The benefits of testosterone replacement far outweigh the few possible negative side effects.
This week’s podcast involves a discussion of the side effects of testosterone replacement. When women consider the replacement of testosterone there are a few questions they always ask, these questions are a reflection of what they have heard and what they fear. They want to know if they will grow hair on their face similar to a beard or a mustache, and they want to know if the hair on their heads will fall out.
In reality these are similar to the risks of testosterone replacement but the real risk is much less severe than the exaggerated symptoms discussed at the hair salon. Truly, with most forms of testosterone, hair loss is minor and preventable, as is facial hair. Usually facial fuzz caused by testosterone is just that and not a major concern compared to the symptoms that testosterone replacement treats. The degree of facial hair or hair thinning is genetically determined. There are ways to treat and ameliorate the risk factors associated with unwanted hair. Essentially a woman has to decide if the risk of not replacing her testosterone and suffering all the medical ills that come with the aging process is her best choice, or if taking the limited risk of hair growth on the face and hair loss on the head, which are cosmetic issues, not health issues, and preventable. If she choses to replace her testosterone, and does develop either of these conditions, they are easily treated with medical intervention, such as finasteride or spironolactone, or by lowering the dose of testosterone. We try to find the balance between good health and good cosmetics that make our patients healthy and happy.
Other concerns that worry women are whether or not there is an increased risk of cancer from taking testosterone replacement, and whether or not their voices will drop in range and make them sound more masculine. What I always tell them is that there is no evidence linking testosterone replacement to increased risks of developing cancer. In fact, for men, the evidence is pretty strong that it reduces the chances of developing prostate cancer! A new, and accurate thought championed by Dr. Morgentaler of Harvard.
Modulation of the voice is something that may change with testosterone but is dose dependent. Generally when we age women’s voices get higher without the effect of testosterone, and when it is replaced we tend to change our voices slightly in the direction of the voice range when we were younger women. You do not have to worry about sounding more masculine, nor do you need to worry about things like bulking up with muscles or having increased levels of rage and anger. You will develop more muscle strength but you will not bulk up like you would on steroids, and you will become more energized to be assertive but taking testosterone replacements will not make you angry.
All of these questions are reflections of concerns women voice in my office. They really are can be managed in most women with dosage regulation. Some of the issues are health related and some are cosmetic. Listen to our podcast to see if any of these issues reflect concerns you have, and let us help inform you so you can make better choices about your health in the future.