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Why Aging Women Need

April 2004

By Edward R. Rosick, DO, MPH, MS

Ways to Increase Testosterone Naturally
Many women are still leery of hormonal supplements such as testosterone. Others do not have the luxury of having a physician who is well versed in integrative therapies. Most mainstream physicians still cling to the idea that testosterone is a man’s hormone and supplementing with it has no place in women’s health, even with the abundance of scientific evidence showing otherwise. The good news is that there are some proven, natural ways a woman can safely increase her testosterone levels to maintain optimal health into her forties, fifties, sixties, and beyond.

Multiple studies have shown that resistance exercise can increase men’s testosterone levels. Some lesser-known but equally impressive studies show that exercise likewise can increase women’s testosterone levels, whether they are 20 or 60 years old. A study in 2001 examined the acute effects of resistance exercise in 47 women aged 19 to 25.10 After just six sets of repetitive motion squat exercises, significant increases were noted in both free and total testosterone levels. A study in 2002 examined the effects of endurance and resistance exercise on hormonal levels, including testosterone, in women 19-69 years of age.11 As in the previous study, testosterone levels increased significantly in women who did either endurance or resistance exercises, regardless of their age. Another study conducted in 2003, which examined the hormonal effects of high-impact physical exercise in 25 early postmenopausal women aged 53-59, showed a significant and acute rise in testosterone levels following exercise.12

Like testosterone, DHEA is a hormone that has long been recognized by holistic practitioners as essential for optimal health in women and men. DHEA is secreted into the bloodstream by the adrenals in humans and other primates, and then converted into DHEA sulfate (DHEA-S). Since DHEA’s discovery, hundreds of scientific articles have been published on its wide-ranging effects.

DHEA is a precursor to testosterone and estrogen. As with testosterone, DHEA levels peak in women in their twenties and then slowly but steadily decline, dropping by about 10% every decade of life. Some intriguing early studies have correlated the decline in DHEA production with many of the degenerative changes seen in aging in women and men, such as heart disease, cancer, and osteoporosis.13

While it is considered physiologically “normal” for DHEA to decline during aging, under certain conditions DHEA levels plummet early in life. Addison’s disease, or primary adrenal failure, occurs in about 1 in every 25,000 people. Without functioning adrenal glands, the body cannot produce many important steroid hormones, including DHEA. Standard treatment for this condition has been to replace the missing hormones. Until very recently, however, most mainstream physicians did not replace DHEA. Furthermore, patients with Addison’s disease, even those who received standard hormone replacement therapy, consistently report a reduced quality of life with symptoms such as persistent fatigue and depression.

A recent study looked at the effects of DHEA supplementation in patients with Addison’s disease.13 In this randomized, double-blind trial, 39 patients (24 women and 15 men, aged 25-69) were given either 50 mg of DHEA daily for 12 weeks, followed by a four-week washout period, then 12 weeks of placebo, or vice versa. After DHEA supplementation, blood levels of DHEA rose from subnormal (as would be expected in Addison’s disease) to the normal range for young adults. More important, both the women and men taking DHEA showed significant positive psychological changes, including enhancements in self-esteem and mood and a decrease in fatigue.

Besides Addison’s disease, other conditions cause a significant decrease in DHEA levels. Adrenal insufficiency is a condition in which the adrenal glands secrete some hormones, but not at normal levels. In a double-blind study of 24 women with adrenal insufficiency, DHEA supplementation (50 mg daily for four months) raised DHEA-S levels to normal.14 It also increased the women’s sense of well being and frequency of sexual thoughts and interest, as well as decreased depression and anxiety.

DHEA Delays Aging’s Physical Effects
Because DHEA is at high levels in young adults and then declines precipitously thereafter, there has been great interest in using DHEA as an anti-aging hormone. One of the most widely touted studies that examine DHEA supplementation to counteract the effects of aging was done by researchers at the University of California School of Medicine.15 This randomized, double-blind, placebo-controlled trial followed 17 women and 13 men, aged 40-70 years, over a six-month period. For three months, they were given 50 mg per day of DHEA, then three months of placebo at bedtime in random order. Within two weeks of starting DHEA, the patients had attained DHEA blood levels of young adults. After three months on DHEA, 82% of the women and 67% of the men reported an increased sense of well being, which included improved quality of sleep, less anxiety, increased energy, and improved ability to handle stress.

DHEA and Optimizing Testosterone
Because DHEA is a precursor hormone for testosterone, it makes sense to think that DHEA supplementation could safely and effectively raise testosterone to optimal levels in women of all ages. A 1998 study examined the effects of short-term treatment of 100 mg per day of DHEA on postmenopausal women aged 52-56.16 This study showed that after only seven days of supplementation, testosterone levels were significantly increased. Another study, this one a randomized, placebo-controlled trial on

60 perimenopausal women aged 45-55, also examined the effects of DHEA supplementation (50 mg per day) on testosterone and other hormone levels over a three-month period.17 Again, women who took DHEA supplements had significantly higher testosterone levels than women who were in the placebo group. Finally, a study was done that examined the hormonal effects of DHEA (50 mg per day) on 31 women, aged 50-65 years, over a six-month period.18 Like the previously cited studies, women who took DHEA had higher levels of testosterone as well as other “beneficial” hormones such as growth hormone, which led the authors of the study to conclude that “DHEA is more than a simple diet supplement or anti-aging product; rather, it should be considered an effective hormonal replacement treatment.”

DHEA and Sexual Function
In both pre- and postmenopausal women, DHEA supplementation has been shown in multiple studies to have a positive effect on sexual functioning. A randomized, double-blind, placebo-controlled study published in 1999 examined the effects of 50 mg per day of DHEA in 280 women and men aged 60-79 years.19 When compared to women taking placebo, the women taking DHEA reported statistically significant improvements in libido, sexual activity, and overall sexual satisfaction. A more recent study published in 2002 in the Journal of Sex and Marital Therapy examined the effects of 50 mg per day of DHEA on 111 pre-menopausal women aged 35-55 years over a period of two to six months.20 As in previous studies, in this study women taking DHEA supplements reported significant improvements in sexual function in terms of desire, arousal, lubrication, satisfaction, and orgasm.

Slowly and begrudgingly, mainstream medicine is beginning to realize that those who believe in the power of integrative medicine may be on to something very important. As more studies show that supplements like DHEA and hormones such as testosterone can help women maintain their zest for life (and for sex) throughout their lives, it is only a matter of time until all women, whether or not they have a physician who is well versed in integrative medicine, will be able to receive the medical care and guidance they deserve to live long and healthy lives.


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20. Munarriz R, Talakoub L, Flaherty E, et al. Androgen replacement therapy with dehy- droepiandrosterone for androgen insufficiency and female sexual dysfunction: androgen and questionnaire results. J Sex Marital Ther. 2002;28 Suppl 1:165-73.