ORLANDO – While testosterone traditionally has been tested in men, the hormone “plays an important role in women” as it relates not only to libido, but energy level and cognitive abilities. And researchers are learning more about just how it affects women’s overall health.
So said Nisha Jackson, PhD, who in her role as a nurse practitioner works with women suffering from what she termed “hormone imbalances.” She is the author of two books on the subject.
Jackson was speaking at the recent joint American Association for Clinical Chemistry (AACC; Washington)/ International Federation of Clinical Chemistry (Milan, Italy) meeting and clinical lab expo here.
“Many patients sort of come to us at the end of their rope,” Jackson told a full house. They come with symptoms such as hair loss, acne, low sex drive and fatigue. Jackson said that by the time a woman turns 40, her testosterone levels have dropped by half. And the typical woman’s estrogen levels drop between 30% and 50% before she even gets to menopause.
Even more significant drops in testosterone occur when women are under a good deal of stress, Jackson said.
Then there’s perimenopause, which is when a woman begins to experience the first symptoms of menopause, which can occur in a woman’s 30s.
With today’s extended life spans, most women will spend one-third of their lives post-menopausal, and Jack-son said that beyond the arrival of menopause, its symptoms may continue for years.
Thus, while Menopause, the Musical might be a big hit on stage, the reality is significantly the reverse.
In menopause, a woman’s ovaries continue to produce small amounts of testosterone, but not in the levels necessary to maintain the desired level of health. Even with women who undergo hysterectomies, few of them have discussions with their doctors about the drop in testosterone, Jackson said.
“Everything really starts in the hypothalamus,” she said.
Sex Hormone Binding Globulin (SHBG) is the carrier protein for estrogen. Measurement of SHBG thus provides opportunities for testing for estrogen and testosterone. Additionally, Jackson said that in her practice with women with hormone imbalances, a “very detailed history” from each patient is taken, including a 150-symptom list.
“We have people who say, ‘Why test women’s hormones, because they’re changing all the time?’”
But she maintains it is important because in addition to quality of life factors, such as sex drive or complaints about fatigue and oily skin, it is thought that hormones play a role in diseases such as polycystic ovary syndrome, cardiovascular disease and even breast cancer.
“I really believe that women’s hormones should be in balance,” Jackson said, with the best time for testing in the morning hours.
Aging is the most significant culprit for declining testosterone levels, but other conditions can alter testosterone production, she said, including ovarian failure and adrenal insufficiency.
There are a variety of hormone replacement therapies, and Jackson said she likes to use plant-based hormone replacements. And she acknowledged that this sometimes causes concern for women, since they read the media reports from studies suggesting that hormone replacement therapy can cause adverse events.
Although she admitted that it “makes the hair stand up on most people’s heads,” Jackson said, “I believe women should take hormones until their last breath,” adding that she didn’t know when there is a time in life when women didn’t want to feel well.