A common symptom of menopause is lost confidence. Self-esteem can take a real nose dive too.
Chances are this is due to low testosterone.
Women have testosterone too, but at much lower levels than men. Levels tend to decline at middle-age, so it can really add insult to injury when you’re having a rubbish time with the menopause already.
Where Does Testosterone Come From?
In women testosterone comes mainly from the ovaries and the adrenal glands.
Women who’ve had their ovaries surgically removed can feel the effects of the sudden drop in testosterone. Particularly emotionally and psychologically. Even just having a hysterectomy (and keeping your ovaries) can have a significant effect, because some of the smaller blood vessels supplying the ovaries are lost.
Your adrenal glands are the other main source of testosterone. Depending on your diet and lifestyle your adrenals could be fatigued, and therefore not producing a lot of testosterone.
In women testosterone naturally declines as we age, but that can be accelerated dramatically by surgery, and worsened by unhealthy diet and lifestyle choices.
Menopause and Lost Confidence
Testosterone in women is important for confidence, self-esteem, and a feeling of vitality.
When levels get low your motivation can evaporate, and your mental stamina to get through a day disappear. You might become indecisive, and although not depressed – feel flat and fatigued.
Seeing a doctor with these symptoms might earn you prescription of antidepressants, when your real issue is low testosterone.
Other Roles Of Testosterone
Testosterone is an anabolic hormone – it contributes to strength, muscle mass, and bone strength.
Around menopause when levels are declining the result can be aching, quicker muscle fatigue, and a loss of physical strength.
As levels get lower there’s a tendency to get flabby as you lose muscle mass, and gain fat in its place. As women get even older there’s a tendency to get physically weaker and more prone to injury.
In the long term testosterone works in harmony with oestrogen and progesterone to support good bones, and helps protect against osteoporosis.
And of course then there’s sex drive and libido. A lot of women lose this in middle-age and HRT with oestrogen and progesterone only doesn’t always help.
Testosterone Replacement?
It’s easy to check your testosterone level, it’s just a blood test.
It’s not routinely checked in women though, because it’s not common practice to treat women for this. It makes you wonder who wrote the guidelines for menopausal treatment. I don’t know, but my guess is it wasn’t a group of menopausal women!
I find the current approach to women’s HRT lacking because if you check the NICE guidelines you’ll notice testosterone only gets a tiny mention under the ‘Altered Sexual Function’ title. It doesn’t even get mentioned in the ‘Psychological Symptoms’ section!
Prescribing testosterone for women is often outside the expertise and comfort zone of GPs. You would probably need a referral to menopause clinic to get it, but not necessarily if your GP has a special interest in menopause.
Perhaps as more and more women become aware of what they may need to feel good, and ask for it.. things will change for the better for us.
If you’ve got any questions or comments – pop them in the box below and I’ll get back to you.
Click here for the next menopause workshop
Have a great week!
Dr Julie
Gosh this really explains away so many of my symptoms!
I really feel very unlike myself since starting the menopause.
I’ve gained weight, have body aches, lost my confidence and am easily fatigued – mentally and physically.
Thank you for this article.
At least I know that I’m not imagining it all.
Hi Sarah, thanks for the feedback that you’ve found this helpful, much appreciated 🙂
How can you increase testosterone levels naturally
Apologies for the delay in getting back to you Sarah. Exercise – resistance training and high intensity interval training are the best. Also – healthy eating, keeping a lid on stress, and getting enough sleep (which is not always easy when you’re menopausal!)