Hormones play a major role in a multitude of bodily functions. This includes the sex hormones estrogen and testosterone as well as other hormones such as growth hormone. It is not widely known is that declining hormone levels can start for some men and women as early as in their 30’s leading to symptoms that often become evident in a person’s 40’s, symptoms we often attribute to being tired, overworked, or just natural aging. It is also not well known that the hormone testosterone is as important for women as it is for men.
Menopause is a stage of life which results in a drastic reduction in hormone levels of estrogen, testosterone and progesterone with the cessation of menstrual cycles in women. Though each woman may experience menopause and the transition into menopause differently, the most commonly recognized symptoms which are related to declining estrogen levels include hot flashes and night sweats and as the low hormone state continues urogenital symptoms can worsen such as vaginal dryness, loss of lubrication, painful intercourse, worsening urinary incontinence and painful urination.
Symptoms of low testosterone
in women include:
- Decreased energy levels/fatigue
- Mood changes including irritability, depressed mood, anxiety
- Lowered libido or sex drive
- Loss of muscle mass and increasing body fat
- Decreased bone mass (which is affected by both estrogen and testosterone)
- Brain fog with decreased memory and focus
Symptoms of testosterone deficiency
in men include:
- Reduced sex drive
- Erectile dysfunction
- Decreased energy/fatigue
- Loss of lean body mass and increasing fat mass
- Mood changes such as irritability, depressed mood, anxiety
- Brain fog with decreased memory and focus
Of course, some of these symptoms are not only specific to low hormones but can also represent other physical health or mental health conditions, so before embarking on a quest for treatment with hormone therapy, it is important to have regular health checks with a primary care provider and to strive toward healthy lifestyle habits such as optimizing one’s diet, getting adequate sleep and getting regular exercise. Also worth mentioning is that despite the boost in well-being that is evident to both men and women who are appropriately treated with hormone therapy, testosterone therapy is still not widely accessible, especially to women. For this reason, men and women who are motivated to improve their quality of life often seek help for their hormonal concerns through clinics that specialize in hormone therapy. In fact, a drastic reduction in prescriptions for hormone therapy for women occurred after 2002 in response to a study published by the Women’s Health Initiate (WHI) which showed an increase incidence of breast cancer and an increase in blood clot related complications. However, some experts have revisited and criticized that the study on the ground that it did not look closely enough at the different groups of women in the study and what types of hormones were used. We do know now that estrogen hormones taken by mouth can increase the risk for blood clots and that using estrogen either in the form of a cream, patch or pellet does not incur the same risk. As far as breast cancer is concerned, whether the hormones are bio-identical may make a difference including whether a progestin is used versus a bio-identical progesterone. There is evidence that testosterone can actually lower a woman’s chance of developing breast cancer, including a recent study published in the European Journal of Breast Health showing a 35.5% lower incidence of invasive breast cancer. None of the participants in the WHI study had testosterone as a part of their hormone replacement program. All of this being said, each person’s decision whether or not hormone therapy is appropriate for them needs to be discussed with a healthcare provider versed in providing these services and the pros and cons of therapy considered.
