Testosterone And Mental Health For Women

As a Nurse Practitioner focusing on hormone replacement and advanced endocrinology in women's health, I have recognized an overarching theme: most women feel some level of lost sense of self at some point in their lives, most notably during periods of profound hormone changes.

I frequently have a new patient in my clinic who exhibits one of two predominant responses to our clinical assessment of her anxious, depressive or otherwise altered mood state: she may sigh or cry with relief that there is hope for what she has been going through, that she is not going crazy, that she is “normal”; or she may rage in disbelief and wonder why no one has ever told her this before.

“This” being the profound affect hormone fluctuations and subsequent decline can have on an otherwise happy, healthy productive life. She may go on to feel the same relief, or rage, that there is hope beyond more prescription drugs for her depression, anxiety and insomnia; that there is possibly a “root cause” and real solution for restoring her prior level of functioning.

The presence of depression and other mood disturbances in women is a widespread, worldwide phenomenon, crossing cultural and ethnic lines with a lifetime prevalence of up to 23% 1. Depression and anxiety are twice as likely to occur in women as in men; are a leading cause of dysfunction, decreased productivity and disability in women, and noted in several studies to be a key component of decreased quality of life and sense of well being.

Menopausal Transition: Consequences of Hormone decline

Menopause comes from the root words "pause in menses" and is defined as the 12- month period after the last menstrual cycle (one year without a menstrual cycle); post menopause is defined as the time after menopause. The peri-menopausal period is the time of irregular menstrual patterns combined with elevated or fluctuating follicle stimulating hormone (FSH) levels preceding menopause, starting as young as the mid 30’s and lasting anywhere from 2-8 years. The terms pre-menopause, peri-menopause, menopause, and post-menopause are often erroneously interchanged or misused and create further confusion when dialoging about this stage of a woman's life.

Hormone decline during the third through fifth decades of life, referred to clinically as the menopausal transition, is central to decreased health and quality of life. An often misdiagnosed and mismanaged sequela during this time is depression, anxiety and altered mood states resulting from hormone decline and exacerbated by symptomatology of hormone decline; specifically androgen decline and deficiency.

The far reaching impact of restoring androgen homeostasis on quality of life is also an often misunderstood phenomenon in both the healthcare and lay communities.

The peri-menopausal and post-menopausal stages of a woman’s life is most devastating regarding symptoms and the impact of symptoms on overall functioning and quality of life. Further, as many healthcare providers are unaware of the connection, hormone fluctuations are often overlooked as a cause of their female patients nonspecific symptoms of mood alterations, fatigue and sleeplessness; she is often diagnosed as “too stressed” and either clinically ignored and told to rest and exercise, or given a prescription for an antidepressant, sleeping pill or anxiety pill to band-aide her symptoms. An astute provider may suggest a trial of estrogen hormone, but often this only accomplishes partial relief of symptoms, and only if she is clinically deficient in estrogen.

It’s Not Just Estrogen: The Role of Testosterone in the Menopause Transition

Historically it has been postulated estrogen is a woman’s key hormone, and estrogen decline has been the primary area of focus for researching women experiencing the menopausal transition; however, emerging data supports the greater role androgens, primarily testosterone, play in neuropsychology.

Androgen receptors are found on virtually every cell in the female human body, indicating the role they play in normal tissue homeostasis. When testosterone is deficient, the risk of pathologies including breast cancer, osteoporosis and cognitive decline may increase.

Androgen deficiency results in several variables that have an impact on health related quality of life, and a woman’s response to symptoms can have deleterious effects ranging from physiological, psychological, biosocial and behavioral outcomes.

Some of these symptoms may include, but are not limited to, sleep deprivation, mood swings, depression, anxiety, brain fog, difficulty focusing, and memory loss; night sweats, weight gain, low libido, and extreme fatigue.

Of these, sleep deprivation has the most significant compounding effect and exacerbates the depression, anxiety, moodiness and impaired cognitive function a woman may be experiencing.

Androgen replacement has been shown in women improve mood, lift anxiety and depression, and improve sleep patterns. Along with improving overall sense of well-being and quality of life, the sex hormones have been shown to prevent osteoporosis, increase muscle mass, increase muscle strength, increase bone density, reduce visceral fat, reduce total cholesterol levels, induce glucose homeostasis, increase metabolism, manage PMS, reduce severity and frequency of migraine headaches, improve cognition and memory, and prevent Alzheimer’s disease.

When dosed and monitored appropriately, androgen therapy is highly effective in relieving depression, anxiety, mood swings and insomnia, which in turn may improve over-all sense of well-being and quality of life in women.

If you have been experiencing any of these symptoms, it may be due to hormonal imbalances. Call to schedule a consultation, where we can discuss your symptoms, test your hormone levels and put together a plan to help you start feeling like yourself again!

Mandi