Your location has mapped you to the following local PBS station s. Please select one below or choose. Please select your affiliate below by picking a state or choose not to. I cried at the drop of a hat and had sweating, pain, swelling and mood swings. My muscles were so weak that I broke my ankle — me, a high-heel wearer. But then five years ago, when she’d reached a low point and was ready to leave the job she loves, her gynecologist, Dr.
Nancy Lebowitz, a clinical instructor at New York’s Cornell Medical Center, started her on another form of hormone replacement, which she has remained on ever since. I no longer have those weepy moments or night sweats. I know I sound like an addict, but I’m really not.
She recovered after chemotherapy, radiation and bone marrow transplants, but was left feeling chronically tired, moody and forgetful, with little interest in sex.
Five years ago, Dr. Rebecca Glaser, a local breast surgeon, started her on a treatment, which she continues today, that has improved her mood, memory and libido. The therapy in both cases? Testosterone, widely and misleadingly understood to be the “male” hormone. And many experts now believe that it’s the loss of testosterone, and not estrogen, that causes women in midlife to tend to gain weight, feel fatigue and lose mental focus, bone density and muscle tone — as well as their libido.
Not all of them will experience its wide variety of symptoms, like low libido, hot flashes, fatigue, mental fogginess and weight gain. For those who do, and who seek to avoid taking synthetic oral hormones shown by National Institutes of Health findings to pose an increased risk for breast cancer, heart attack, stroke, blood clots and dementiabioidentical testosterone whose molecular structure is the same as natural testosterone has been shown to be safe and effective.
Some testosterone is converted by the body into estrogen — which partly explains why it is useful in treating menopausal symptoms.
For those at high risk for breast cancer, or who have had it, that conversion can be prevented by combining testosterone with anastrozole — an aromatase inhibitor that prevents conversion to estrogen.
Nonetheless, testosterone has been shown to beneficial for patients with breast cancer. Preliminary data presented at the American Society of Clinical Oncology have shown that, in combination with anastrozole, testosterone was effective in treating symptoms of hormone deficiency in breast cancer survivors, without an increased risk of blood clots, strokes or other side effects of the more widely used oral estrogen-receptor modulators tamoxifen and raloxifene.
MORE: Is Menopausal Hormone Therapy Right for You? Yet many patients, and doctors, are unaware of testosterone therapy for women. The number of women in the United States currently on testosterone therapy is estimated to be in the tens of thousands — miniscule compared with the millions prescribed oral estrogen-progestin regimens, like Premarin and Provera.
With a growing recognition of testosterone’s benefits for women, those numbers may increase, but it may still be a while before the therapy reaches the mainstream. Advocates say that the very idea requires a rethinking of long-held notions about hormones. And many women have a knee-jerk suspicion that any hormone treatment can increase their risk of breast cancer.
However, clinical studies show that testosterone not only does not increase a woman’s risk of breast cancerit may play a key role in warding off the disease.
Male Menopause Symptoms, Treatments, Causes, and More
Some women believe, also incorrectly, that testosterone therapy will produce “masculinizing” traits, like hoarseness and aggression.
While the hormone may cause inappropriate hair growth and acne in some women, those side effects can be remedied by lowering the dose. Testosterone therapy has been approved for a variety of conditions in women as well as men in Britain and Australia.
But while the U. Food and Drug Administration has approved of testosterone for use in men whose natural levels are low, the agency has not sanctioned it for women, for any reason. Similar concerns have been put forth by the North American Menopause Society, although that group has also acknowledged testosterone’s efficacy in treating low libido in women.
Doctors, however, have the legal discretion to prescribe testosterone, off-label, to women, as they see fit and often do so to combat fatigue, mental fogginess and low libido.
Glaser thinks this will likely remain the status quo for a while, given the prohibitive cost of conducting the long-term safety studies needed to win fuller FDA approval.
How Treatment Works Women can take testosterone as a cream, through a patch or in the form of pellet implants, which have the highest consistency of delivery. Synthesized from yams or soybeans, and compounded of pure, bioidentical testosterone, the pellets, each slightly larger than a grain of rice, are inserted just beneath the skin in the hip in a one-minute outpatient procedure. They dissolve slowly over three to four months, releasing small amounts of testosterone into the blood stream, but speeding up when needed by the body — during strenuous activities, for example — and slowing down during quiet times, a feature no other form of hormone therapy can provide.
The problem, Glaser says, “is that testosterone is difficult to accurately measure in women. Levels vary considerably, not only throughout the month, but also during the day, making a single level unreliable. Once inserted, pellets can’t be removed. If symptoms recur, patients can return for re-evaluation. Since testosterone is not FDA-approved for women, though, it is rarely covered by insurers.
Advocates call this unfair, because men with sagging libidos are covered, while women seeking treatment for the same condition, to say nothing of breast cancer or heart disease, are not.
Testosterone pellets have long been covered for women in Britain. Since implantation is a surgical procedure, and the pellets are manufactured by a variety of pharmaceutical compounders, who may have varying safety standards, it’s important for women to consult with an experienced, board-certified physician about treatment. But while a growing number of gynecologists, family practitioners, urologists and cardiologists, among others, now treat women with pellet implants, there is as yet no national resource to direct patients to vetted doctors who provide this treatment.
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You are using an outdated browser. Please upgrade your browser to improve your experience. WKNO WLJT WMHT Educational Telecommunications WNED WNIN Tri-State Public Media, Inc. Starting a New Career. Special Report Aging Well Through Arts. Special Report Transforming Life as We Age. Should Women Consider Taking Testosterone? Fearing the potential side effects, Naomi had resisted estrogen therapy. MORE: What to Do About Loss of Libido.
Other benefits cited for testosterone therapy include:. Relieving symptoms of menopauselike hot flashes, vaginal dryness, incontinence and urinary urgency. Enhancing mental clarity and focus. Researchers at Utrecht University in Holland recently found that testosterone appears to encourage “rational decision-making, social scrutiny and cleverness.
Reducing anxiety, balancing mood and relieving depression combined with fatigue. Increasing bone density, decreasing body fat and cellulite, and increasing lean muscle mass. George Yu, a urologic surgeon and aging specialist at Aegis Medical and Research Associates in Annapolis, Md. Women can take testosterone as a cream, through a patch or in the form of pellet implants, which have the highest consistency of delivery. To determine a patient’s dosage, some doctors measure testosterone levels in the blood or saliva, while others make judgments based on symptoms.
Side effects of the insertion procedure, which are rare, include infection, minor bleeding and the pellet “working its way out,” Glaser says. Hide Show Comments comments. Now it’s a symbol of mine. Sign up for E-Newsletters. Produced for the PBS system by:.