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Sexual Health
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
When low libido persists, despite the aforementioned interventions, testosterone cream can be prescribed. Be aware that testosterone therapy for women is not approved by the FDA, meaning that it is used “off-label.” Testosterone is often provided as a compounded topical cream or as a reduced dose of a testosterone gel that is FDA approved for men (eg, AndroGel® 1%).
Macronutrients
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Estrogens are female hormones of which estradiol is the most potent. They maintain the female reproductive tissues in a fully functional condition, promote the estrous state of preparedness for mating, and stimulate development of the mammary glands and of other feminine characteristics. Progesterone is a hormone secreted by the female reproductive system that functions mainly to regulate the condition of the inner lining (endometrium) of the uterus. Progesterone is produced by the ovaries, placenta, and adrenal glands. In the ovaries the site of progesterone production is the corpus luteum. Progesterone prepares the wall of the uterus to accept a fertilized egg that can be implanted and developed into a fetus. Testosterone is an androgen hormone that primarily influences the growth and development of the male reproductive system. It is produced by the male testes (66, 134–135).
Erythropoietin, Atrial Natriuretic Peptide and Sex Hormones
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Testosterone is the main androgen produced by the testes in the male. It is produced in small amounts by the adrenal cortex and by the ovary in the female. Cholesterol is the chief substrate for testosterone synthesis. The reproductive functions of androgens are the control of spermatogenesis, maturation of sex organs and development of secondary sex characteristics. Testosterone has anabolic effects in muscle by promoting cell division, growth and maturation, resulting in an increase in muscle strength.
Testosterone treatment and change of categories of the International prostate symptom score (IPSS) in hypogonadal patients: 12 years prospective controlled registry study
Published in The Aging Male, 2023
Aksam Yassin, Daniel Kelly, Joanne Nettleship, Raidh Talib, Raed M. Al-Zoubi, Omar M. Aboumarzouk, Bassam Albaba
Functional hypogonadism is a condition characterized by low serum testosterone concentrations and symptoms in males, a condition that becomes increasingly prevalent as men age [1]. Approximately 20% of men over the age of 60 have low testosterone levels, rising to 30% over the age of 70 and 50% over the age of 80 [2]. The clinical features of functional hypogonadism include absence or regression of secondary sex characteristics, insulin resistance or type 2 diabetes (T2D), hypertension, dyslipidemia, anemia, muscle atrophy, reduced bone mass or bone mineral density, oligospermia, decreased libido, decreased sexual function and abdominal adiposity [3]. Along with T2D, other co-morbidities potentially caused by low testosterone include metabolic syndrome (MetS) and obesity, all of which are associated with increased age [4]. These co-morbidities often exacerbate the effects of hypogonadism, significantly reducing the quality of life (QoL) for patients and ultimately increasing mortality [3,4].
Transgender health and the impact of aging and menopause
Published in Climacteric, 2023
A. S. Cheung, B. J. Nolan, S. Zwickl
Trans people presumed female at birth who commence masculinizing hormone therapy will generally achieve serum testosterone concentrations in the typical cisgender male reference range [11,31]. Testosterone therapy is given in the same manner as that for hypogonadal cisgender men. This induces lowered voice, body and facial hair growth, as well as changes in body composition with increase in muscle mass and reduction in fat mass. Non-binary individuals may desire a more androgynous appearance and may use low-dose testosterone therapy for more gradual effects, often achieving testosterone concentrations above the cisgender female reference range but not necessarily in the cisgender male reference range [32]. Adverse effects of testosterone therapy include polycythemia, reduced high-density lipoprotein cholesterol, androgenic alopecia, acne, gynecological effects such as pelvic pain and genital dryness, and cardiovascular effects as discussed further in the following [33].
Androgens in premenopausal women and women with premature ovarian insufficiency
Published in Climacteric, 2021
Women with POI appear to have impaired sexual function compared with age-matched controls, mainly pertaining to impaired desire and arousal2. Even despite using systemic ERT, women with POI often continue to experience difficulty with lubrication and pain during intercourse46. Most RCTs of testosterone therapy for HSDD have been limited to women aged 40 years and older, and therefore provide no evidence of benefit of testosterone therapy for women with POI23. In a study of women with hypopituitarism, transdermal testosterone was associated with improved sexual well-being compared with placebo39. RCT data for women with isolated POI are lacking. However, it is the author’s opinion that, as women with POI have lower circulating testosterone than their healthy counterparts, and as testosterone has been shown to be effective for older postmenopausal women with HSDD, it would be reasonable to offer a trial of testosterone therapy for women with POI who experience HSDD despite adequate ERT. As per the guidance of the 2019 Global Consensus Position Statement on the Use of Testosterone Therapy for Women, treatment should be with non-oral testosterone and serum testosterone concentrations should not exceed the physiologic premenopausal range23.