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Life Extension Magazine

LE Magazine October 2004
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The Science Behind The Sexy Years
The New Book by Suzanne Somers
By Edward Rosick, DO, MPH, MS

Testosterone and The Sexy Years
True to its title, the second part of The Sexy Years focuses on sex, and more specifically, on the vitally important role that testosterone—the traditional “male” hormone—plays in maintaining sexual health in women. Although doctors have been aware that women produce testosterone, most mainstream physicians generally thought that testosterone was not important for women. It was assumed that only levels of the “female” hormones—progesterone and estrogen—had any significant impact on a woman’s health and well being. Yet as Suzanne details, a growing body of evidence indicates that testosterone is a very important hormone for women, especially for staying fit and lean, and for maintaining an active sex life.

While some mainstream physicians now believe that testosterone replacement in women who have had oophorectomies (surgical removal of one or both ovaries) can enhance their mood and well being, most still scoff at the idea that testosterone replacement has any use for women with their ovaries intact. Fortunately for women all over the world, physicians such as Drs. Laura Berman and Jennifer Berman, who are interviewed in the The Sexy Years, exemplify a new breed of researchers who recognize that the expression of sexuality is just as important for a woman as it is for a man.

Another preeminent researcher in women’s sexual health issues, Dr. Susan Davis, is examining the many ways in which testosterone supplementation can benefit women, whether or not they have had an oophorectomy. At the Jean Hailes Foundation, a not-for-profit organization in Australia devoted to women’s health care issues, Dr. Davis and her colleagues have been studying why and how testosterone is important for women’s overall health. In a detailed report on testosterone replacement therapy in both pre- and postmenopausal women, Dr. Davis demonstrated that in women who are postmenopausal or have had an oophorectomy, the judicious use of testosterone therapy elicited a direct improvement in sexual drive, arousal, and frequency of sexual fantasies.2

Groundbreaking research is showing that besides helping women to maintain an active sex life no matter what their age, testosterone may help guard women against breast cancer. A recent study examined the effects of testosterone and tamoxifen on breast cell stimulation.3 The researchers showed that while breast cells exposed to estrogen showed cancer-like rapid growth, those same cells, when also exposed to testosterone, showed significantly less growth. An even more recent study also found that testosterone significantly inhibits breast cell growth, leading the authors to conclude “ . . . androgens [testosterone] may protect against breast cancer. . .”4

Adding Testosterone to Counter Andropause
At casual glance, one might mistake The Sexy Years for a book for women only. In fact, Suzanne delves into the use of bioidentical hormones for male sexual enhancement and longevity. Over three chapters, she explains in clear detail the phenomenon of andropause—the male equivalent of meno-pause—and how testosterone supplementation can help men overcome the problems brought about by this change of life. The book contains a testimonial from Suzanne’s 67-year-old husband, Alan Hamel, about how supplemental testosterone has given him a new lease on life.

As explained in The Sexy Years, when men reach their forties, most start noticing some subtle (or perhaps not-so-subtle) physical and emotional changes taking place. The idea of a male equivalent to menopause is still considered a myth by many mainstream medical doctors. They claim that because men do not have a physical signpost (such as the cessation of menstruation seen in women), andropause does not exist.

It must be noted, however, that while women do have this biological point of demarcation in their lives, other changes of menopause take place over a period of several years. In the case of andropause, the majority of physical, mental, and emotional changes are thought to take place over a period of 10-15 years. These changes—which include declines in libido, sexual functioning, muscle mass, and strength, an increase in prostate size leading to benign prostatic hypertrophy, and often fatigue and depression—begin around age 40 for most men.

As in women, testosterone production declines as a man ages. Most anti-aging physicians believe this decline in testosterone level to be a hallmark biochemical signpost of andropause. Testosterone levels peak in men at approximately the age of 30; by the age of 40, 5% of men are thought have low testosterone levels, and by the age of 70, that figure rises to at least 40-50%.5 Fortunately for the tens of millions of male baby boomers who are entering andropause, multiple studies show the positive effects of supplemental testosterone in combating the symptoms of andropause.

As Suzanne’s husband Alan relates in The Sexy Years, supplemental testosterone can help andropausal men regain their vitality and zest for life. In multiple studies, testosterone supplementation has been shown to improve libido and erectile capability.6-8 In other studies, supplemental testosterone has been shown to alleviate other andropausal symptoms such as depression, loss of energy, and increased LDL, which are often markers of heart disease.9,10 Testosterone supplementation can also help reverse the potentially devastating effects of muscle loss (sarcopenia) and osteoporosis often seen in older men. Supplemental testosterone has been shown to increase bone mass of the lumbar spine in elderly men.11 And a study done in 1995 showed that when given to six men aged 64-69 who had low testosterone, supplemental testosterone caused a measurable increase in skeletal muscle protein synthesis along with an increase in muscular strength.12

The Breast Cancer Dilemma
The Sexy Years presents valid arguments for using bioidentical hormone replacement therapy to combat menopausal and andropausal symptoms as well as aging itself. While the book offers compelling reasons for women—especially those suffering from significant menopausal symptoms—to use bioidentical hormones, some questions remain unanswered concerning hormone replacement therapy in relation to breast cancer.

