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Benfits of Tesosterone in Female HRT
By: Road2HardCoreIron Date: September 19, 2023, 6:11 am
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The Benefits of Testosterone in Female HRT
Those who have read my previous work will be aware that my work
predominantly focuses on the male aspect of the topic. However,
while The Men’s Health Clinic may appear targeted to solely men,
there are also pressing issues we need to address in the world
of Hormone Replacement Therapy (HRT) for women, too. Female HRT
is more well known among the general population than TRT, but
the in’s and outs of what constitutes a proper HRT protocol is
still left to the gp. This article will explain a bit more about
HRT for women and the benefits of including Testosterone in
female HRT. This is an important read for any woman out there in
need of HRT, so please do share it to those it may be of
relevance to.
Female HRT is typically used to relieve symptoms of menopause,
effectively replacing low-concentration hormones which typically
occur with the approach of menopause. It’s history started in
the 1960s and it gained significant popularity in the 1990s,
declining in popularity after initial clinical trials suggesting
more detrimental effects versus beneficial [1]. This led to
early media reports creating panic among users and new guidance
for prescribing doctors. In later years, the reanalysis of
previous trials was performed; new studies demonstrated that HRT
use in younger women or early postmenopausal women actually had
beneficial effects on the cardiovascular system, reducing
coronary disease, and all-cause mortality [1]. Don’t discredit
it; it certainly has its place in medicine to ensure a healthy
state and improved quality of life for women in need of it. The
users of HRT will typically focus on pre-menopausal purposes,
though other conditions can warrant its needs. That can include
polycystic ovary syndrome, hypogonadism, metabolic syndrome and
more.
Typically, HRT will include some kind of Oestrogen and often
progesterone (combined-HRT). Oestrogen only is sometimes used if
the womb has been removed during a hysterectomy [2]. While
Oestrogen certainly is a primary sex-steroid hormone produced by
the ovaries, it isn’t all a woman typically produces that is
vital for good health.
A Look at the Hypothalamic Pituitary Ovarian Axis
Abbreviated as HPOA. The HPOA is the system responsible for a
woman’s cycle. It’s also responsible for bone maintenance,
muscle growth, strength development, cardiac health, libido,
mental wellbeing, regulating metabolism, the reproductive cycle,
secondary sex characteristic maintenance and much more. A
diagram is shown below of the HPOA [3].
(click for full-size image)
The HPOA controls the reproductive cycle. The average adult
reproductive cycle lasts 28 days, ranging from 23 to 35 days,
and has distinct phases [4], [5]:
Menstruation, which is when the elimination of the thickened
lining of the uterus occurs. Oestrogen and Progesterone are at
their lowest. So is Testosterone.
The follicular phase, which starts with the onset of menses,
ending with the day of the Lutenising hormone (LH) surge. It is
brought about by the release of FSH by the pituitary gland,
which stimulates the ovary to produce 5-20 follicles that bead
on the surface and house an immature egg (often, only one
follicle will mature into an egg); the growth of the follicles
stimulates the lining of the uterus to thicken. Oestradiol
increases during this phase, as does Testosterone and
progesterone.
Ovulation, which causes the release of a mature egg from the
surface of the ovary often around 2 weeks or so prior to
menstruation starting and within the first 30-36 hours of the LH
Surge. Oestrogen peaks just beforehand and then will drop
shortly afterwards. The same is true of Testosterone.
The Luteal phase starts on the day of the LH surge and ends with
the onset of menses. The uterus gets thicker to prepare for
possible pregnancy. Progesterone is produced, peaks, and then
drops.
The secretory phase occurs next where the uterine lining
produces chemicals that will either help support the egg
implanting to the uterus lining if fertilized, or prepare to
break down the lining and shed if not.
Women involved in sports may attest that the early follicular
phase (~10 days from the start of menstruation) can reduce
exercise performance as hormones will have been low from the
menstruation phase and are only starting to recover [6]. It’s
important to note that Testosterone is predominantly produced
within the zona fasciculata of the adrenal cortex (in the
kidneys) and ovarian stromal and thecal cells which accounts to
50% of total Testosterone secretion in women; the remainder is
produced in peripheral tissues like bone, breast, muscle, and
fat [7].
Males have the HPTA, where T stands for Testes. The primary
difference in terms of hormone output is concentration;
respectively, women make significantly more Oestrogen than males
and males more Testosterone than females. Yet both sexes need
both hormones for good health. Drop Oestrogen in men too low and
they’re in for some nasty side effects like bone mineral loss,
anxiety, and worsened cardiac health.
The Importance of Testosterone in Women
While women make less Testosterone than men, Testosterone is an
important component of female sexuality, where it enhances
interest in initiating sexual activity and the response to
sexual stimulation. That is, it’ll make your sex life a whole
load better, ladies. Testosterone is also associated with much
greater well-being and reduced anxiety and depression in women
[8]. It also helps improve cardiovascular health in younger
women (although, we aren’t so sure in older post-menopausal
women) [9]. It is an essential hormone for women, much like
Oestrogen is essential for men, but must be maintained at the
correct concentration; lower for women, just like Oestrogen will
be lower for men versus women.
