Why women need testosterone and how to boost yours if it’s low – from using creams and, perhaps soon, skin patches to diet and exercise
- Low testosterone in women can result in a poor sex drive, low energy levels, poor muscle tone and more – their eyes can be affected, for example
- Skin creams containing the hormone are one option, and a UK company is trying out a testosterone patch for use by postmenopausal women
If you thought testosterone was only a male hormone, think again.
Even though its safety for use in women has been evaluated for the past 80 years, it is still only licensed to treat low libido in women – and then only in some parts of the world.
Hong Kong-based Dr Susan Jamieson says women with lower testosterone may report a poor sex drive.
But they will also notice lower energy levels and, no matter how much they exercise, poor muscle tone, she says.
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Testosterone targets receptors in the brain responsible for sexual activity. But it also targets many other receptors – as many receptors as oestrogen does – and across many areas of the brain.
These include the amygdala, which drives motivation; the hippocampus, which is involved in storing long-term memories and in making those memories resistant to being forgotten; and the striatum, which is responsible for decision-making and the formation of emotions and habits.
Testosterone plays a powerful role cognitively: it helps to manage mood, boost concentration, promote verbal learning and improve spatial awareness. It might even help ward off dementia later in life, as it supports memory.
Studies have shown that in women, both testosterone and oestrogen can counter the biochemical reactions in the brain associated with Alzheimer’s disease, reactions that can cause an increase in amyloid plaques – protein deposits that form between nerve cells – poor brain glucose metabolism and reduced blood flow.
But testosterone receptors have been identified in other parts of the body too: in breast tissue, the skeleton, muscles, adipose tissue or fat, and genital tissues.
It is a whole-body hormone whose impact – whether the level is too high or too low – is widely felt. For example, it can have an impact on the eyes: testosterone supports the function of our Meibomian glands, the sebaceous glands in eyelids which produce a secretion that helps keep our eyes healthy and well lubricated.
Testosterone is seen as a ‘male’ hormone, but it’s actually important for both men and women
Advocates of testosterone use in women are excited by the news that a UK company is trying out a testosterone patch, called Tepi, specifically for postmenopausal women.
“Currently, there is no approved testosterone patch available for women,” says Dr Louise Newson, of Newson Health in Stratford-upon-Avon in the UK.
“AndroFeme 1 – developed in Australia in 2020 – is a testosterone cream designed for women which contains testosterone identical to the testosterone the ovaries and adrenal glands in women produce.”
It is not licensed in Hong Kong and requires a special import permit, says Laurena Law, a Hong Kong family doctor, or general practitioner. Many women are not aware of its use in treating low libido.
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“Not all women need it and sexual health is complex,” Law says. “But for some, it could be part of the solution in combination with sex therapy, couples therapy and/or counselling.”
Previously the only testosterone available to women in transdermal preparations – that is, via the skin – were the gels manufactured for male use and applied in minuscule amounts, such as Androgel, which is licensed for use in men in Hong Kong.
“Traditionally, medicine and research has viewed women’s health through a lens of reproduction rather than overall health,” Newson says. “Testosterone is seen as a ‘male’ hormone, but it’s actually important for both men and women” – although women have much lower levels.
However, she says, it should not be viewed only in terms of reproduction. “We know that testosterone can work to maintain muscle and bone strength and can help with your overall sense of well-being and zest for life,” Newson says.
Low oestrogen levels were always blamed for osteoporosis in women – and women suffer disproportionately from the condition that leads to brittle bones. Yet in men, the condition was put down to testosterone levels dropping off.
Why would testosterone play a role in bone strength in men and not women? Indeed, a study published in the science journal Nature in 2022 suggests low testosterone levels affect the bone health of both genders.
The study showed a positive correlation between testosterone levels and bone density in women aged 40 – ie. pre-menopausal – to 60.
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Several theories have been put forward as to why testosterone supports bone density. One is that testosterone seems to regulate the formation of osteoclasts, a type of bone cell that breaks down bone tissue.
Another theory is that testosterone might inhibit the production of B cells and thus prevent bone loss.
Young women rarely consider their testosterone level, but if it is low they can experience a host of problems. Ideally, women should have 15 to 70 nanograms of testosterone per decilitre of blood.
Low testosterone levels in both men and young women can exacerbate fertility problems if they are trying to conceive.
Sometimes birth-control pills interfere with healthy testosterone production in younger women; they work by interfering with the ovaries, where testosterone is manufactured. Adrenal stress is another factor.
More women are becoming aware of the value of maintaining a higher testosterone level. The UK’s National Health Service recently revealed that the number of women using transdermal testosterone had increased by a factor of 10 in the past seven years.
The word is out.
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How to boost testosterone
The jury is still out as to whether you can increase your testosterone levels naturally.
However, by losing some weight and getting active your overall health and outlook will improve – and often that is enough to get the level of this hormone moving in the right direction. Here are some other things to consider.
Chronic stress depletes testosterone because stress prompts the production of cortisol, which has a negative effect on the production of testosterone.
Further, in men, high levels of cortisol can increase fat deposition, resulting in conversion of testosterone to the female hormone oestrogen.
2. Have more sex
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3. Eat well and have more foods rich in magnesium, zinc and B vitamins
Some foods and food groups are thought to boost testosterone, such as nuts and seeds – especially pumpkin seeds – wild fish, green vegetables, and beans, especially black beans and kidney beans.
Onions and ginger are also examples. A small 2012 study found that taking ginger supplements for three months increased testosterone levels by 17.7 per cent. Both of these foods are good for health and easy to add to many recipes – onions in a curry, ginger in tea, for example.
Some nutritionists advocate supplements including dehydroepiandrosterone or DHEA. DHEA is a precursor to testosterone and is found in the adrenal glands. Its supply is depleted by cortisol – the stress hormone.
Another, similar small study found that drinking pomegranate juice for just two weeks elevated testosterone levels in the saliva of both men and women by nearly 25 per cent, as well as lowering blood pressure.
Both vitamin D and magnesium might be beneficial too – from food, supplements or, in the case of vitamin D, exposure to the sun.
