There were women 89 percent in the first examination, women 87 percent in the second examination, and women 82 percent in the third examination. There were women 77 percent participating in all three rounds, and 85 percent women provided data from at least two examinations. Testosterone levels.
At each examination, blood was drawn in days 3—7 of the follicular phase of the menstrual cycle and after an 8-hour fast. For women not normally menstruating within 3 months of the examination, blood was drawn after fasting and indexed to the anniversary date of their first annual examination.
Total testosterone was assessed with a solid-phase I radioimmunoassay based on a testosterone-specific antibody immobilized to the wall of a polypropylene tube. Behavioral characteristics.
The annual examinations included the administration of health questionnaires. Smoking status was based on questionnaires and women were categorized as never, former, or current smokers. Groups 2, 3, and 4 are the first, second, and third tertiles, respectively, among those who report consuming alcohol at least once a week. Annually, women reported physical activity during the previous week, previous July, and previous December.
These data were averaged, and an algorithm modeled on the Stanford Five City instrument was used to indicate average weekly activity in metabolic equivalents METs One MET is the energy consumed per minute of sitting at rest. Anthropometric measures. Body composition body fat percent , lean and fat mass kg was determined using dual energy x-ray absorptiometry DEXA Lunar Corporation, Madison, Wisconsin.
Scanning speed was selected for the anterior-posterior abdominal thickness of the woman being evaluated. Reproductive measures. Women were classified as never, former, or current users of hormone replacement therapy and oral contraceptives, based on self-report. Current use was confirmed with interviewer observation of container labels.
Women were also identified as having a hysterectomy with and without double oophorectomy and confirmed by medical record. Nutritional measures. Daily macronutrient intake was estimated from the item Health Habits and History Questionnaire All statistical procedures in this analysis were performed using SAS software version 6.
Univariate statistics were calculated for continuous variables, and frequency statistics were calculated for categorical variables. Testosterone concentrations were analyzed using a square root transformation, but the data presented in tables 1 through 4 have been untransformed to facilitate recognition of the units.
However, the beta coefficients and standard errors in the longitudinal models table 5 remain in their transformed state because of the complexity of the standard error measure. Analysis of variance was used in comparing the mean testosterone levels and standard errors for groups at the first, second, and third examinations.
The comparison groups for the cross-sectional evaluations of the data were defined by lifestyle factors and reproductive status. Regression models were used to identify those variables independently associated with testosterone concentrations from among the significant associations in the bivariate analysis.
Longitudinal mixed models were used to evaluate possible time trends and the influence of the time-varying variables measures of body composition and ovarian status with respect to testosterone concentrations over the 3-year period Proc Mixed; SAS Institute. The random intercept and random slope, plus measurement error, were used to model the variability in the correlated measurements. Only those variables identified as consistently important in the cross-sectional analyses were entered into the longitudinal analyses, and then those variables that were no longer significant in an overall model were removed i.
A similar process was also used for the data of women who were at the 95th percentile or greater of the baseline testosterone distribution. The characteristics of participants are shown in table 1. Among the participants, the average age was 38 years, and the age range was 27—47 years at the last examination. Older age within this cohort of relatively younger women was not an important explanatory variable.
Characteristics of the participants of the Michigan Bone Health Study reported from each of the three consecutive annual examinations. The mean amount of alcohol consumed increased somewhat, although, overall, the amounts reported were quite low. The proportion of the population that reported current smoking behavior decreased slightly. The mean level of physical activity remained constant. The prevalence of hysterectomy was 11 percent. Smoking behavior was associated with increased serum testosterone levels.
The pattern among current, former, and nonsmokers was consistent at each examination. Current smokers had the highest mean levels, with mean total testosterone concentrations decreasing in former and nonsmokers.
Self-reported alcohol consumption was not associated with total testosterone concentrations cross-sectionally. The mean testosterone levels did not differ significantly between drinkers and nondrinkers with the exception of the examination. However, when the analysis was then restricted to only those individuals participating in all years of the study, differences in concentrations in the third examination were no longer statistically significant.
Physical activity was not associated with testosterone concentrations in any of the 3 years of examination table 2. Women in the upper tertile of the physical activity distribution had testosterone concentrations similar to those in women in the lowest tertile of physical activity cross-sectionally and across time. The grams of protein, fat, or carbohydrate intake, as well as total energy intake calories , were not associated with total testosterone concentrations data not shown.
Women using oral contraceptives and women using hormone replacement therapy had significantly lower testosterone concentrations than did women who were nonusers table 3.
Whereas women with oophorectomy had significantly lower testosterone concentrations than did premenopausal women, women with hysterectomy and ovarian conservation had testosterone concentrations that were not significantly different from those of premenopausal women.
Increasing weight was associated with increasing total testosterone concentration at every examination table 4. Measures of body composition were consistently associated with testosterone concentrations in a dose-response relation.
The amount of fat mass explained more variation in total testosterone than did lean body mass, although both were significantly associated with testosterone concentrations. Increased percent body fat, assessed with DEXA, was associated with higher levels of testosterone. The relation persisted following adjustment for smoking.
There were no significant interactions between smoking and any of the anthropometric measures in relation to testosterone concentrations. A greater waist circumference was associated with higher testosterone concentrations cross-sectionally. Cross-sectional regression models considered smoking, hormone use, oophorectomy, fat mass, lean body mass, and waist circumference simultaneously.
