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I am a New Zealand registered nurse and nutritionist (Grad Cert Sci: nutrition, Massey Univ). I am a Certified Zone Instructor, and have worked teaching Zone diet principles to hundreds of clients over the last 10 years. More recently after finding that eating Paleo food choices was the "icing on the cake" health wise, I have become a Paleo enthusiast and teacher. Follow me on twitter @juliannejtaylor

Are your menopause symptoms caused by low testosterone?

I’ve written previous posts on menopause, but this is a topic I do want to address as little has been written about it.

Back in 2013, I was struggling post menopause. I’d officially hit menopause (over a year since menstruation). I was studying post grad, advanced topics in micronutrients.

Here is what I noticed:

Memory problems: I’d keep forgetting where I put my car keys or my glasses. (That is definitely not me). I struggled to hold a lot of concepts and facts in my mind while writing an assignment. I couldn’t remember things I’d just studied. It was though my brain had sprung leaks and information that should be staying in just fell out. My brain felt fuzzy, unusual for me. (Image source)

State of mind, mood: I felt somewhat pathetic, my motivation decreased, I just lacked oomph.

Libido: Decreased

Strength: I was going to the gym and lifting weights but my strength seemed to be decreasing. I expected it to at least stay the same.

Weight gain: More specifically an increase in fat around my trunk, waist size was up 3- 4 cm and difficult to shift.

I happened across this Huff Post article, and immediately felt I’d found someone who was experiencing what I was – and they used supplemental testosterone which sorted it out. Is Low Testosterone Adding to Your Menopause Miseries?

I did a bit more research – this time on PubMed. In this study, the authors state “Testosterone plasma levels correlate to depression in a parabolic curve: at about 0.4-0.6 ng/ml plasma free T a minimum of depression is detected. Lower levels are related to depression, osteoporosis, declining libido, dyspareunia and an increase in total body fat mass.”

In another paper those women who had  surgical menopause “are among the populations most likely to experience T deficiency, a syndrome characterized by blunted or diminished motivation; persistent fatigue; decreased sense of personal well-being; sufficient plasma estrogen levels; and low circulating bioavailable T (either a low total T/sex hormone binding globulin (SHBG) ratio or free T in the lower one-third of the female reproductive range); and low libido. Exogenous estrogen, particularly when administered orally, increases SHBG, which, in turn, reduces free T and estradiol (E2).” (This suggests that supplementing with estrogen may make the free testosterone lower.)

When I had my levels tested – here is what they came back as:

11 Nov 2013, Testosterone
Testosterone:    < 0.4 nmol/L ( ideal: 0.5 – 2.6 ) LL
In other words too low to be measured.

I got a prescription for testosterone cream and started using it. That helped so much – I felt normal again in 3 weeks.

I continued using it for a year or so, and after that I tapered off, it seemed I just didn’t need it anymore, and I felt like my levels were too high. Sure enough they tested above ideal. My levels had come up. Recently they measured at 0.8 nmol/L (with no supplementation). Without testing I knew they were okay – my strength is increasing, my memory and everything else feels pretty much normal.

Memory loss in peri and early menopause is typical for many women, however this is temporary and memory improves again. Working memory in particular is affected, and this explains why things did not stay in my brain. Sadly my study at the time was affected, and I got my lowest mark ever for a post grad paper. I’m happy to report the memory loss was temporary Menopausal women ‘suffer from temporary loss of memory’, study finds. Once my working memory came back and I adjusted some of my study habits to accomodate the change in how my brain worked, I finished post grad with grades I was happy with.

It appears that the testosterone drop is temporary for some women. This graph is interesting – it shows DHEA levels dip and then increase again – DHEA converts to testosterone (reference The relationship of circulating dehydroepiandrosterone, testosterone, and estradiol to stages of the menopausal transition and ethnicity.) 

According to this article in the post menopause time testosterone can actually increase (no references given for this statement though). “Menopause (between ages 50 and 60). By the time women are experiencing the full-blown effects of menopause, hormones such as estrogen and testosterone have been significantly depleted. As the body produces less estrogen, testosterone production can sometimes increase.”

However in this study hair loss is associated with increased androgen to estrogen ratio.

Testosterone is not the only hormone that affects muscle strength; progesterone, but not estrodiol supplementation post menopause also increases muscle mass. ( Testosterone and Progesterone, But Not Estradiol, Stimulate Muscle Protein Synthesis in Postmenopausal Women)

Skeletal muscle protein fractional synthesis rate (FSR) in postmenopausal women during basal, postabsorptive conditions before and after no intervention (control) or treatment with T, estradiol, or progesterone (top) and the treatment-induced changes in FSR in each group (bottom). Data are mean ± SEM. *, Value significantly different from corresponding value before treatment (P < .05); †, value significantly different from corresponding value in the control group (P < .05).

I’ve not tried progesterone supplementation, and my progesterone does measure low, so as yet this is untested for me. If I were to try it, I would use bio-identical hormones.

So if you are suffering through uncomfortable menopause symptoms, and you have symptoms associated with low testosterone, get tested for all 3 hormones; testosterone, progesterone and estrogen, and supplement if your health professional recommends that. Use bio-identical hormones if you do. Let me know how you respond.

And thank you all for your feedback in previous menopause posts, it is useful to hear of other recommendations and N=1 experiments.

Julianne

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