Testosterone and DHEA

Testosterone is just as important for women, as it is for men

Mister T

Testosterone, The Universal Hormone

Although testosterone is called the “male sex hormone” and is at a much higher level in men, it is important to both genders. Everyone needs it, to support muscle, bones, the heart, the personality and the libido. In youth, it is mainly made in the testicles (or ovaries), but all our cells can convert DHEA into testosterone for themselves, by a process which Professor Fernand Labrie  (1) termed “intracrinology”, back in the ‘80s .

Testosterone isn’t simply the main hormone responsible for maintenance and repair of our muscle, bone, skin, sweat glands, hair: it also minimises our anxieties, shields us from depression, supports the libido in both male and female and maintains our self-confidence, encouraging a positive outlook.

Maximum testosterone production, beginning at puberty, is approximately 10 times greater in men, than women. The superhigh testosterone is responsible for the male sex chacteristics – beard and body hair, deepening of the voice by enlargement of the larynx, greater muscle mass, stronger, heavier bones, development of the prostate and the penis and heightened self-confidence (?-Overconfidence?).
In the female, testosterone production is insufficient to stimulate male pattern hair growth, hypertrophy of the larynx and other male characteristics; but it is important nevertheless: it supports self-confidence, self-assurance, cognition and libido, as it does in the male.

Male Testosterone levels

Much of our testosterone supply is produced in peripheral cells, by modification of the DHEA molecule. Therefore, not surprisingly, there is a gradual fall in Testosterone production, paralleling the 1% per year reduction in the DHEA supply, starting at age 26 in both sexes.

In women, the normal serum testosterone at age 20–25 is only 20-30 picomoles per litre, so a 1% loss is easily demonstrated. However the 1%/year downward trend in Testosterone is hard to “see” in men, because their blood level spans a wide range (60–900 pmol/litre) and because the male’s Testosterone level varies, both with the time of day (highest at 8AM) and with physical and sexual activity. *
Here, there is a difference between men and women, because the testicles don’t lose function completely at “andropause”, as the ovaries do at menopause; but by age 80, men’s testosterone production is 10-20% of what it was at 25.

* In the male, the testoterone level often doesn’t match with symptoms: while some men with mid-normal “T” levels present to the MD with Low-T problems, even in their 20s, but many older men with “low T” are fit, sexually active and cognitively sharp,

Female Testosterone levels

Women’s ovaries also produce testosterone in youth, but at menopause they shut down completely. The peripheral cells continue “intracrine” testosterone production, but the amount made depends on the DHEA supply, which varies widely from person to person. A relatively small percentage of women approach the 30 pmol/litre “normal” upper limit of serum testosterone in the third decade, a surprising number of young women suffer from extremely low testosterone levels and in post-menopausal women, serum Testosterone tends towards zero.

In contrast to the male’s experience, reduced testosterone level in the female tends to be symptomatic, since it is always associated with DHEA deficiency and often, with intracellular hypothyroidism (IH). The “low testosterone syndrome” (my terminology) in women usually begins at age 26 – 30, but may be symptomatic by age 20.
It often presents in combination with a mixture of low testosterone and hypothyroid symptoms and signs: hair loss, brittle fingernails, dry skin, vaginal dryness, reduced self-confidence, low libido, “fuzzy thinking”, weight gain, poor glucose and cholesterol management, etc..

The syndrome, often seen in 20-to-30-year-old women, usually responds quickly and well, to oral supplementation of DHEA: if it does not, thyroid tests should be done, including TSH, FT4, FT3 and T3, so as to diagnose or exclude IH, which is easily and safely treated with slow-release triiodothyronine.

Childhood Stress and “The Troubled Teen”

A frank episode of PTSD, chronic neglect, abuse or a subjective perception of inequity and unfairness in the family dynamic, is sufficient to stress a child to the point where he or she begins to overproduce the stress hormone, cortisol.

The hypercortisolism, usually unrecognised, is associated with reduced DHEA and intracellular hypothyroidism and may persist into and throughout the teenage years. The reduced availability of serum T3, due to IH, results in dysregulation of brown fat function, leading to inefficient calorie, glucose and cholesterol management. The “picture” is one of obesity, pre-diabetes, hypercholesterolemia and possibly, other metabolic problems, as a result of which some individuals begin the 3rd decade “behind the 8 ball”.