Estrogen (with or without progesterone) is the recognised standard treatment for symptoms of perimenopause and menopause. These symptoms can affect multiple organ systems in the body: vasomotor, genitourinary, emotional, cognitive, musculoskeletal, metabolic, and cardiovascular.

Although the clinical benefits of testosterone treatment have been accepted and recognised for many decades, there is still confusion about this important hormone with many clinicians and women. Testosterone is actually the most biologically active hormone in women and women have higher levels of testosterone than estradiol when they are younger. Testosterone levels decline with age and this loss often leads to symptoms occurring, including low mood, anxiety, reduced energy, poor motivation, brain fog, muscle and joint pains, headaches, urinary symptoms and reduced libido.

While testosterone treatment for women is currently approved in guidelines for women with reduced libido, many studies have shown it is effective for treating symptoms including musculoskeletal health, mood, cognition, and general wellbeing.

A new study just published in the Journal of Sexual Medicine has found that adding testosterone to existing HRT regimens led to significant improvements in symptoms that affect the whole body.

This study, undertaken by the Newson Research team with Prof Mo Khera’s team from the Baylor Institute in US, evaluated subjective symptoms score changes in women attending Newson Clinic who completed the Symptom Questionnaire before and after starting testosterone.

The women had all been on hormone treatments – transdermal estradiol (either with or without progesterone) – for at least three months. Before they started testosterone replacement, the 279 women (average age of 56) reported their symptoms and severity.

The most common symptoms were:

• 92.9% reported fatigue, making it the most common symptom

• 89.6% reported decreased libido

• 88.9% reported memory impairment

• 86.4% reported concentration issues

• 82.1% reported irritability

The most severe symptoms were:

• 63.4% had loss of libido which affected them considerably

• 47.7% experienced fatigue

• 38% had memory issues

• 33% had musculoskeletal pain

The women were then treated with transdermal testosterone (as a cream or gel) and made no changes to their existing HRT dose or type. After three months, they again completed the Symptom Questionnaire.

The study found that 15 out of the 24 symptoms showed significant improvement. There were notable reductions in symptom frequency as well as severity. Importantly, these improvements were seen across the body:

• 59% of patients reported an improvement in vaginal dryness

• 54.9% reported an improvement in hot flushes

• 54.8% reported an improvement libido

• 53.9% reported an improvement in dizziness

• 49.6% reported an improvement in tearfulness

• 44.8% reported an improvement in musculoskeletal pain

• 44.4% reported an improvement in tension headaches

This study has found that adding testosterone to standard hormone treatments (estrogen and progesterone) improves many symptoms.

You can read the full paper, Improvement in multiple organ systems following testosterone replacement therapy in women previously on standard hormone replacement therapy, here.

‍