What role does testosterone play during menopause?
Testosterone is often thought of as 'the male sex hormone'. This is because it is produced at much higher levels in male bodies. However, testosterone is also an important sex hormone for women. Testosterone is well-known to help in libido, bone density and muscle mass, and is crucial for energy production. Menopause can affect testosterone levels. What happens when testosterone levels change?
What does testosterone do?
In women, testosterone is produced in the ovaries and adrenal glands. Testosterone is an essential hormone with several functions. For example, it is responsible for increasing and maintaining muscle mass and bone mass, and for increasing energy levels and libido or sexual desire.
During menopause, oestrogen and progesterone levels fluctuate and decline. At the same time, the production of testosterone decreases. These hormonal changes can affect processes in the body and how you feel.
Note: the term 'androgens’ refers to the group of sex hormones that includes testosterone.
What is the relationship between testosterone and other sex hormones?
The sex hormones testosterone, oestrogen and progesterone play an important role in the female body. All of these hormones work together to help regulate various functions and keep your body in balance.
Testosterone is a hormone that helps build muscle and bone mass. Oestrogen and progesterone work together to regulate the menstrual cycle. But they also have other important functions in the female body. Read more about the main functions of oestrogen and progesterone.
The role of testosterone in women’s health at different life stages
Throughout a woman's life, testosterone levels vary. During puberty, the body starts producing more testosterone, which contributes to bone density and muscle mass. Testosterone levels are relatively stable during a woman’s fertile years, but they can fluctuate during menstrual cycles.
Perimenopause usually begins in the early to mid-40s. During perimenopause, oestrogen levels decline while testosterone production remains relatively constant. Testosterone levels may even rise slightly in the first years of perimenopause.
As menopause gets closer, testosterone decreases gradually, but not as strongly as oestrogen and progesterone. Oestrogen and progesterone levels usually fall more rapidly and abruptly.
In postmenopause, the stage where your periods are officially behind you, hormone production remains constant and at a low level. The ovaries and adrenal glands still produce testosterone, but in lower amounts than before menopause.
What symptoms can testosterone cause during menopause?
Many of the typical symptoms of menopause like hot flashes and mood swings are caused by a drop in oestrogen levels. Although the decline in testosterone levels occurs gradually, it is associated with many bothersome symptoms, such as low energy, decreased sexual drive (libido) – studies show that 40 percent of women experience a loss of sex drive in postmenopause – and reduced muscle strength.
During perimenopause, oestrogen levels drop faster than testosterone levels. This temporary imbalance between oestrogen and testosterone can lead to testosterone dominance, which in turn can cause symptoms such as hair loss, excessive hair growth in unusual areas, acne, mood swings, restlessness, anxiety and even depression. Note: these symptoms can also be caused by other factors (such as sleep deprivation).
Although every person is different and the effects of high testosterone levels can affect women's health in a few different ways, high testosterone relative to oestrogen has been linked to insulin resistance. This means that the body doesn’t respond to insulin properly, inhibiting the absorption of glucose in the cells. This can lead to weight gain in the abdominal area.
What can you do?
A healthy lifestyle, which includes regular exercise and eating a well-balanced diet, can help reduce symptoms caused by hormonal changes during menopause. Here are some essential tips for a healthy lifestyle.
- Eat a balanced diet. Eat plenty of fruit, vegetables, whole grains, healthy fats (such as avocados, nuts, and seeds), and protein to support hormonal balance. More about nutrition and menopause.
- Get plenty of rest and relaxation. Stress can disrupt hormonal balance, which can make menopausal symptoms worse. Try to incorporate relaxation techniques like yoga, meditation or breathing exercises into your daily routine. More about stress and menopause.
- Make physical activity a habit. Try to exercise every day. Walking, cycling, tennis and the gym are all good options. Exercise not only reduces stress, but it also stimulates the production of ‘happy hormones’ called endorphins.
Sources
- Al-Azzawi, F., & Palacios, S. (2009). Hormonal changes during menopause. Maturitas, 63(2), 135–137. https://doi.org/10.1016/j.maturitas.2009.03.009
- Chakravarti, S., Collins, W. P., Forecast, J. D., Newton, J. R., Oram, D. H., & Studd, J. W. (1976). Hormonal profiles after the menopause. British Medical Journal (BMJ), 2(6039), 784. https://doi.org/10.1136/bmj.2.6039.784
- De Maddalena, C., Vodo, S., Petroni, A., & Aloisi, A. M. (2012). Impact of testosterone on body fat composition. Journal of Cellular Physiology, 227(12), 3744–3748. https://doi.org/10.1002/jcp.24096
- Johansen, N., Lindén Hirschberg, A., & Moen, M. H. (2020). The role of testosterone in menopausal hormone treatment: What is the evidence? Acta Obstetricia et Gynecologica Scandinavica, 99(3), 283–291. https://doi.org/10.1111/aogs.13819
- National Institue on Aging. (2021). What is Menopause? https://www.nia.nih.gov
- Zouboulis, C. C., Blume-Peytavi, U., Kosmadaki, M., Roó, E., Vexiau-Robert, D., & Kerob, D. (2022). Skin, hair and beyond: The impact of menopause. Journal of Cosmetic Dermatology, 21(2), 434-442. https://doi.org/10.1080/13697137.2022.2050206
Tips and advice
What role does progesterone play during menopause?
In perimenopause, progesterone is the first hormone to decline, oestrogen declines later. What does progesterone do in your body? And what can you do about the symptoms caused by low progesterone?
What is the role of oestrogen in menopause and why is it so important?
Oestrogen plays an important role in every stage of a woman's life. What happens to oestrogen during menopause? What are symptoms of low oestrogen and what can you do about them?
Leptin resistance and menopause: what are the signs and what can you do about it?
Menopause is associated with changes in hormone levels. This increases the risk of leptin resistance. What does this mean? And what are the signs of leptin resistance?
What are signs of oestrogen dominance and what can you do about it?
One of the main causes of menopause-related symptoms before reaching menopause.
FAQ
Why does testosterone increase during menopause?
During menopause, oestrogen levels drop faster than testosterone levels. Even though total testosterone remains unchanged, the rapid decrease in oestrogen can create a state of relative testosterone excess. This imbalance can lead to various symptoms.
How long does it take for hormone therapy to work?
Typically, noticeable changes begin to emerge after a few weeks of starting HRT but it can take up to several months to feel the full effects. Remember, every woman is different. Also, it may take a while to find the dose of hormones that is most suitable for you. Read more about hormone therapy.
