8 Misconceptions About Women Using Testosterone For TRT

Testosterone, or testosterone, is a sex hormone found in both men and women, and it plays an important role in maintaining overall health, muscle mass, athletic performance, libido, and more. When testosterone is lower than normal in both men and women, it can hurt the above aspects. At this time, it is necessary to go to the hospital for some corresponding treatment, that is, testosterone replacement therapy (English is testosterone replacement therapy, abbreviated as TRT). TRT is common in men, especially men with low testosterone due to aging or physical impairment, and it is also common in retired bodybuilders. But in fact, some women also need TRT. Compared with domestic countries, there are more cases and studies in this area abroad. At present, the common method in domestic hospitals is to inject testosterone undecanoate or testosterone patches. This article introduces 8 common misunderstandings when women use testosterone for TRT. It is for reference only and should not be regarded as medical guidance. Readers in need should go to the local hospital for detailed consultation.

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Testosterone has long been called the "male hormone," but in fact, it's also the most abundant active hormone in women. Men indeed have higher circulating levels of testosterone than women, but according to scientists Glaser and Dimitracakis, testosterone, not estrogen, is a woman's primary sex steroid throughout her lifespan.

Writing in "Maturitas," the two scientists write, "Look at how women's estrogen levels are measured—only in picograms per deciliter—while their testosterone levels are measured in nanograms per deciliter.", which is a 10-fold higher unit of measure." In addition to estrogen, there are even higher and exponentially higher amounts of androgen circulating in the body, such as DHEA sulfate, DHEA, and androstenes Diketones, each of which provides a lot of extra testosterone.

Even the androgen receptor gene, on which testosterone and other sex hormones depend, is on the X chromosome, not the Y or male chromosome. Deploring the myopic stance of the medical establishment, Glaser and Dimitracakis wrote: "Despite any clear justification, estrogen is still considered the 'hormone replacement therapy' hormone for women."

They point out that this assumption holds even though testosterone has been the treatment of choice for the treatment of menopause in women as far back as 1937. Why, then, has testosterone been largely excluded as a viable treatment option for perimenopausal women? When you start looking at the common myths associated with using testosterone—some of which also hold men back from TRT—you sort of understand.

Myth 1: Testosterone Makes a Woman a Man

While some "masculine" Olympic female athletes from East Germany and the Soviet Union around 1970 played a role in the origin of this misconception, the real contributor to this widespread stereotype was female bodybuilding.

Women who simply do bodybuilding training will not develop very exaggerated muscles. After all, even men can only show exaggerated muscle effects after using anabolic/androgenic steroids (these are synthetic derivatives of testosterone), so However, those women who are professional bodybuilders also have to use these exogenous hormones while doing bodybuilding training. As a result, they bear inevitable side effects, conflicts, and even criticisms of secular values while their muscles grow bigger.

With the help of various media, these pictures and videos that are different from "normal" women have been spread to every corner of the world. So, a lot of the medical establishments and their patients are justifiably afraid of testosterone, but what they need to know is that all of this is dose-dependent. For normal women, the doses of testosterone replacement therapy actually "stimulate the female" by increasing fertility and promoting ovulation. In the past, testosterone was even used safely to treat nausea in early pregnancy.

While some side effects do sometimes occur, Glaser and Dimitracakis write, "true virilization is not possible at normal doses." Even so, the benefits are often so great that some women typically choose to Treat side effects rather than lower the dose.

The authors also acknowledge that pharmacological and suprapharmacological doses of testosterone are commonly used in female patients who wish to become male and that it may result in increased facial hair growth, general hirsutism, and mild clitoral enlargement, but these effects are It is largely reversible, as long as the dose is lowered. However, an enlarged clitoris is not a medical problem per se, but a cosmetic one.

Myth 2: The only reason women need testosterone is to increase libido

Indeed, women often experience a once-depressed libido after testosterone replacement therapy, but women have androgen receptors everywhere, not just in their brains and genitals. These androgen receptors are found widely in the heart, breast, blood vessels, lungs, spinal cord, bladder, peripheral nerves, bone, bone marrow, synovium, adipose tissue, muscle, and of course uterine, ovarian, and vaginal tissues.