You’ll note I say ‘correct concentration’, because you can have
too little and too much. Too much and we could increase the risk
of thrombotic events [7]. Too little and we increase the risk of
anxiety, depression, reduced muscle strength, libido, increased
risk of metabolic syndrome and type-2 diabetes mellitus, and
worsened cognition.
HRT often fails to provide Testosterone to women because there
just weren’t enough studies around its safety. A significant
concern in the HRT world for women is the risk of cardiac events
and there is a long held belief that Testosterone increases said
risk. Sure it does, in high doses. Or when Sex-hormone binding
globulin (SHBG) is too low. It’s very important for the level of
Total and free Testosterone and SHBG to be examined. A previous
article I wrote on SHBG details why. While it may seem targeted
to men, the same physiological principle of high versus low SHBG
still applies.
Put simply, Testosterone is vital for your well-being as a
woman. Not just Oestrogen and Progesterone. DHEA is also
important, another steroid hormone which has a whole host of
important effects in the body.
The overall goal of any HRT should be balance, a yin and yang of
hormones. That is, having the correct balance of hormone
concentrations for all sex-steroid hormones for you – whatever
optimal for you is. You work this out with your Doctor based on
blood tests, body composition, health assessments, and symptom
reports. If you need Testosterone because your levels are too
low and you’re symptomatic, then you should be prescribed it,
but within reason. Your Doctor must work with you to ensure you
have adequate free Testosterone levels, appropriate SHBG levels,
enough DHEA, in addition to Oestrogen and Progesterone. This
ensures you feel your absolute best and are in the best health
condition possible. HRT shouldn’t take any other shortcut.
Conclusions
The Men’s Health Clinic initially focused on just men’s health.
But, it’s now focusing on women too as they have been inundated
with requests from current TRT patients to apply the same
methodology in women. No other clinic in the UK currently
microdoses to our knowledge, nor takes such a holistic approach
towards your health to ensure that you get the best bang for
your buck and above all, the best health outcomes. Testosterone
is essential for women, just like Oestrogen is for men. It’s
essential to ensure correct hormonal balance and resultantly a
better quality of life and health status. It’s just all about
ensuring you have enough for you, based on your body, your age,
your response, and your genetics. The Men’s Health Clinic
ensures that the protocol is personalised for you. Hence the
inclusion of Testosterone in TMHC’s HRT protocol for women.
Remember ladies, you need a little bit of Testosterone for the
three H’s: happy, healthy, and horny. Don’t skip Testosterone,
work with your Doctor to include it.
Further information on our Female HRT programme can be found
here.
References
[1] A. Cagnacci and M. Venier, “The Controversial History of
Hormone Replacement Therapy,” Medicina (Mex.), vol. 55, no. 9,
p. 602, Sep. 2019, doi: 10.3390/medicina55090602.
[2] “Hormone replacement therapy (HRT) – Types,” nhs.uk, Oct.
23, 2017.
HTML https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/types/<br
/>(accessed Feb. 20, 2022).
[3] “Hypothalamic-Pituitary-Ovarian Axis,” BrainKart.
HTML http://www.brainkart.com/article/Hypothalamic-Pituitary-Ovarian-Axis_25823/<br
/>(accessed Feb. 20, 2022).
[4] “Menstrual cycle – Better Health Channel.”
HTML https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstrual-cycle<br
/>(accessed Feb. 20, 2022).
[5] “The menstrual cycle, explained.”
HTML https://helloclue.com/articles/cycle-a-z/the-menstrual-cycle-more-than-just-the-period<br
/>(accessed Feb. 20, 2022).
[6] K. L. McNulty et al., “The Effects of Menstrual Cycle Phase
on Exercise Performance in Eumenorrheic Women: A Systematic
Review and Meta-Analysis,” Sports Med. Auckl. NZ, vol. 50, no.
10, pp. 1813–1827, Oct. 2020, doi: 10.1007/s40279-020-01319-3.
[7] V. Tyagi, M. Scordo, R. S. Yoon, F. A. Liporace, and L. W.
Greene, “Revisiting the role of testosterone: Are we missing
something?,” Rev. Urol., vol. 19, no. 1, pp. 16–24, 2017, doi:
10.3909/riu0716.
[8] S. Davis, “Testosterone deficiency in women,” J. Reprod.
Med., vol. 46, no. 3 Suppl, pp. 291–296, Mar. 2001.
[9] S. R. Davis and S. Wahlin-Jacobsen, “Testosterone in
women–the clinical significance,” Lancet Diabetes Endocrinol.,
vol. 3, no. 12, pp. 980–992, Dec. 2015, doi:
10.1016/S2213-8587(15)00284-3.
By Joseph Hearnshaw BSc (Hons) DPS, MSc, FRSA, MRSB, MBCS,
MInstLM February 28, 2022
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