Testosterone – the underrated hormone


Doped cyclists, muscle-bound boxers: What the macho hormone of men does, we know. But what happens when women have too much testosterone?

Testosterone has one thing above all: neat proll potential. Athletes become aggressive high-performance machines and normal-men become muscle packs. What is much less known: The supposed male hormone also plays an important role in the female body, has an influence on health and well-being, on desire and energy. The pharmaceutical industry has therefore recently discovered testosterone as the “female hormone ” for itself and now for the first time as a drug for women on the market – in the form of a patch.

Testosterone is produced in women in the ovaries and adrenal cortex, but it also develops in fat and muscle tissue. Overall, circulating in the blood of women about one tenth of the usual amount in men. The effect is manifold: during puberty, it can grow underarm and pubic hair, it promotes the desire and sex, strengthens muscles and bones, supports the cholesterol degradation, provides drive and energy. Last but not least, the most important male sex hormone is the direct precursor of the most important female sex hormone: a single enzyme converts testosterone into estradiol.

Unintentionally childless? It may be due to testosterone

The balance of sex hormones is controlled in the brain and is part of a complex system of interactions: testosterone not only affects the body and psyche, its concentration in the blood is also dependent on physical and mental states. For example, in the case of female players of the Portuguese women’s soccer league, the testosterone level rose significantly before a final. After the match, the value remained elevated for a while – but only for the women who won the game. 

Fluctuations in the testosterone budget are therefore quite normal. Serious disturbances, however, can have noticeable effects, and they are very unpleasant. One of the most consequential is associated with too high a testosterone level:Polycystic ovarian syndrome (PCOS). Although five to ten percent of childbearing women are affected by it and it is the most common cause of unwanted childlessness, it is rather unknown – also because the diagnosis is not easy.

Because almost no woman has all the symptoms at once. In addition to an elevated testosterone level, the typical external signs such as strong body hair and acne may occur, the menstrual period may be rare or completely absent, and the ultrasound of the ovaries usually shows – but not always – cyst-like blisters. They arise because the oocytes do not fully mature due to the hormonal imbalance. However, these so-called polycystic ovaries alone are not automatically a health problem – they occur in one-third of all women, with no increase in testosterone. 

The triggers of the PCOS are still largely unclear. Inheritance plays an important role, and too many pounds, if properly predisposed, can favor the development of the disorder.At the same time, obesity is also a consequence of the syndrome, as the hormonal imbalance easily leads to impaired fat and sugar metabolism, which also increases the risk of diabetes. 

As complex as the clinical picture, so difficult the treatment: “The PCOS is not completely curable,” says Susanne Hahn, internist with endocrinological special practice in Wuppertal. “You can treat the symptoms, but if you stop the therapy, the disorder is back.” It is important in any case to reduce any excess weight. The drug metformin, which is otherwise used for diabetes, is particularly helpful in the treatment of drugs. Also effective are hormone supplements such as the pill or – if there is a desire for children – anti-estrogens.

No desire for sex: Can a hormone help?

But also a lack of testosterone can cause problems in women: about sexual aversion, listlessness or depressive mood. However, since the natural decline of the hormone begins as early as the beginning of 20 and varies individually, it often takes a long time before a serious disorder is detected. 

Women who have libido problems due to the loss of both ovaries have been treated with the testosterone patch since the beginning of the year.And the loss of libido that many menopausal women complain about? Could a plaster help too? Hamburg gynecologist Anne Schwenkhagen considers the study situation to be unclear. For example, Australian researchers found in a large study in 2005 in 1400 women between 18 and 75 years no relationship between low testosterone levels and Libido problems. 

Nevertheless, pharmaceutical companies are seeking further uses for testosterone in menopausal women. “But if you just do not feel like your partner, then no hormone helps,” said Schwenkhagen