Like men, women's testosterone levels begin to decline with age, which can lead to anxiety, irritability, depression, physical fatigue, bone loss, muscle loss, insomnia, cognitive changes, memory loss, Breast pain, urinary tract discomfort and, of course, sexual dysfunction or apathy. Testosterone plays an important role in women's health, and not just in bed.

Myth 3: Testosterone causes heart disease in women

This is a classic example of the "cause and effect fallacy" - men have more testosterone than women, so men are more prone to heart disease than women. If testosterone is associated with heart attacks in men, it is more likely to be associated with low testosterone levels, as this condition is associated with an increased risk of disease and mortality from all causes.

Contrary to popular belief, there is overwhelming evidence that testosterone is cardioprotective, helping men and women improve glucose metabolism and lipid profile (two factors that play a role in heart disease).

Testosterone also dilates blood vessels, making it easier for blood to rush through any plaque or partial blockage. It also has immunomodulatory effects that can inhibit the formation of these same blockages. Clinical studies have shown that testosterone improves functional capacity, insulin resistance, and muscle strength in men and women with congestive heart failure.

Of course, a certain amount of testosterone aromatizes (chemically converts) into estrogen, and this excess estrogen can cause adverse side effects in heart patients as well as in healthy people. These side effects include swelling, anxiety, and weight gain.

In addition, other drugs commonly used to treat heart disease increase aromatization, which indirectly contributes to the side effects of testosterone therapy. The message you can have, though, is that testosterone is largely heart-protective, and normal or adequate levels can reduce the risk of cardiovascular disease.

Myth 4: Testosterone damages women's livers

Testosterone doesn't cause liver damage, but it's easy to guess where that belief comes from. Bodybuilders and some strength professionals routinely take staggering doses of oral synthetic testosterone, which is processed by the liver and can cause liver damage in the long run.

Testosterone itself is not taken orally, though, and is either injected, implanted, or absorbed through the skin as a cream. Each of these methods allows testosterone to bypass the liver, keeping the organ from "fighting".

Myth 5: Testosterone makes women lose their hair

Hair loss is a complex, multifactorial, genetically determined process that is poorly understood. However, there is little or no evidence that testosterone or testosterone replacement therapy is a cause of hair loss in women. Women with PCOS with insulin resistance indeed have higher testosterone and hair loss, but again this does not prove cause and effect.

Also, hair loss is common in women and men who are insulin resistant. What happens is that insulin resistance (and obesity) increases levels of 5-alpha-reductase, which can cause some testosterone to be "reduced" to dihydrotestosterone, or DHT, the androgen associated with baldness.

However, this is not the case for healthy women, many of whom (about a third) begin to lose their hair as they age, which coincides with declining testosterone levels. It is worth noting that, contrary to what most people believe, including doctors, two-thirds of women who undergo testosterone therapy begin to experience hair regrowth.

Many people who don't are more likely to experience some related medical problems, such as hypoparathyroidism or hyperparathyroidism, iron deficiency, or obesity. As evidence of the innocence of testosterone therapy in causing hair loss in women, none of the 285 patients treated with testosterone therapy for up to 56 months complained of hair loss.

Myth 6: Testosterone makes women irritable

Men with aggressive behavior tend to attribute it to a "testosterone attack" or a "steroid rage" rather than their inherent emotional instability, but this type of thing is either rare or not at all with TRT None, especially in women because the doses are simply too small. Furthermore, there is significant evidence "across multiple species" that estrogen, rather than testosterone, plays an important role in aggression.

Of course, some testosterone does aromatize (enzymatically converts to estrogen) in both women and men, but again, the amount of estrogen produced by traditional doses of testosterone replacement therapy does not cause Hulk-like tantrums in women. On the contrary, the study found that in 90 percent of women treated for testosterone deficiency, subcutaneous implants of testosterone granules reduced aggression, restlessness, or anxiety.

