What Causes Low Testosterone In Females and How To Treat It?

Testosterone In Females

Testosterone is an important hormone when it comes to the female reproductive system. It is the testosterone which influences the libido and how a female will respond to sexual stimulation. This hormone also decreases depression and anxiety in females and promotes a sense of feeling good and healthy. Testosterone deficiency in females has not been studied excessively due to the limited literature available which does not give a clear picture of its prevalence.[1]

Whatever study that is available suggests that females who become menopausal after surgery tend to have testosterone deficiency more than normal population. Testosterone deficiency is characterized by a lack of sexual desire, persistent fatigue and feeling sick. Studies suggest that females who have their ovaries removed tend to have a decline of testosterone levels by almost 50%.[1]

Researchers are studying on testosterone replacement as an alternative to estrogen replacement therapy in females who have had oophorectomy or ovarian failure and are surgically menopausal. Oral form of methyltestosterone is the preferred way to manage low testosterone in females in the United States even though as of now the perfect product to manage this condition has not yet been arrived at while the research continues to find one.[1]

Studies also suggest that the levels of testosterone change in a female throughout the various phase of her life, before periods, during the menstrual cycle, and after it.

Sometimes, the testosterone levels may change during the course of a day as well. There is a common misconception that testosterone is a male sex hormone but the fact is that while testosterone is found more in males, both genders require it as a part of their reproductive system.[1]

Studies show that females need anything between 15-70 ng/dL of testosterone, even though there is no consensus built on what level should be considered as low in females.[1]

What Causes Low Testosterone In Females and How To Treat It?

There are two primary causes of low testosterone in females. One is the normal process of aging as a result of which there is less of testosterone produced in the body.

The second is a problem with the pituitary or the adrenal gland resulting in reduced production of testosterone in females. The reduction in the production of testosterone in females starts after reaching menopause. This is the time when the ovaries start to produce fewer hormones.[2]

Females who are on medications for management of side effects of menopause also tend to affect the production of testosterone. Oral estrogen is the most common medication used by females which reduces the production of testosterone in females. Testosterone deficiency may also arise in females if they have had their ovaries removed. Females with adrenal gland insufficiency also have a tendency to produce less testosterone causing deficiency of this hormone.[2]

How to Treat Low Testosterone In Females?

Estrogen replacement therapy is the route to go for management of testosterone deficiency in females. However, testosterone replacement is being studies as a replacement of this therapy for management of testosterone deficiency in females. This is because estrogen replacement therapy does not produce enough testosterone to replenish the levels required by the body.[2]

Testosterone may be given directly to the patient by way of injection or orally similar to the treatment given to males with hormone deficiency. The aim is to get the desired effect of improving sexual drive, treat lethargy, and provide the female with an overall sense of well-being. The efficacy of testosterone administration is still being studied and many physicians are against giving direct testosterone to females.[2]

The United States Food and Drug Administration has approved a few treatments only for low testosterone levels in females. This is due to the side effect profile of these treatments which include but are not limited to hair loss, acne, hoarseness of voice, development of facial hair, and hirsutism. In fact, a task force formulated for studying the effects of drugs on testosterone levels in females came to a conclusion of not allowing any treatment for deficiency of this hormone in females.[2]

They came to this conclusion due to lack of conclusive evidence of the efficacy of these treatments. They however voiced for alternative therapies to treat this condition and making lifestyle modifications like stress management, getting adequate sleep, and eating a balanced diet. Taking over the counter DHEA has also been suggested as a means to treat low testosterone in females.[2]

DHEA is a steroid hormone which is produced in the adrenal gland and is quite effective in treating low testosterone levels in females. However, physicians do not recommend taking this medication for a prolonged period of time as there are not studies to prove the safety of this drug when used for a long time.[2]

In conclusion, research is still ongoing as to best describe low testosterone in females and its effect on the body and also how to best manage the condition. Age is a primary factor for testosterone deficiency in females, especially after menopause. The best way to diagnose low testosterone levels is by doing a blood test after peristent symptoms as seen with low testosterone levels like lack of sexual desire and persistent fatigue.[2]

It is highly recommended to consult with a physician before starting any type of hormone replacement therapy as they may lead to unpleasant side effects and do more harm than good.[2]

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