a number of therapeutic benefits.
Testosterone Fuels a Woman's Desire
Just as men's bodies manufacture small amounts of estrogen, women's bodies produce testosterone through the ovaries and adrenal glands. A multitalented hormone, testosterone boosts both libido and energy, maintains muscle mass, strengthens bone and ensures the nipples and clitoris are sensitive to sexual pleasure.
As we age, our bodies produce less androgen (testosterone), estrogen and progesterone. By age 40, women produce about half the testosterone we did in our twenties. These levels drop further still with the onset of menopause or for women who have had their ovaries removed. Many clinicians believe that the diminished energy, decreased sexual desire and "flatness" of mood that some women experience during and after menopause are directly related to declining levels of testosterone.
Hormone Replacement Therapy and Testosterone
Doctors traditionally respond to menopausal complaints by dispensing prescriptions for estrogen and progesterone, traditional "female" hormones that address some of the discomforts of menopause and provide the added advantage of protecting against heart disease, Alzheimer's disease and osteoporosis. But although estrogen can quench hot flashes and ease vaginal dryness, it does little to enhance libido or energy.
Several studies suggest, however, that small amounts of androgen added to estrogen replacement therapy can restore sexual desire, improve energy and promote a sense of well-being. And that's not all. Testosterone also helps prevent bone loss, improves body composition (building lean mass and reducing body fat) and supports cognitive function.
Clinicians such as Dr. William Regelson, M.D., author of "The Superhormone Promise," argue that testosterone is the missing link in hormone replacement therapy. "For many women who feel they are not quite themselves," he says, "the ingredient missing from the blueprint is testosterone." He has found that adding testosterone to the hormonal "cocktail," even for a short period of time, duplicates our "normal hormonal state" and helps women better tolerate estrogen and progesterone.