Myth 7: Testosterone May Raise Breast Cancer Risk

Breast cancer has long been known to be estrogen-sensitive cancer, but clinical trials have found that testosterone has beneficial effects on breast tissue because it reduces breast cancer cell proliferation and prevents breast cancer cell stimulation.

It seems that the ratio of testosterone to estrogen, or the balance of these two hormones, gives testosterone some role in breast protection. Additionally, once you activate the androgen receptor, it "exercises pro-apoptotic (leading to cancer cell death), anti-estrogenic, growth-inhibitory effects in both normal and cancerous breast tissue."

However, some testosterone can aromatize into estrogen, which has the potential to disrupt the hormonal environment in the body if not monitored. Regardless, testosterone still appears to reduce the risk of breast cancer in women who have been treated with estrogen.

Myth 8: Testosterone replacement therapy for women is novel and its safety is unknown

Testosterone therapy has been offered to women in the UK and Australia for almost 70 years. Testosterone implants have been used safely in women since 1938. There are long-term data on the safety and tolerability of testosterone in women at doses up to 225 mg, which is a very high dose for women.

In summary, aromatase activity (which converts testosterone to estrogen) increases with age, obesity, alcohol intake, breast cancer, insulin resistance, medications, recreational drugs, sedentary lifestyle, and unrestricted increased intake of processed foods.

Combine this fact with the possibility of producing more estrogen through testosterone replacement, and the risk of hormonal imbalance increases. This makes it imperative for physicians to monitor aromatase levels in women undergoing testosterone therapy to maintain the ratio of testosterone to estrogen within a safe range and to ensure the health of the patient.

The mechanism of Cistanche boosts the testosterone effect

Cistanche has been found to boost testosterone levels in a number of ways. Firstly, it contains compounds known as echinacoside and acteoside, which have been shown to enhance the production of luteinizing hormone (LH) in the pituitary gland. LH stimulates the Leydig cells in the testes to produce testosterone. Cistanche also contains polysaccharides and phenylethanoid glycosides, which have been shown to have antioxidant and anti-inflammatory properties. This can help reduce oxidative stress and inflammation in the testes, which can impair testosterone production Additionally, Cistanche has been found to increase the expression of genes involved in testosterone synthesis and reduce the activity of enzymes that break down testosterone, such as 5-alpha-reductase. Overall, the combination of these mechanisms is thought to contribute to Cistanche's testosterone-boosting effects.

Reference:

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2. Margaret Le, David Flores, Danica May, Eric Gourley, and Ajay Nangia, Current Practices of Measuring and Reference Range Reporting of Free and Total Testosterone in the United States, The Journal of Urology, Vol. 195, 1-6, May 2016.

3.Eric Bachman, et al. Testosterone Induces Erythrocytosis via Increased Erythropoietin and Suppressed Hepcidin: Evidence for a New Erythropoietin/Hemoglobin Set Point, J Gerentol A Biol Sci Med Sci, 2014 Jun;69(6): 725-735.

4. Edward Choi, et al. Comparison of Outcomes for Hypogonadal Men Treated with Intramuscular Testosterone Cypionate versus Subcutaneous Testosterone Enanthate, SIU Academy, 2022. 309864; BSP-06.01 Topic: Treatment.

5.J.C. Hanneke, et al. Erythrocytosis in the general population: clinical characteristics and association with clonal hematopoiesis, Blood Advances, (2020) 4 (24): 6353-6363.

6.Angela Yee Moon Wang, et al. Effects of losartan or enalapril on hemoglobin, circulating erythropoietin, and insulin-like growth factor-1 in patients with and without posttransplant erythrocytosis, AJKD, Volume 39, Issue 3, March 01, 2002.

7. Jemma Hudson, et al, Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis, The Lancet, Vol 3 June 2022.

8. Rebecca Glaser and Constantine Dimitrakakis, Testosterone Therapy in Women: Myths and Misconceptions, Maturitas, 74, 2013, 230-234