HRT myths and breakthroughs for women

Last week, I wrote about ways for men to enhance testosterone levels.

Now let’s focus on testosterone and oxytocin hormone replacement for women.

 But first, let’s review the most common symptoms women can experience as a result of low testosterone…

• Decreased interest in sex
• Loss of muscle mass
• Fatigue
• Difficulty losing weight
• Difficulty concentrating
• Low mood, mood swings, anxiety
• Hair loss

Of course most women would want to alleviate those symptoms if at all possible. So it seems pretty straight forward: just take a testosterone supplement, right?

Actually, there is more to the story…

Is testosterone replacement for women effective and worth the side-effects?

In a 2008 study reported in Fertility and Sterility, the author points out the most important factors contributing to low sexual desire — even more than low testosterone: painful intercourse, emotional distress, life stressors, and conflict in the relationship—and reported that a testosterone supplement provides only “modest” improvement.

However testosterone is best known for its crucial role in a woman’s sex drive. And more recent studies have blown away some of the old myths about T-therapy in women.

For starters, testosterone is the most abundant biologically active female hormone, even more abundant throughout a woman’s lifespan than estrogen. So no longer can we refer to it as a “male” hormone.

Additionally, the benefits of testosterone replacement go far beyond a woman’s libido. Androgen deficiency in women— previously only recognized in men — produces symptoms in addition to those listed above such as hot flashes, breast pain, rheumatoid (joint pain) complaints, bone loss, urinary incontinence and sexual dysfunction. All of these can also be alleviated with testosterone therapy.

So while there’s no doubt it can help with sexual desire, there are side effects to consider when a woman supplements with testosterone. The main side effects reported in clinical trials are increased facial hair (a.k.a. hirsutism) and acne, although acne is not seen with testosterone cream.

Hirsutism is annoying for women for sure. It affects 5-8% of the entire female population. But here is some good news about hirsutism: this unwanted side effect is dose dependent.

In lower doses testosterone actually stimulates femininity. Therefore, any unwanted androgenic side effects are entirely reversible by lowering the dosage. That’s why if you decide to go with bio-identical hormone therapy, it’s important for your doctor to closely monitor your levels.

Moreover, the risks of hirsutism can be reduced by natural means as well. These include the following:

• Balance blood sugar and detoxify bad estrogens by eating green vegetables in at least 2 meals per day; low carbohydrate diet; starchy and non-starchy vegetables instead of grains (i.e. breads, cracker, cereals, pastas); healthy fats in every meal (nuts/seeds, avocados, coconut oil); meats like chicken, fish, shellfish, turkey; and lots of water and herbal teas.
• Reduce stress: unmanaged stress increases DHT (the metabolite of testosterone responsible for acne, hirsutism and hair loss).
• Supplements that have been studied and found to help reduce hirsutism are diindolylmethane (DIM), N-acetyl cysteine (NAC), green tea, spearmint, licorice, reishi mushroom (reduces the amount of testosterone converted to DHT), saw palmetto, black cohosh and or chaste tree extract.

Health risks of testosterone supplementation in women

If you are considering taking a testosterone supplement, there is another consideration: there is some scientific literature suggesting that taking a testosterone supplement could promote breast cancer: “Epidemiological findings agree that higher endogenous serum androgen levels confer increased breast cancer risk both before and after menopause. Androgenic hormonal replacement regimens also increase the risk of breast cancer.”

The mechanism behind this is thought to be from supplemental testosterone getting metabolized into bioactive estradiol (in peripheral fat, breast tissue, or tumors already growing) which stimulates abnormal cell growth.

However, in The European Menopause Journal Maturitas, authors spell out that many of these previous worries were just that, worries. In fact, a larger look at the scientific literature show us that in women, “T is not masculinizing, T does not cause hoarseness, T increases scalp hair growth, T is cardiac protective, T is mood stabilizing and does not increase aggression, T is breast protective, and the safety of T therapy in women is under research and being established.”

Regarding heart health risk, a meta-analysis (looking at many studies) reveals not only a lack of association between a testosterone supplement in women and heart disease risk, but that lower levels of testosterone or dihydrotestosterone (DHT) are associated with higher heart disease risk for both men and women.  This means it should be beneficial to help lower heart disease risk. Therefore, if a woman has few or no heart disease risk factors, testosterone replacement would be considered safe in this regard.

One thing many doctors will do is start you off at the lowest dose and carefully monitor your levels. Many women find relief at a low dose, so don’t be discourage. And if you get a doctor who doesn’t want to monitor you levels regularly, see someone else.

Oxytocin supplementation for women

What is oxytocin? Oxytocin is a hormone that was previously known only as a pregnancy hormone — released by the brain to stimulate labor, and also release breast milk for nursing. Now we know that there are oxytocin receptors in many areas of our body and that it has many functions.

Here’s where it gets more interesting:

• Oxytocin is the hormone involved with increased trust and attachment between individuals. It is the neuro-hormone of bonding, and involved with the formation of loving relationships.
• Oxytocin has also been referred to as “love hormone”—it is released when we hug, touch, and experience orgasm.
• Taking Viagra has been shown to cause oxytocin release from the brain.
• Women who are deficient in oxytocin can have difficulty with sexual arousal, plus not be able to achieve multiple orgasms.
• Men who are deficient in oxytocin will not desire to be touched, and lose the ability to orgasm.

Oxytocin is now thought to be an addition to the neurochemicals in the brain that are involved with sex: dopamine for desire and libido; acetylcholine for arousal; GABA (gamma amino butyric acid) to calm any anxiety; and serotonin for a good mood.  Who wouldn’t want more oxytocin?

In my next article, I’ll show you the science of oxytocin supplementation and why this can be a part of safe hormone supplementation for women — and possibly men too.

To feeling good and having balanced hormones,

Michael Cutler, M.D.

Sources:

1. http://www.maturitas.org/article/S0378-5122(13)00012-1/fulltext

2. http://www.maturitas.org/article/S0378-5122(13)00012-1/fulltext

3. Shufelt CL, Braunstein GD. Safety of testosterone use in women. Maturitas. 2009 May 20;63(1):63-6. PubMed PMID: 19250779. https://www.ncbi.nlm.nih.gov/pubmed/19250779

4. Unluhizarci K, Karaca Z, Kelestimur F. Hirsutism – from diagnosis to use of antiandrogens. Front Horm Res. 2013;40:103-14. PubMed PMID: 24002408.  https://www.ncbi.nlm.nih.gov/pubmed/24002408

5.  http://www.maturitas.org/article/S0378-5122(13)00012-1/fulltext

6. Schover LR. Androgen therapy for loss of desire in women: is the benefit worth the breast cancer risk? Fertil Steril. 2008 Jul;90(1):129-40. Review. PubMed PMID: 18023435. https://www.ncbi.nlm.nih.gov/pubmed/18023435

7. Kenemans P, van der Mooren MJ. Androgens and breast cancer risk. Gynecol Endocrinol. 2012 Mar;28 Suppl 1:46-9. PubMed PMID: 22394304. https://www.ncbi.nlm.nih.gov/pubmed/22394304

8.  http://www.maturitas.org/article/S0378-5122(13)00012-1/fulltext

9.  Kim C, Cushman M, Kleindorfer D, Lisabeth L, Redberg RF, Safford MM. A review of the relationships between endogenous sex steroids and incident ischemic stroke and coronary heart disease events. Curr Cardiol Rev. 2015;11(3):252-60. Review. PubMed PMID: 25563292. https://www.ncbi.nlm.nih.gov/pubmed/?term=CVD+risk+testosterone+supplementation+in+women