How important is testosterone to our overall health?
Because of the association with male health, you might have encountered scaremongering or misinformation about the role of testosterone in women’s health and perhaps been told that supplementing low levels can lead to the development of ‘male characteristics’, such as increased muscle mass, hair growth and a deeper voice.
Testosterone is produced in our ovaries and adrenal glands, and although the levels in women are much lower than in men, it has an equally essential role in our bodies and brain health. Testosterone plays a part in several critical functions, including maintaining muscle mass, bone density, and libido. It also supports cognitive function, mood and energy levels, which are vital for our daily life.
As we age and enter perimenopause and menopause, our hormone levels, including testosterone, naturally decrease. This decline is often linked to symptoms such as reduced energy, low mood, decreased libido, and cognitive difficulties, commonly referred to as ‘brain fog’, which many women going through perimenopause will be all too familiar with.
The role of testosterone in our brain
However, the impact of low testosterone goes beyond this, as this hormone has a profound influence on our brain’s structure and function as women. It is known to support the growth and survival of neurons (nerve cells) and helps regulate neurotransmitters, the chemicals that transmit signals in our brain. These neurotransmitters, including dopamine and serotonin, play a vital role in regulating mood, focus, and motivation.
When testosterone levels drop, as they do around menopause, we may experience changes in cognitive function. Brain fog is one of the most commonly reported symptoms, characterised by difficulties in concentration, memory lapses, and a general sense of mental cloudiness. While not every woman will experience this symptom of menopause, it can be incredibly frustrating and affect both confidence and productivity at work and at home.
Fascinatingly, the decline in testosterone is also linked to changes in brain structure. Research suggests that lower levels of testosterone are associated with a reduction in grey matter, the part of the brain involved in processing information and decision-making. This reduction may contribute to the cognitive decline that some of us experience as we age.
How does low testosterone impact our brain health during menopause?
So what does this mean for women as we enter menopause and levels of testosterone decline? It’s important to say that research into the role of testosterone and women’s brain health during and beyond menopause is still limited.
What research does currently indicate is that as we age, the risk of developing neurodegenerative conditions like dementia increases and the relationship between hormones and dementia is complex. Emerging evidence suggests that testosterone may play a protective role in brain health by reducing inflammation and oxidative stress, which are contributing factors to dementia.
Women with higher testosterone levels have been found to have a lower risk of Alzheimer’s disease, while those with significant drops in testosterone (particularly those carrying the APOE-ε4 gene) may be at higher risk. However, low testosterone levels also significantly affect our mental health, contributing to mood swings, depression, anxiety, and fatigue.
Testosterone also influences serotonin activity, and its deficiency can lead to decreased motivation and a cycle of low mood and energy, exacerbating mental health challenges during menopause. Finding the right balance of testosterone is crucial, as both low and abnormally high levels can have negative effects on our mental and cognitive health.
Signs and symptoms of low testosterone in menopause
How do you know if you have low testosterone, or your levels are declining during perimenopause? Spotting early signs of declining levels can help you to seek support. Symptoms to look out for include:
If you are experiencing any of the symptoms above, or suspect that low testosterone may be affecting your brain health or mental well-being, it’s essential to seek advice from your GP. A diagnosis can be made based on your symptoms. Blood tests aren’t necessary but they can helpful in looking at your current hormonal status overall.
How is low testosterone treated in women during menopause?
It’s important to know that the NHS does not currently license testosterone products for female use. However, you can request a prescription for testosterone ‘off-license’ and use a lower dose than prescribed for men. It’s important to follow the instructions you are given by your doctor or dispensing pharmacist and administer testosterone carefully.
In the UK, there are two options for testosterone hormone treatment, both in gel form. These are:
- Tostran® 2% is a gel in a pump dispenser. 1 pump has 10 milligrams (mg) of testosterone. You normally use this gel 3 times a week.
- Testogel® is a gel in a sachet. You normally use 1 sachet over 1 week. You use a small part of the sachet 1 time each day.
Other considerations
Lifestyle changes can also help to support hormone imbalance. Taking regular exercise, eating a healthy diet rich in omega-3 fatty acids, supplementing with Vitamin D as recommended by the NHS during winter months and getting decent sleep can all help maintain healthy testosterone levels and support cognitive function. Adding mindfulness techniques or yoga into your daily routine can help to ease chronic stress which can negatively impact hormone levels.
HRT is also beneficial for many women during perimenopause and into post-menopause, and typically involves a combination of oestrogen and progesterone. These hormones also play essential roles in brain health, and their replacement during menopause can help alleviate some of the cognitive and mood symptoms associated with hormonal changes. Always discuss appropriate treatment for your symptoms with your GP.
Final word from Dr Clara
“Research into hormonal changes and brain health is moving at pace, and hopefully this will soon translate into better understanding and more treatment options for women.
It’s a complex area, no ‘one-size-fits-all’, but it’s important to pay attention to your symptoms and look at the whole picture, including considering your hormone health.”
