From the Guidelines
A perimenopausal 46-year-old woman should not take 2 units of testosterone without medical supervision, as the current evidence does not support the use of testosterone therapy in women for the primary prevention of chronic conditions 1. The provided evidence primarily focuses on the use of hormone therapy in postmenopausal women for the prevention of chronic conditions, and it does not specifically address the use of testosterone in perimenopausal women. However, it is essential to note that testosterone therapy may be considered for perimenopausal women with specific symptoms, such as decreased libido or fatigue, under the guidance of a healthcare provider. The medication is usually administered as a cream, gel, or occasionally as an implant, with application to the skin of the lower abdomen or thighs once daily. Before starting testosterone, baseline hormone levels should be measured, and regular follow-up monitoring is essential to check for side effects and adjust dosing. Testosterone may help address symptoms like decreased libido, fatigue, and reduced muscle mass that some women experience during perimenopause. The hormone works by supplementing declining natural testosterone levels, which typically decrease with age and particularly during the perimenopausal transition. Side effects can include acne, facial hair growth, and voice deepening, so starting with a low dose and careful monitoring is crucial. It is also important to consider the potential risks and benefits of testosterone therapy in perimenopausal women, as the evidence is limited, and more research is needed to fully understand its effects. In summary, while testosterone therapy may be considered for perimenopausal women with specific symptoms, it should only be done under medical supervision, and the potential risks and benefits should be carefully weighed.
From the Research
Testosterone Therapy in Perimenopausal Women
- There is no direct evidence in the provided studies to support the use of testosterone therapy in perimenopausal women, specifically a 46-year-old taking 2 units of testosterone 2, 3, 4, 5, 6.
- The studies primarily focus on menopausal hormone therapy, selective estrogen receptor modulators, and their effects on menopausal symptoms, osteoporosis, and cardiovascular disease.
- None of the studies mention the use of testosterone therapy in perimenopausal women or its potential benefits and risks in this population.
Menopausal Hormone Therapy
- Menopausal hormone therapy is effective in managing vasomotor symptoms, such as hot flashes and night sweats, and preventing osteoporosis in postmenopausal women 3, 6.
- The risks and benefits of menopausal hormone therapy vary depending on the type, route, and dose of estrogen and progestogen used, as well as the individual woman's health status and preferences 3, 6.
Selective Estrogen Receptor Modulators
- Selective estrogen receptor modulators (SERMs) are an alternative to hormone replacement therapy and can produce beneficial estrogen-like effects on bone and lipid metabolism while antagonizing estrogen in reproductive tissue 4, 5.
- SERMs, such as raloxifene and tamoxifen, have been shown to have positive effects on breast, bone, and lipids, but may increase the risk of venous thromboembolism and hot flashes 4, 5.