Menopause with high testosterone

by JH
(AZ)

Hi, I was lead here because I am in menopause and started bio-identical hrt, and within a week I started a period (it's been 2 years). I am looking for another way to help horrible menopause symptoms.

Reading about only taking progesterone is intriguing however not finding anything about those who have high testosterone like I do. I have high testosterone and low estrogen and progesterone on blood testing prior to starting bio hrt. I have a history of high testosterone being younger but did not realize after all the years is still high. I had to stop the bio hrt because of the bleeding off the bat, I am not willing to do that anymore.

My question is how would going on only progesterone affect the high testosterone? Will it help balance that out or antagonize it?

Thank you

Comments for Menopause with high testosterone

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Jun 20, 2021
Menopause and high Testosterone
by: Joy

Hi JH

As you most probably have read, a missed period for 12 months puts one in Menopause. It is not uncommon for a woman to experience a bleed or two during menopause, any more than that you need to ask questions.  The HRT that you were using probably caused this, but it can happen when one uses progesterone only but, as mentioned, this can happen one or twice.
 
High testosterone levels usually start at the onset of Peri-Menopause and Menopause.  Progesterone only will certainly help.

A bit about testosterone.  Each month women make more testosterone than estrogen, but most of it is converted to estrogen by the enzyme aromatase. This also occurs in men too, but to a far lesser extent. When first starting progesterone, or using too little it stimulates testosterone production, followed by it's conversion to estrogen. High testosterone also causes severe PMS. If bound to SHBG (sex hormone binding globulin) testosterone becomes inactive, progesterone raises levels of SHBG, see here, so preventing the rise of free testosterone and severe PMS.  It also causes visceral fat to increase, which causes weight gain on the abdomen, see here and here. Plus heart disease and cancer in women too. It would appear your aromatase is not sufficient to convert the testosterone, has anyone checked this? High amounts of progesterone will suppress the testosterone by increasing levels of SHBG. It might be an idea for now to avoid all foods high in carbs, i.e. all grains, legumes, processed milk and sweet starchy fruits and vegetables. Fructose, sucrose and glucose, reduce SHBG by 80, 50 and 40% respectively, see here. Thereby allowing testosterone to rise. And to avoid alcohol as it affects hormone levels in women, see here and here. It decreases progesterone levels and increases androgen levels, both the total testosterone and free testosterone become higher. Once your level has come down you should be able to eat and drink these again. 

Usually between 100-200mg progesterone cream is needed per day.  Use a good quality progesterone cream such as Natpro which is a 3% cream.  Use half in the morning and the other half at night.  You may need to experiment with the amount, you may need to use more.  Everyone is different, so please experiment.  You can always reduce the amount of cream once things become stable. Never use less than 100mg progesterone cream a day.  Please read the How to use Progesterone Cream and Estrogen Dominance pages.      

Vitamin D3 is vital, not only does it reduce the benefits of progesterone but D3 and the co-factors are so important to help fight this dreaded COVID-19 virus that we are all faced with.

Jun 22, 2021
Hi Joy!
by: JH

So nice to meet you, thank you for your help!

The testosterone being high was also something they found in my younger years, because of PMS and severe adult acne, so was not a surprise to hear it on my blood work for pre-hrt treatment.

Here are all the results it includes the shbg: dhea sulfate 164, estradiol 17.34,fsh 76.3,free t4 1.43,oh 63.1, progesterone 0.22,shbg 68, testosterone free 4.54, testosterone total 41.5,TSH 2.34

Thank you for all this great information, I am excited to learn more about all of this. I will be going through all the links, but do have this follow up question. Once the progesterone cream stabilizes my testosterone and other things in me, would there be a time I would add estrogen or the biest back in, does it ever become necessary?

Jun 23, 2021
Hi Joy
by: Joy

Hi JH

Such a pity that they didn't sort out your high T level when you were younger.  You can compare your test results as seen on our Hormone Testing page.

As for adding estrogen, you know my thoughts on this, I do not believe that any woman needs it as it is there are well over 100 estrogen mimics in our Environment as it is, why take more?  However, that is your choice, but by adding estrogen one would always remain in a state of estrogen dominance, unless you use a huge amount of progesterone to counteract that.

Take care.

Jun 23, 2021
making sense finally!
by: JH

I was tried on spriolactalone and had bad reactions to it, bottomed out my already low BP, and the birth control pills only added to the symptoms. I guess I am now finally understanding why because morestrogen was in the bcp. And now with hrt with biebuest I am having the PMS and heavy period problems again. Do you have any advice on other high T treatment options besides just adding the progesterone cream?

Thank you for your expertise and help here, I am so lucky I found this site!!

Jun 24, 2021
question about starting natpro progesterone cream
by: JH

If I may ask one more question, I am doing some reading on the how to take progesterone page and since I am in menopause with a high testosterone and possible estrogen dominance what dose of the cream should I start at?
Also appreciate any other treatment advice for the high T
Thanks so much!

Jun 26, 2021
Making sense finally etc etc
by: Joy

Hi JH

I'll answer all your latest posts here.

I have already advised how much to use in my reply to you further up.

I am so glad that you are off spiro, it's not good for a person. For a start, it does come with a cancer warning see here plus there are other side effects, too many to post here but here is one, see here. I am sure that you can do further research yourself or just type spiro in the search bar above.  

My advice to help lower your T level is to balance your hormones with the correct use of progesterone, Vitamin D3 etc.  Chuck any estrogen that you may have in the garbage can and try to avoid as many estrogen mimics as you can, difficult I know, but try to cut back or eliminate plastics!  It's essential to avoid all sugars, even those hidden in grains, legumes and sweet, starchy fruit and veggies. Progesterone raises SHBG substantially, which causes testosterone to drop, see here. That should help greatly to lower your T level.

Jun 26, 2021
Thank you!!
by: JH

Thank you Joy for all your great knowledge and help , I am so grateful to have found you and this web site!! A great big veil has been lifted for many of us lost women, thanks to you and Wray, many blessings to you both!!

Jun 29, 2021
Thank you
by: Joy

Hi JH

Many thanks for your kind words. If you use progesterone correctly, it will work.

Take care.

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