Your Brain On... Testosterone

Ayesha Sherzai (0:00)

There's a hormone that midlife women are being told they're missing, that it drained away at menopause, that it's the reason for the brain fog, the exhaustion, the weight that won't shift, that flat feeling that something's just off. And the fix, they're told, is simple. Get your levels checked, get a prescription, get it back. I'm a neurologist. I hear this in my clinic almost every week. A woman comes in with a video open on her phone and a question in her eyes. Should I be on testosterone? So I went to the one person I'd actually trust to answer that. Not an influencer or someone not reading the science and looking at the bigger picture. A scientist who's spent more than 30 years measuring this hormone in women's bodies and who's become one of the most important voices pushing back on the hype. Some of it might surprise you. And some of it might save you a lot of money and a lot of worry. This is Your Brain On Testosterone.

Welcome to Your Brain On Podcast. I'm Dr. Ayesha Sherzai, one of the hosts along with my brilliant partner, Dean Sherzai. I'm a neurologist and I spend my days studying how the choices we make every day shapes the aging brain and my time in clinic with women asking real questions about their bodies and about their minds. And lately, one question comes up more than almost any other, testosterone. If you've been anywhere near social media, you've heard the pitch. Testosterone is a hormone women lose at menopause. It sharpens your thinking. It builds muscle. It protects your brain. It melts fat. It brings back your energy. Every woman should be on it and any doctor who won't prescribe it is just behind the times or doesn't care enough about you. That's a lot of promises for one hormone. So today we're going to do what this show always does. We're going to sort out what the evidence actually supports from what's just being sold to you. My guest is Professor Susan Davis of Monash University in Melbourne. She's a consulting endocrinologist, a brilliant scientist and runs one of the world's leading women's health research program. She actually helped write the global guidelines that doctors use around the world. And she's been studying testosterone in women since the 1990s long before it was a trend. So when she tells you what the evidence shows, understand this.

In a lot of cases, she's the one who gathered the data. One quick thing before we start. Nothing here is medical advice for you personally. If you're wondering whether testosterone is right for you, this episode will help you ask sharper questions. But the real conversation is always between you and your doctor. This is just for educational purposes. Let's get into it.

Dr. Davis, I'm so grateful for your work. Testosterone for women is a topic that is being brought up over and over again, and the social media is completely overwhelmed and saturated with different products and different kind of messages from different people. So it's a pretty confusing area to be in, and I wanted to take this opportunity to ask you some questions because you've done a lot of research in this field, and also help our audience understand what they need to do to take care of themselves. So the first question that I have for you is something that I keep hearing on social media, and it goes something like this. Menopause influencers say that women make testosterone, and they say that for much of our life, we actually carry more testosterone in our blood than estrogen, and that most people don't have an idea about that.

What is testosterone and what is it actually doing in a woman's body every day?

Susan Davis (3:40)

Women don't have more testosterone than estrogen in their body. In the big studies, when we've measured estrodial and testosterone in premenopausal women, then the levels are about similar. Then if you look at estrone, which is another major estrogen in women, we see equal amounts of estrodial, so that's double the amount of testosterone that's in the circulation. So the main estrogen we talk about for women, estrodial, there's estrone sulfate, and these are the three big circulating ones. So the belief that women's body, women have more testosterone, the estrogen is probably mythology, women have more estrogen than testosterone.

Ayesha Sherzai (4:18)

And you've spent decades understanding this hormone and studying it in women's body at a time when most research assumed that testosterone was really a man's issue. What made you go into the field and what were some of the things that you found out were not being addressed initially?