Are you having a bout of memory loss? You know, that “where is my car/my purse/my mind” experience?
Or maybe it’s your body that’s pooping out. And you find yourself skipping exercise class more often, because you just don’t have it in you to work out.
And then there’s your sex drive—which seems to be firmly stuck in park—or worse, reverse! You’ve lost that lovin’ feeling, and you’re worried that it may never come back! Is menopause-related low estrogen to blame or could something else be going on—like a case of low testosterone (Low “T”)?
Dr. Michael Krychman, Executive Director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach California explains, “While estrogen is critical, it is my belief that there is interplay between lowered estrogen and lowered testosterone levels in women as they age.”
What to know about testosterone:
- It’s part of our hormonal makeup.Testosterone is a steroid hormone primarily found in men, but smaller amounts are also produced in women’s body: one specific place is the ovaries. Testosterone is necessary for muscle tone, a healthy libido, and strong bones. Women begin experiencing low “T” during their menopausal journey, which may begin a decade earlier than when menstrual periods stop.
According to Dr. Krychman, “Many feel that surgical or abrupt menopause can cause more severe and abrupt symptomology rather than a gradual decline. It seems that when science or disease interferes with Mother Nature, she retaliates by sudden withdrawal and plunging testosterone.”
- Symptoms of low Testosterone. Women with low testosterone levels can experience depression, fatigue, weight gain, bone and muscle loss, and cognitive dysfunction. Then there is the whole “loss of libido” issue, which can be dramatically decreased. As for orgasms, if we have them, they can be more “ho-hum” than “woo hoo!” if our “T” level is down, according to a report from The North American Menopause Society.
- Benefits of testosterone supplementation. Supplementing with testosterone can benefit your heart, mood, energy, and bone and muscle health. Additionally, testosterone can sustain skin elasticity and tone, encourage heart health, boost libido, help prevent osteoporosis risks, decrease body fat and increase muscle strength.
You think you have low “T.” Now what?
- First, schedule a visit with your health care professional, or menopause specialist to rule out any other medical problem. Underactive or overactive thyroid, for example, can also affect your energy level, libido and general physical health or well being.
- Ask about testosterone testing. Total testosterone and “free” testosterone are typically measured and calculated. Free testosterone , measures your levels of bioavailable testosterone that is not bound by the blood proteins. It is the active portion. Ranges vary between post-menopausal and premenopausal women, with a gradual decline as we age, says Dr. Krychman. However, he adds, “I advise treating symptoms, not lab values. A comprehensive assessment with a good differential is the rule. Testosterone supplementation is not the panacea. It is important to remember that this there is also approximately 40% placebo effect!”
- Treatment options. If your testosterone levels are below norm and you have the symptoms, your health care professional may suggest an “off-label use” of testosterone, with or without estrogen. Why “off-label? Because the FDA has yet to approve any testosterone drug for women.
According to WebMD, when you take it orally (by mouth) and it gets processed by the liver—which can result in a change of cholesterol levels. But that same effect doesn’t occur when testosterone is administered by skin patch, gel or cream (aka transdermal) or in pellet form (the size of a grain of rice) inserted under the skin. “What form to use depends on many facets including patient tolerability, patient price, side effects and clinician preference,” says Dr. Krychman.
- Weigh the risks vs benefits with your health professional or menopause specialist. Dr. Krychman has a frank and candid conversation with his patients about the benefit versus the risk – safety and efficacy are always balanced, he states. He further recommends that before starting therapy you are aware of the benefits and risks and that once you start therapy, you need to have regular blood work to keep track of your levels. It is important to monitor your blood count and lipid panel, coupled with testosterone levels.
To “T’ or not to “T” that is the question! Bottom line? You don’t need to star in Sexless in the City, so don’t blame Mama Estrogen for all your menopause miseries. Papa Testosterone could be partly responsible for your brain fog, exhaustion and crashing libido! Get the info you need to take charge of dealing with your symptoms. Evaluate the risks and benefits, to determine what is best for your body and your quality of life.
Suffering in silence is OUT. Reaching out is IN.