Why a Butch Needs Estrogen and a Femme Needs Testosterone

We need a good balance of sex hormones for a lot more than sex. Unfortunately, many factors can cause our bodies’ production of hormones to decrease, increase, or become imbalanced. Natural aging, genetics, diet and environmental toxicity can all contribute to this situation, but there are things we can do about all of it!

Estrogen is important for the maintenance of our libido, but also the elasticity of our skin (it’s what keeps our skin looking young!), cardiovascular and bone health, and the functioning of our brains. Many women find that menopause brings brain fog and forgetfulness, and I have often seen those symptoms rapidly improve with estrogen replacement. Estrogen has also been shown to help prevent Alzheimer’s disease in the female brain (interestingly, in male brains, testosterone has the same effect!).

Additionally, many vaginal/urinary symptoms, especially post-menopausal dryness, incontinence, and pain or bleeding with sexual activity, can respond quickly to a low-dose estrogen cream. When applied topically, bio-identical estrogen carries none of the risks of oral synthetic estrogen replacement.

Progesterone is needed not just for pregnancy, but also, importantly, to counterbalance estrogen. In this age of environmental toxicity with xeno-estrogens all around us (in everything from plastic water bottles to hand sanitizers), many of us become estrogen dominant, where our ratio of estrogen to progesterone is weighted too heavily towards the estrogens. Estrogen dominance is associated with increased long-term risks of breast, uterine and ovarian cancer, and is one reason that many conventionally-trained doctors are afraid of estrogen replacement therapies after menopause. However, we see that when Progesterone is also given to keep estrogen in a proper ratio to Progesterone, these cancer risks do not materialize.

Progesterone is also very important for sleep. Many women find that menopause brings insomnia, and this is correlated to our bodies’ dropping progesterone levels. For these women, adding a progesterone pill before bed can make all the difference in sleep. For younger women who may be making too much estrogen but not enough progesterone, we can work with herbs and diet to help rebalance the ratio, and/or add a progesterone pill during the second half of the menstrual cycle.

Testosterone can have a huge effect on libido, but also on energy levels in general, muscle mass and fat-to-muscle ratio, and the strength of our bones. When testosterone gets low, as is most common after menopause, all of these areas can suffer. Testosterone also helps to strengthen tissues in general, and vaginal application of low-dose testosterone can be a big help with pain and bleeding associated with sexual activity.

Testosterone can also get too high, more commonly in pre-menopausal women, and can cause symptoms such as acne, increased hair growth on the face and body, and hair loss on the top of the head. If this is something you’d like to change, it is important to look at the reasons for the excess production, as these can be addressed from the root cause, in addition to using herbs or medications to lower the hormonal production.

Trans women have their own unique concerns but overall approaches to hormonal balancing can actually be surprisingly similar for Trans and Cis women. This is a topic I will be elaborating upon further in a future post.

Dr. Rebeccah Shalev specializes in a whole-body approach to hormonal balancing. In addition to treating conditions such as menopause, PMS and PCOS, she rocks at hypothyroidism and insulin resistance! Using Naturopathic and Functional Medicine, she can help find the root cause(s), and help you to correct the imbalance. She uses advanced labwork, herbs, homeopathy, dietary and lifestyle counseling, detoxification, bio-identical hormone replacement (BHRT), glandular support (e.g., Natural Dessicated Thyroid), and/or pharmaceutical interventions, and can tailor her approach to your preferences. She is currently accepting new patients at Labrys Healthcare Circle. Call 510-859-8460 for appointments with Dr. Shalev.