Testosterone Deficiency in Perimenopausal Women

Female cyclist drinking water to demonstrate testosterone deficiency in women

Many women are unaware of the important role that testosterone plays in their sexual, physical and mental health and wellbeing.

Testosterone is usually referred to as “the male sex hormone”. However, it is vital for female health and wellbeing, particularly during the perimenopause and after.

Testosterone’s main function is to provide a sense of vitality and sexual drive. It’s also responsible for feelings of confidence and assertiveness, physical strength, stamina and bone density.

Women produce about one tenth the amount of testosterone produced by men in the ovaries and the adrenal glands. Women’s testosterone levels peak in their early twenties and by the time they’re in their mid-forties levels have decreased by almost 50%.

However, not all women experience a testosterone level drop when they enter perimenopause; in fact some women actually experience an increase in their testosterone levels as oestrogen levels decline.

Other women may have normal testosterone levels but be experiencing low libido due to an oestrogen deficiency. It is also possible for women with low testosterone levels to have a normal sex drive.

Symptoms of Testosterone Deficiency in Perimenopausal Women

Symptoms of testosterone deficiency include:

Constant fatigue
Loss of interest in sex
Depression and anxiety
Difficulties with sexual arousal
Loss of joie de vivre
Weight gain around the belly and hips
Feeling insecure or timid
Poor muscle tone and muscle weakness
Lack of stamina
Hair loss
Difficulty coping with stress
Loss of confidence and assertiveness

Are you sure it’s Testosterone Deficiency and not Something Else?

The symptoms of testosterone deficiency in women are very similar to those of depression, hypothyroidism (underactive thyroid) and iron deficiency.

Lack of libido can also be due to oestrogen deficiency, so make sure your GP measures your oestrogen, progesterone and testosterone levels as well as your thyroid hormones and iron levels.

It’s vital that your health practitioner rules out the possibility of these conditions as you will only benefit from taking supplemental testosterone if you have a deficiency.

Causes of Testosterone Deficiency in Women

The older you are, the lower your testosterone levels are likely to be. Apart from hormonal declines during perimenopause, testosterone levels can also be affected by your diet, alcohol use, stress levels, smoking and your general state of health. Low testosterone levels may also be due to adrenal exhaustion caused by chronic stress.

Treatment for Testosterone Deficiency

Unfortunately, there is no licenced testosterone treatment for women. Only a few doctors recognise how important it is and are prepared to prescribe it off-licence.

Testosterone is normally administered in the form of a gel, such as Testim Testosterone Gel although some clinics do have access to implants which are inserted beneath the skin.

If you are concerned about your symptoms please speak to your GP about testing your hormone levels. If you are testosterone deficient and your GP does not feel comfortable prescribing testosterone, ask for a referral to a Gynae-Endocrine Consultant or a menopause clinic near you.

If you are worried about talking to your GP about this matter please read my article on How to Become an Empowered Patient.

Further Information:
I’ve written about my personal experience of testosterone treatment in a couple of blog posts.
HRT and Me: The Battle for Testosterone
HRT and Me: Using Testim Testosterone Gel as a Woman

Listen to the true story of my journey From Hormone Hell to Feeling Well. In it I tell of how my menopause symptoms were misdiagnosed, being treated for depression for years while my life fell apart, and how HRT and testosterone treatment restored me to health.

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4 Responses to Testosterone Deficiency in Perimenopausal Women

  1. Georgina Law July 14, 2016 at 6:07 pm #

    Angie ,where can i get testim gel if my gp in uk wont prescribe it ,,,can i take testosterone without oestrogen as three years ago i had an early breast cancer ,,,i am 60 now and feel so exausted foggy brain no libido etc ,,,,do i have to buy it from internet sites abroad ?

    • Angie Macdonald July 15, 2016 at 5:04 pm #

      Because of your age and history of breast cancer I think you’re going to struggle to find any NHS doctor willing to prescribe you any form of HRT. At this stage your best bet is probably finding a private gynaecologist who is willing to experiment if you are willing to take the risk or going to a medical herbalist and addressing the root cause of your exhaustion, foggy brain etc with herbs etc. Because of your breast cancer history it’s probably best to take testosterone without oestrogen, but there are very few studies that look at only testosterone use in women so nobody really knows how safe it is. The one study I did come across was actually by Professor Studd and in that study some of the women on testosterone only did develop breast cancer, but it was hard to tell if they already had the breast cancer before the trail commenced. I really don’t advise you self-administering testosterone as, unless you monitor yourself regularly with blood tests, you won’t know if the testosterone is being aromatased into oestrogen, which is what you don’t need. But if you want to go down the testosterone route then you could try an Australian site – Lawley Pharmaceuticals: https://www.hormone-skin-cream.net/lawley/ They make Androfeme cream which is a testosterone cream for women and is licensed for use in Western Australia. Perhaps other readers of the site could help if they have purchased Testim from the internet.

  2. Emma October 31, 2015 at 10:42 am #

    Hello, i am peri menopausal and have low testosterone. I’ve been prescribed hrt, however i just wanted to take testosterone – not because of a low sex drive, but because when i have sex i have no real sensation or climax. I’ve always suffered with my hormones, it’s been the bane of my life. I hate taking hrt but was told “no hrt, no testosterone”! So i’m stuck with black moods, no energy and fuzzy head until i can get it. Reading your articles i think i need to find out how easy it’s going to be to get prescriptions filled! I’m hoping the testosterone will give me the kick start i need and hopefully stop everything – i want to be back in control!!
    Thank you for sharing

    • Angie Macdonald October 31, 2015 at 1:18 pm #

      Hi Emma. From the symptoms you describe it sounds to me as if low testosterone levels are the cause. You will have to take testosterone in conjunction with oestrogen and progesterone (if you have a uterus) because it’s important that these three main sex hormones are in balance. Getting it prescribed will depend on your GP and whether or not they are prepared to prescribe testosterone for you ‘off-label’ because it is not licensed for use in women. If they aren’t, then your best bet is to ask to be referred to a menopause clinic at your local hospital, if there is one, or to ask for a referral to a Gynae-Endocrine Consultant. Consultants in menopause clinics are used to dealing with sexual problems experienced by perimenopausal women and are more likely to be willing to prescribe testosterone as it not such an unusual thing for them. Once a consultant has prescribed it and written to your GP, then it is a simple matter of getting the prescription from your GP and taking it to the pharmacy. I hope that helps.

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