Many much-publicized studies link synthetic hormone replacement therapy to an increased risk of developing breast cancer.13,14 Researchers also know that estrogen has proliferative effects on breast cells. As a result, most physicians will not prescribe hormone replacement therapy to women who, like Suzanne, have been diagnosed with breast cancer, for fear that the exogenous estrogen would cause any cancer cells still remaining in the body to proliferate and metastasize. Researchers also point to the fact that women who have had breast cancer and take aromatase inhibitors, which reduce estrogen biosynthesis in the body, show a decreased risk of breast cancer recurrence.

As is the case in so many areas of medicine, the relationship between hormone replacement and breast cancer recurrence is not as clear as might seem at first glance. Those who advocate bioidentical hormone replacement—even for women like Suzanne who have had breast cancer—point to other studies that have found no statistically increased risk of cancer recurrence in women who had breast cancer and then took hormone replacement therapy.15 Couple this with the dearth of studies at any level on the relationship between bioidentical hormone replacement therapy and breast cancer, and it is easy to see why this issue is likely to remain unresolved for some time to come.

Timely Book, Timely Subject
The Sexy Years is a superbly written book by an intelligent, informed woman who has taken control of her health in order to live life to the fullest. It clearly describes how both women and men can use bioidentical hormone replacement therapy to combat the many signs and symptoms of aging. Suzanne’s use of physician interviews gives the book an authoritative air to bolster its claims, and her discussions with women of different ages and backgrounds who are starting, going through, or have finished menopause gives the book an intimate touch.

In addition to its in-depth examination of bioidentical hormone replacement, the book details the importance of using supplements, including antioxidants, coenzyme Q10, and omega-3 fatty acids, to maintain optimal health. Suzanne also speaks to the vital importance of keeping a healthy psychological outlook on aging, which she encapsulates quite wonderfully in just a few sentences:

“As we approach middle age, we gain a whole new perspective on who we are in the world. We may not be the youngest, hottest babes in the room anymore, but what we have lost in this area we have gained in wisdom and confidence. . . once you figure this out, you’ll start having more fun than ever before.”

References

1. Francisco L. Is bio-identical hormone therapy fact or fairy tale? Nurse Pract. 2003 Jul;28(7 Pt 1):39-44.

2. Davis S. Androgen replacement in women: A commentary. J Clin Endocrinol Metab. 1999 Jun;84(6):1886-91.

3. Zhou J, Ng S, Adesanya-Famuiya O, Anderson K, Bondy CA. Testosterone inhibits extrogen-induced mammary epithelial proliferation and suppresses estrogen receptor expression. FASEB J. 2000 Sep;14(12):1725-30.

4. Dimitrakakis C, Zhou J, Wang J, et al. A physiologic role for testosterone in limiting estrogenic stimulation of the breast. Menopause. 2003 Jul;10(4): 292-8.

5. Anawalt BD, Merriam GR. Neuroendocrine aging in men. Endocrinol Metab Clin. 2001 Sep;30(3):647-69.

6. Morley JE, Perry HM, Kaiser FE, et al. Effects of testosterone replacement therapy in old hypogonadal males: a preliminary study. J Am Geri Soc. 1993 Feb;41(2):149-52.

7. Hajjar RR, Kaiser FE, Morley JE. Outcomes of long-term testosterone replacement therapy in older hypogonadal males. J Clin Endocrinol Metab. 1997 Nov;82(11):3793-96.

8. Wang C, Swedloff RS, Iranmanesh A, et al. Transdermal testosterone gel improves sexu- al function, mood, muscle strength and body composition parameters in hypogonadal-men. J Clin Endocrinol Metab. 2000 Aug;85(8):2839-53.

9. Marin P, Holmang S, Gustafsson C, et al. Androgen treatment of abdominally obese men. Obesity Res. 1993 Jul;1(4):245-8.

10. Ellyin FM. The long term beneficial treatment of low dose testosterone in the aging male. Proc 77th Meeting of The Endocrine Soc., Washington, DC, 1995;2-127.

11. Snyder PJ, Peachey H, Hannoush P, et al. Effects of testosterone treatment on bone mineral density in men over 65 years old. J Clin Endocrinol Metab. 1999 Jun;84(6): 1966-72.

12. Urban RJ, Bodenburg YH, Gilkison C, et al. Testosterone administration in elderly men increases skeletal muscle strength and protein synthesis. Am J Physiol. 1995 Nov;269(5 Pt 1):820-6.

13. Beral V. Breast cancer and hormone-replacment therapy in the Million Women Study. Lancet. 2003 Aug 9;362(9382):419-27.

14. Chlebowski RT, Hendrix SL, Langer RD, et al. Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women’s Health Initiative randomized trial. JAMA. 2003 Jun 25;289(4):3243-53.

15. Lea R, Bannister E, Case A, et al. Use of hormonal replacement therapy after treatment of breast cancer. J Obstet Gynaecol Can. 2004 Jan;26(1):46-60.