Testosterone production in women, as in men, is variable in several respects. Just after birth girls produce relatively large amounts of testosterone. Production declines throughout childhood and increases again with the onset of puberty. Testosterone levels peak around the age of 30, after which there is a steady decline. Women of around forty produce only half the amount of testosterone produced by those in their twenties. Testosterone production also fluctuates with the menstrual cycle: around ovulation the concentration is obviously highest, which is also when women feel most like having sex. It has also been shown that women have small day-to-day fluctuations: testosterone concentration in the blood is highest at about ten in the morning, and falls again through the day.
In his book De Mietjesmaatschappij (The Sissy Society, 2000), science journalist Marcel Roele writes that housewives produce on average less male hormone than career women. If one compares different kinds of working woman, women who are employed as pas, nurses or primary schoolteachers have less testosterone than women doctors, lawyers or managers. The more testosterone, the greater the competitive urge? Who can say? In De Pikorde (The Pecking Order, 2006) Marleen Finoulst and Dirk Vanderschueren report that years ago a British gynaecologist had prescribed testosterone to five of the then ii8 female mps, in the hope that this would help them compete better with their male colleagues on committees and in parliamentary debates. The female politicians gave this idea short shrift and protested that they had no need of testosterone!
In the menopause, when activity in the ovaries slowly fades, the production of testosterone also declines. Yet after the change women often have to deal with unwanted hair growth, for example on the upper lip and around the chin, while the hair on their head tends to thin. That is mainly because the liver produces less transport proteins, so releasing more free testosterone. The free form is the ‘active’ one, so that despite the falling hormone production the relative quantity of active testosterone in creases. This is why unwanted masculinizing features occur.
In the United States menopausal women are regularly prescribed testosterone. Over 30 per cent of older American women take hormone pills and in half of these cases the pills contain testosterone. In many other countries that is still highly unusual. A drop in normal testosterone levels may, as has been said, be the result of the menopause, but also, for instance, of the removal of both ovaries and chemotherapy. In such cases women may suffer acute listlessness, a reduction in muscle power, loss of pubic hair, loss of sexual appetite and may find it difficult or impossible to achieve orgasm. Giving testosterone supplements only makes sense if there really is a deficiency. Similarly, menopausal problems like vaginal dryness and hot flushes are not treated with testosterone; oestrogens are used for this purpose. The same phenomenon is found in those taking the contraceptive pill: taking extra female hormones leads to a decrease in testosterone production.
chapter five