The correlations between smoking, fat mass, hormone use, and oophorectomy and total testosterone remained statistically significant, while lean body mass and waist circumference were no longer significantly correlated. We also evaluated the association of testosterone concentrations over time in longitudinal models considering body composition, smoking behavior, hormone use, and reproductive surgery status table 5.
Smoking behavior and increasing body mass index were each associated with increasing testosterone concentrations over time, whereas hysterectomy with oophorectomy was associated with a decline in testosterone concentrations over time. These relations were consistent whether the entire population was considered table 5 , panel A or whether the women with the highest 5 percent of body composition were excluded from analysis table 5 , panel B.
Likewise, the same variables remained important when the data from women with the highest 5 percent of testosterone concentration table 5 , panel C were excluded in the event that they might have undiagnosed polycystic ovary syndrome. In this population-based study, smoking behavior and measures of body composition were associated with increased serum testosterone concentrations.
There were no significant associations with other lifestyle variables representing alcohol consumption, physical activity, and intake of energy and the macronutrients, protein, carbohydrate, and fat. Smoking was associated with increased serum testosterone concentrations and after adjustment for other factors, including body mass index.
Of the few studies that have previously examined smoking and androgen levels in women, the findings are highly inconsistent. Longcope and Johnston 14 measured the metabolic clearance rates and production rates of estrogen and androgens in smokers and nonsmokers as part of an ongoing study of hormones and osteoporosis in 88 pre- and postmenopausal women.
They found that the metabolic clearance rates for smokers were lower for androstenedione, testosterone, estrone, and estradiol when compared with those of nonsmokers. However, following adjustment for weight, these differences disappeared with the exception of androstenedione.
Khaw et al. Current cigarette use was positively associated with concentrations of the adrenal androgens, dehydroepiandrosterone sulfate, and androstenedione. However, mean concentrations of estrone, estradiol, sex hormone binding globulin, and testosterone did not differ significantly between smokers and nonsmokers. Thomas et al.
They found no significant differences in plasma testosterone, androstenedione, and dehydroepiandrosterone concentrations. A possible explanation for the inconsistency between our findings and those of other studies is the choice of populations to study.
The Michigan Bone Health Study subjects are largely premenopausal while the other studies focused primarily on postmenopausal women or a combination of pre- and postmenopausal participants. In premenopausal women, testosterone is produced in the ovaries and adrenals, while in postmenopausal women, testosterone is produced by the adrenals and the peripheral conversion of androstenedione in adipose tissue.
We speculate that the greater concentrations of testosterone observed among current smokers were more likely a product of decreased metabolism rather than increased biosynthesis of the hormone. Longcope and Johnston 14 provide evidence to support this theory. Cytochrome P hydroxylases are responsible for the oxidative metabolism of steroid hormones in general.
These enzymes mediate the introduction of an oxygen atom derived from water or molecular oxygen into the steroid nucleus. P hydroxylases are subject to inhibition by carbon monoxide. Smokers have greater circulating carbon monoxide concentrations as a by-product of tobacco smoke. This may inhibit P hydroxylases and explain the increased concentrations of testosterone and its precursors. Thus, future studies of androgen and smoking in women need to consider products in the androgen pathway as well as the availability of bioactive testosterone, concentrations of sex hormone binding globulin, and receptor binding.
Alcohol consumption was not associated with testosterone concentrations in this study, and findings are inconsistent in other studies. For example, Cigolini et al. Testosterone plays an important role in sex drive, energy, and behavior, so a significant change in your levels may be alarming.
Find out more about…. Here's how increased testosterone can help you lose fat. Hormones like estrogen and testosterone are crucial to your heath, and a hormonal imbalance can cause symptoms like acne and weight gain. Learn more. Low estrogen is typically seen in younger women and women approaching menopause.
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All About Testosterone in Women. Medically reviewed by Deborah Weatherspoon, Ph. Purpose and function Normal levels Treatment Natural remedies Bottom line When it comes to sex hormones, women are driven by estrogen and men are driven by testosterone , right? Remember Every person has testosterone. What does testosterone do in each sex? Do women need to be treated for abnormal testosterone levels? Can you treat abnormal testosterone levels naturally? Because testosterone plays a role in libido, women with lower-than-normal levels of testosterone can experience hypoactive sexual desire disorder—or HSDD.
Depression and fatigue often occur with HSDD. Researchers have yet to pin down the exact causes of HSDD. The extent to which testosterone levels contribute to HSDD is also not well-understood.
Low testosterone levels are, however, linked with less sexual desire, and testosterone hormone therapy can boost sexual desire in both pre-menopausal and post-menopausal women. High female testosterone levels are also linked with an increased risk of obesity and infertility. Post-menopausal women with elevated testosterone may be more likely to experience insulin resistance, which can make diabetes more likely. If you have high levels of testosterone, speak with your healthcare provider to learn about hormone imbalance treatment options.
In some cases, hormone therapy or medication can help get levels back to a balanced state. What lowers testosterone in women? If you're looking for natural ways to increase testosterone , it can help to know that several herbs and other plant-based foods may be able to naturally decrease T levels in women:.
Also, keep in mind that if you're experiencing high testosterone, it's a good idea to talk with your healthcare provider to learn what their recommendation is. If your hormone levels fall outside a healthy, normal range, then your health and well-being may be at risk. The Everlywell Testosterone Test makes this easy to do at home—giving you accurate information on a key part of your hormonal health, which you can discuss with your healthcare provider.
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