Androgens, such as testosterone, play important physiological roles in women as well as men. Androgens appear to have an important effect on women’s energy and well-being. One Australian clinical trial of a transdermal testosterone patch developed specifically for women, showed that postmenopausal women had an improvement in overall well-being, particularly in relation to depression, increased energy, and improved libido.
One problem in this type of treatment, however, is that there is no accepted clinical definition of androgen deficiency in women. Therefore, most doctors are hesitant to perform this type of treatment. Dr. Susan R. Davis, MBBS, PhD, of the Jean Hailes Foundation, an Australian not-for-profit organization, is involved in education about, research into, and treatment of women’s health care issues, including the use of testosterone. She has stated that she would consider treating any woman with symptoms of deficiency (e.g., fatigue) whose free testosterone levels fall below the midpoint of the normal range.
Because testosterone levels decline with age, women in their later reproductive years may have lower levels of testosterone than younger women. By the time a woman has gone through menopause, her testosterone levels may be further depleted, especially if she is taking estrogen replacement therapy, since this can significantly reduce bioavailable testosterone.
Additionally, oral contraceptives also can greatly reduce levels of bioavailable testosterone, which may be the reason that some women on the pill report a loss of libido. Dr. Davis cautions that testosterone treatment should only be initiated after other causes of symptoms, such as depression or iron deficiency are ruled out.
Although some people mistakenly believe that testosterone increases risk of heart disease, Dr. Davis maintains that this is an unsubstantiated claim. In her studies, testosterone has some benefits and doesn’t appear to have risks. While adverse effects of testosterone in women, such as masculinization and fluid retention, are possible, these effects are unusual when hormone levels are maintained within normal physiological levels, which is why proper medical supervision is so important.
Eating, Obesity and PMS
There is a connection between obesity and PMS, according to a study appearing in the Journal of Psychosomatic Obstetrics and Gynaecology (2005; 26(1):33-9). Researchers interviewed 874 women between the ages of 18 and 44. They answered questions on the Shortened Premenstrual Assessment Form. Obesity was assessed by body mass index (BMI). Overall prevalence of PMS in the group was a little over 10%. Obese women (defined as having a BMI of 30 or greater) had nearly a three-fold higher incidence of PMS than non-obese women. Diet affects PMS and PMS affects diet (or at least the tendency to crave foods.)
Many PMS sufferers have a tendency to overeat during menstruation, according to a study appearing in the British Journal of Nutrition (2001; 85(4):475-82). Obese women were screened for, using the Steiner self-rated questionnaire. Of 144 who were screened, 88 were determined to have PMS. The women then kept dietary diaries over the course of two menstrual cycles. Analysis of the dietary diaries of the women suffering from PMS showed that they ate more calories premensturally compared to postmenstrually. They showed a significant increase in the consumption of fat, simple sugars and carbohydrates.
Boron and Menopause
Boron is a trace element that may be beneficial to the immune system. Physiological amounts of dietary boron decrease skinfold thickness after antigen injection in gilts and elevated circulating natural killer cells after adjuvant injection in rats. Research appearing in the Journal of Trace Element Experimental Medicine (1999;12:251-261) looked at 43 perimenopausal women experiencing discomfort associated with menopause. This was a double-blind crossover study; the subjects were given 2.5 mg of boron (in the form of sodium borate). The women were given a placebo for 90 days either before or after the treatment with boron. The effect on menopausal symptoms was mixed, with 21 women experiencing an increase in hot flashes and night sweats. Ten of the women reported a reduction in symptoms while taking the boron. The other 15 women experienced no change in symptoms while taking boron. Boron supplementation did, however, increase the white blood cell count in the subjects. Boron also increased the levels of 17 beta estradiol, alkaline phosphatase and thyroxine.
Menopause and Bioflavonoids
Hesperidin is a bioflavonoid that is found in citrus fruit. It offers similar nutritional support to other bioflavonoids, like quercetin. It acts to support the vascular system by strengthening the capillaries and it also acts as an antioxidant. In research appearing in Chicago Medicine (March 7, 1964), 94 patients who had undergone menopause (36 surgically and 58 physiologically) were given a supplement containing 50 mg of hesperidin complex,150 mg. of hesperidin methyl chalcone and 200 mg of vitamin C. The control group was given calcium carbonate, salicylamide and an estrogenic substance. The group receiving the vitamin C/bioflavonoid supplement experienced more relief from hot flashes than the control group. It is possible the mechanism for the vitamin C/bioflavonoid supplement in improving hot flashes involves strengthening the capillary bed and reducing vasodilation.
