Signs and Symptoms of Testosterone Deficiency in Women
In 2002 many of the world's leading medical researchers and clinicians in the area of endocrinology, gynaecology and sexual health met at Princeton University in Michigan, USA and produced a document entitled The Princeton Consensus Statement. This document provided a definitive classification of female androgen (testosterone) deficiency and made recommendations regarding diagnosis and assessment of androgen deficiency states in women.
The androgen deficient female was defined as having:
- Diminished sense of well-being, gloomy mood and/or reduced motivation
- Persistent, unexplained fatigue
- Sexual function changes, including decreased libido, sexual receptivity and pleasure
- (potential) bone loss, decreased muscle strength, changes in cognition/memory.
The Princeton Statement set these symptoms against a background of women having adequate estrogen levels, excluding other causes that may bring about symptoms, and testosterone blood levels being in the lower range of normal healthy females.
Typical symptoms of diminished testosterone levels include:
- Loss of sexual desire
- Unexplained tiredness and fatigue
- Mood changes
- Sleep disturbances
- Reduced motivation and
- Body shape changes
There are volumes of medical literature demonstrating that surgically menopausal women with low sexual desire respond positively to treatment with testosterone.
In the United States, 600,000 hysterectomies are performed annually. Bilateral salpingo-oophorectomy (removal of both ovaries) is performed in conjunction with hysterectomy in about half of women aged 40-44 years of age who undergo the procedure and in almost 80% of women 45-54 years old. U.S. data collected between 1980 and 1993 showed that the likelihood of removal of the ovaries when undergoing hysterectomy is age related. Approximately 18% of women aged 15-24 years who had undergone hysterectomy also had bilateral oophorectomy. This proportion increased with age, peaking at 76% among women aged 45-54 years then declining to 62% among women aged greater than 55 years. It is estimated that one in four women will undergo this procedure at 60 years of age. In over 50% of cases removal of the ovaries is routinely performed. Reasons may include prophylactic prevention of ovarian cancer, endometriosis or pelvic inflammatory disease.
The cost in terms of immediate onset of menopause, loss of sexual drive and potentially diminished quality of life is unknown.
Other women, for various reasons, have lower than normal testosterone production, even without removal of the ovaries. Their symptoms are no different to those listed above.
Female sexual dysfunction (FSD) is the medical term given to women who experience loss of sexual desire, lack of arousal and low libido.
A study published in 1999 in the USA found that 43% of women aged between 18 and 59 years of age experienced some degree of sexual dysfunction. Of these women 22% considered their loss of libido to be their most significant symptom affecting their lives. This loss can have significant psychological ramifications and can adversely affect social and personal relationships.
The answer for many women is the restoration of testosterone levels.