What women need to know about testosterone

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by Dr. Angela DeRosa, DeRosa Medical / Special to azfamily.com

GMAZ interview by Kaley O'Kelley

Posted on November 11, 2013 at 10:42 AM

Updated Tuesday, Nov 12 at 3:11 AM

PHOENIX -- Hormones are the foundation of our biological makeup, however, there is a lot of confusion about the importance of testosterone to women’s health and wellness. Many believe testosterone is only found in males, but when working properly, a woman's body makes 60 percent estrogen and 40 percent testosterone, and a man's body makes 95 percent testosterone and 5 percent estrogen.

Testosterone deficiencies or low T, impedes proper glucose metabolism, causes weight gain, fatigue and lower libido, reduces mental clarity, and increases insulin resistance. Insulin resistance causes more weight gain, and the cycle continues, raising the risk for developing diabetes, heart disease, strokes, and other serious conditions.

Testosterone deficiency can begin as early as a woman's 20s, and it's far more common than you'd think. Even though most women don't start perimenopause until their 40s, roughly 20 percent of women in their 20 will have testosterone deficiency due to genetic makeup, environmental exposures such as alcohol and drug use, pesticides, radiation, and other factors.

Antidepressants, blood pressure, cholesterol, and pain medications can also wreak havoc on testosterone levels. But here’s the kicker: perhaps a third of women in their 20 will have testosterone deficiencies because they use oral contraceptive pills.

When used correctly oral contraceptives are highly effective, and they are prescribed for many conditions besides birth control. Most contraceptive pills include a combination of synthetic estrogen and progesterone that replace the ones your ovaries would normally produce. What they don’t replace is testosterone. Ovaries manufacture 90 percent of the body’s needs, with the remaining 10 percent made by the adrenal glands.

Simply using oral contraception means the level of one major hormone is dramatically reduced, but that’s not the end of the process. Oral contraceptives are metabolized through the liver, triggering production of a protein that starts to bind up testosterone made by the adrenal glands, and another that binds the “free thyroid” hormone needed to fuel metabolism. Now we have real trouble. Testosterone is critically important for the thyroid gland to manufacture proper amounts of thyroid hormone, which fuels metabolism, gives us energy and so much more.

Happily, testosterone can be safely replaced or supplemented in the body. There are many delivery methods like troches, which dissolve under the tongue, creams, gels and injections. However, these are not ideal as they produce rapid spikes and fall. Topical applications avoid testosterone supplements if they are pregnant or planning to become pregnant in the near future.

The gold standard delivery method for hormone supplementation is a bio-identical subcutaneous pellet that’s about the size of a grain of rice, with a dosage compounded to meet the needs of the individual patient. In a quick and painless office procedure, the pellet is implanted under the skin. The hormone is released gradually, like the body would do naturally, so levels stay more consistent. The pellets dissolve naturally, and after three to four months, a new dosage can be implanted.

Most important of all for men and women: avoid the As Seen on TV testosterone boosters. Any hormone deficiency should be diagnosed and treated by an experienced, licensed medical provider.


Dr. Angela DeRosa is a nationally recognized expert in the field of Internal Medicine and Women's Health. DeRosa Medical has locations in Scottsdale, Sedona and Chandler. For more information, call 480-619-4097 or visit DeRosaMedical.com.

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