Magnesium and PMS
A study in the Annals of Clinical Biochemistry (1986;23:667-670) found that the level of magnesium found in the red blood cells of PMS sufferers was significantly lower than those of healthy controls. Other studies have shown the value of magnesium supplementation for PMS sufferers. Subjects of another study, appearing in Clinical Drug Investigation (2007; 27(1): 51-8), were supplemented with magnesium (250 mg/day) after being observed for three months without supplementation. The women were given the magnesium for only part of their cycle (from 20 days after the start of the last cycle until the beginning of the next cycle). The study lasted for three cycles and found a 33.5% reduction in symptoms according to the Moos’ Modified Menstrual Distress Questionnaire. An article appearing in Family Practice News (March 1, 1996;33) cites two small studies that show magnesium supplementation to be useful for patients who have migraine headache associated with their cycles.
Magnesium is the cofactor for over 300 chemical reactions in the body. Deficiency can cause a variety of health problems. According to an article appearing in Pediatric Asthma, Allergy and Immunology, (1993;7(4):211-215), symptoms of magnesium deficiency can include PMS and headaches. Other symptoms include high blood pressure, nervous irritability, hives, fibromyalgia and even heart problems. Mood swings and breast tenderness associated with the menstrual cycle are commonly seen in women who are magnesium deficient.
Hypothyroidism Increases Cardiovascular Risk in Women
Hypothyroidism has been shown to be a risk factor for cardiovascular disease. Now, research appearing in the Annals of Internal Medicine (2000; 132(4):270-8) shows that subclinical hypothyroidism and thyroid autoimmunity can also increase the risk of heart disease. In subclinical hypothyroidism, patients do not have the symptoms of hypothyroidism, but their blood tests indicate an underfunctioning thyroid. Women in the study had a 70% higher chance of having hardening of the aorta (the largest artery in the body), and more than two times the risk for a heart attack than the group with normal thyroid hormone levels. It is estimated that 17% of all older Americans have subclinical hypothyroidism.
In the study, even after statistically adjusting for all the other factors affecting heart disease risk — including weight, smoking, cholesterol levels, and blood pressure — women with hypothyroidism were 70% more likely to have hardened aortas than those with normal hormone activity. They also had more than twice the risk of heart attack. Having autoimmune hypothyroidism increased the risk even further. The researchers concluded that subclinical hypothyroidism is a strong indicator of risk for atherosclerosis and myocardial infarction in elderly women.
Pregnancy and Gluten Sensitivity
We all know that the mother’s diet can affect the health of her fetus. If the mother is sensitive to gluten and does not know it, there can be serious health repercussions for the unborn baby. For one thing, the birth weight is affected. Research appearing in the journal Human Reproduction (2010 Feb;25(2):528-34) looked at this issue. A total of 1,504,342 babies were born to 836,241 mothers during the study period. Of those, 1105 babies were born to women with diagnosed celiac disease and 346 were born to women with undiagnosed celiac disease. Women with untreated celiac disease delivered smaller babies and had a greater risk of having a VSGA (very small for gestational age–in the 5th percentile of birth weight) than women diagnosed with celiac disease who, avoiding gluten. Women with untreated celiac disease also had a higher risk delivering preterm.
Another study, appearing in Gastroenterology (2005 Aug;129(2):454-63) had similar findings. A national register-based cohort study restricted to women aged 15-44 years with singleton live born infants was used. We identified 2078 offspring to women who had received a diagnosis of celiac disease (1964-2001): 1149 offspring to women diagnosed prior to birth and 929 offspring to women diagnosed after infant birth. Main outcome measures were: intrauterine growth retardation, low birth weight ( There may even be a connection between mental health and maternal gluten sensitivity. In a study appearing in The American Journal of Psychiatry (VOL. 169, No. 6, june 1, 2012), the authors analyzed archival dried blood spots obtained from newborns to assess whether levels of immunoglobulin G (IgG) directed at dietary antigens were associated with a later diagnosis of a nonaffective psychotic disorder. The study population consisted of individuals born in Sweden between 1975 and 1985 with verified register-based diagnoses of nonaffective psychoses made between 1987 and 2003 and comparison subjects matched on sex, date of birth, birth hospital, and municipality. A total of 211 case subjects and 553 comparison subjects consented to participate in the study. Data on factors associated with maternal status, pregnancy, and delivery were extracted from the Swedish Medical Birth Register. Levels of IgG directed at gliadin (a component of gluten) and casein (a milk protein) were analyzed in eluates from dried blood spots by enzyme-linked immunosorbent assay. Odds ratios were calculated for levels of IgG directed at gliadin or casein for nonaffective psychosis.
The authors found that of anti-gliadin IgG (but not anti-casein IgG) above the 90th percentile of levels observed among comparison subjects were associated with nonaffective psychosis (odds ratio=1.7, 95% CI=1.1–2.8). This association was not confounded by differences in maternal age, immigrant status, or mode of delivery. Similarly, gestational age at birth, ponderal index, and birth weight were not related to maternal levels of anti-gliadin IgG.
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Raya Shanazarian
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Montrose, CA 91020