Women & Testosterone

[madman]

Dr. Harper and I discuss the importance of testosterone for women’s health, including muscle mass, metabolism, mental health, and the health of the genitourinary tract. We address common questions and misconceptions about testosterone, such as why it isn’t easy to prescribe and the normal ranges for women. We also explore the use of testosterone in the treatment of genetic urinary syndrome of menopause and its potential benefits for breast cancer survivors. The conversation highlights the need for personalized hormone therapy and the importance of considering other factors that may impact libido and overall well-being.




HERE’S WHAT WE DISCUSS

*Why are there many urologists who are experts in female pelvic health and hormones?

*There are no “perfect” testosterone levels; we don’t treat it to a level, but rather, there is a range.

*How Testosterone helps with genitourinary syndrome of menopause (GSM).In perimenopause, sometimes testosterone is the first thing we start for symptoms.

*Sometimes testosterone supplementation takes several months to have effects.

*What to do if you don’t feel effects. Dr. Harper shares some tips and tricks.

*Testosterone is important for women’s health, including muscle mass, metabolism, mental health, and the health of the genital, urinary tract.

*There are misconceptions and challenges surrounding the prescription of testosterone for women, including the lack of a female-licensed product and the off-label use of male testosterone products.

*Testosterone can be beneficial for women with genetic urinary syndrome of menopause and breast cancer survivors, but individualized treatment and monitoring of hormone levels are important.

*Hormone therapy should be personalized, and other factors that may impact libido and overall well-being should be considered.

*Testosterone positively affects brain function and mental clarity, which can greatly improve the quality of life for women.

*Should we use hormones for preventative health?We make estrogen via the androgen pathway.

*Reasons that we benefit from testosterone.There is no female-licensed product in either the UK or the USA

 

[madman]

post #14

Testosterone for women

In this presentation, Dr Louise Newson looks at the role of the hormone testosterone throughout a woman’s body, the impact of menopause, and testosterone as a menopause treatment. This presentation covers: • About testosterone – is it just a male hormone? • Why testosterone is a key hormone...

www.excelmale.com

 

[madman]

Androgen Levels in Women Across the Menstrual Cycle

Circulating dihydrotestosterone, testosterone, and free testosterone levels and dihydrotestosterone-to-testosterone ratios in healthy women across the menstrual cycle (2022) Grace Huang, M.D, Shalender Bhasin, M.B., B.S., Karol Pencina, Ph.D., Ming Cheng, M.S., and Ravi Jasuja, Ph.D Objective...

www.excelmale.com

Key point here!

*The present study aimed to examine the changes in the T and DHT levels across the menstrual cycle in carefully characterized healthy young women using LC-MS/MS assays certified by the HoST with a high level of precision and accuracy in the low range of these hormones prevalent in women. We also measured the free T levels using a standardized equilibrium dialysis method to separate bound and unbound fractions of T and then directly measure the T levels in the dialysate using a sensitive LC-MS/MS assay. We also examined the sex differences in relative levels of total T to DHT levels using these validated techniques.




*Measurements of the circulating testosterone (T) levels in women are important for identifying abnormalities in gonadal and adrenal function in conditions such as polycystic ovary syndrome (PCOS), hirsutism, congenital adrenal hyperplasia, and androgen-secreting tumors. However, accurate measurement of the T levels in women poses significant challenges because women have substantially lower serum T levels than men and these levels progressively decline with age (1, 2). Despite advances in steroid hormone assay techniques, substantial variability exists among assays, and most commercial radioimmunoassays lack the sensitivity and specificity required to accurately measure the low T levels in women (3). The T levels in women vary substantially during the menstrual cycle (4, 5). The paucity of normative data on the T levels and other androgens across the menstrual cycle has further confounded their interpretation in women. Thus, the development of accurate and sensitive androgen assays is important to define reference ranges and establish thresholds for diagnosing androgen excess and deficiency syndromes in women. An improved understanding of the menstrual phase–specific distribution of the total and free T levels measured using reliable assays will ensure that these cutoffs can be applied appropriately to women in different phases of their menstrual cycle.


*Currently, liquid chromatography-tandem mass spectrometry (LC-MS/MS) and equilibrium dialysis are considered the reference methods for the measurement of the total and free T levels, respectively, against which all other methods are compared. Compared with direct immunoassays, these techniques offer the highest sensitivity and specificity to measure the T levels in the low range in women with high accuracy and precision (5, 6). However, these methods require significant expertise, and their results can vary across laboratories owing to methodological and calibrator differences (7). The Centers for Disease Control and Prevention (CDC) has established the Hormone Standardization Program for Testosterone (HoST) to harmonize T assays across laboratories; the hormone levels and reference ranges generated using a HoST-certified assay can be applied to other HoST-certified laboratories (8, 9). Only a few published studies have reported the menstrual phase–specific reference limits in women for total T using the LC-MS/MS technique, and these studies preceded the advent of the HoST (5, 10, 11). Only 1 study used the equilibrium dialysis method to measure the free T levels across the menstrual cycle, but none has measured the free T levels during different phases of the menstrual cycle using equilibrium dialysis coupled with direct measurement of the free T levels in the dialysate using a HoST-certified LC-MS/ MS assay (6). Most studies collected samples at only 2 or 3-time points (e.g., follicular, midcycle, and luteal phases); repeated measurements across the entire menstrual cycle would more comprehensively capture the variability in the androgen levels during a menstrual phase.




Table 2. Hormone levels for phases of the menstrual cycle (n=17.)

Table 3. Comparison of the hormone levels in healthy women and age-matched healthy men.