@Dr. Deborah Matthew : 我是美国快乐荷尔蒙医生黛博拉·马修博士。女性体内也含有睾酮，其含量有时甚至高达雌激素的10倍。睾酮对女性的性健康、肌肉骨骼健康和整体感觉至关重要。低睾酮水平会导致性欲下降、肌肉无力、骨质疏松、情绪低落、缺乏动力等问题。服用避孕药、压力过大以及年龄增长都会导致睾酮水平下降。压力会导致皮质醇水平升高，从而抑制睾酮的产生。解决低睾酮问题不应直接进行睾酮替代疗法，而应先解决潜在的压力因素，以恢复身体平衡。我们可以通过运动、压力管理技巧、冥想等方法来管理压力。肾上腺除了产生皮质醇，还产生脱氢表雄酮 (DHEA)，它是睾酮的前体激素。补充DHEA可以帮助身体自然产生更多的睾酮。对于更年期妇女，可能还需要睾酮替代疗法。充足的睡眠、营养均衡的饮食（包括足够的蛋白质和健康脂肪）、减少环境毒素暴露等，都有助于维持正常的睾酮水平。
我是凯蒂，来自wellnessmama.com。最近，我有幸与美国快乐荷尔蒙医生黛博拉·马修博士（Dr. Deborah Matthew）进行了一次深入的访谈，主题是女性睾酮。这次对话让我对女性荷尔蒙，特别是睾酮，有了全新的认识，也让我意识到，许多女性可能低估了睾酮对自身健康的重要性。
黛博拉博士首先指出一个令人惊讶的事实：女性体内也含有睾酮，其含量有时甚至高达雌激素的10倍。这颠覆了我们通常认为睾酮是“男性荷尔蒙”的认知。事实上，睾酮对女性的健康至关重要，它影响着三个主要方面：
是什么导致女性睾酮水平下降？
黛博拉博士强调了几个关键因素：
如何解决低睾酮问题？
黛博拉博士强调，解决低睾酮问题不能简单地依靠睾酮替代疗法。首先，我们需要找出导致睾酮水平下降的根本原因。 如果问题源于压力，那么解决方法应该是管理压力，而不是直接补充睾酮。
她建议采取以下方法来管理压力：
此外，黛博拉博士还提到了脱氢表雄酮 (DHEA) 的作用。DHEA是睾酮的前体激素，肾上腺会产生DHEA。当压力过大时，肾上腺会优先产生皮质醇，从而减少DHEA的产生，最终导致睾酮水平下降。补充DHEA可以帮助身体自然产生更多的睾酮，尤其对年轻女性有效。
对于更年期女性，由于卵巢功能衰退，可能需要考虑睾酮替代疗法。
其他影响睾酮水平的因素：
除了压力，以下因素也会影响睾酮水平：
如何进行睾酮检测？
通常通过血液检测来测量总睾酮和游离睾酮水平。黛博拉博士建议，如果女性睾酮水平低于20，并且伴有低睾酮相关的症状，就应该积极寻求解决方法。
结论：
女性睾酮并非可有可无，它对女性的性健康、肌肉骨骼健康和整体感觉都至关重要。 解决低睾酮问题需要一个多方面的方法，包括管理压力、补充DHEA（如有必要）、保持健康的生活方式以及均衡的饮食。 如果出现相关症状，建议咨询医生进行专业的评估和治疗。 不要忽视你身体发出的信号！
The Wellness Mama Podcast⋅18h ago
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05:45 女性体内也含有睾酮，其含量有时甚至高达雌激素的10倍，对女性的性健康、肌肉骨骼健康和整体感觉至关重要。
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07:06 睾酮水平低会影响女性的性欲、唤起、敏感度和性高潮等方面。
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07:28 服用避孕药会降低睾酮水平，这可能是导致性欲下降的原因之一。
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09:11 压力和皮质醇水平升高会降低睾酮水平，从而影响性欲和整体感觉。
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10:52 解决低睾酮问题不应直接进行睾酮替代疗法，而应先解决潜在的压力因素，以恢复身体平衡。
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11:17 长期压力会导致皮质醇水平持续升高，最终影响其他激素的平衡，包括睾酮。
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14:37 如果只补充睾酮而不解决压力问题，睾酮补充疗法的效果可能不会最佳。
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15:06 在进行激素治疗前，应先找出激素失衡的原因，例如压力，并采取相应的措施。
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16:42 睾酮有助于维持肌肉和骨骼健康，随着年龄增长和睾酮水平下降，肌肉和骨骼会逐渐流失。
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18:17 睾酮影响女性的情绪和精力，低睾酮水平会导致情绪低落、缺乏动力、难以做决定等问题。
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33:08 改善低睾酮水平的第一步是管理压力，可以通过运动、压力管理技巧、冥想等方法来实现。
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34:28 肾上腺除了产生皮质醇，还产生脱氢表雄酮 (DHEA)，它是睾酮的前体激素。压力会抑制DHEA的产生，从而间接影响睾酮水平。
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35:42 补充DHEA可以帮助身体自然产生更多的睾酮，但对于更年期妇女，可能还需要睾酮替代疗法。
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37:05 充足的睡眠、营养均衡的饮食（包括足够的蛋白质和健康脂肪）、减少环境毒素暴露等，都有助于维持正常的睾酮水平。
00:01
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00:47
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01:14
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01:47
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02:09
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02:36
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02:50
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Hello and welcome to the Wellness Mama podcast. I'm Katie from wellnessmama.com and this episode goes deep on the topic of testosterone for women and specifically what to know, when to test, and ways to optimize with or without hormones, as well as confounding factors that might influence the results that you get and what to know about that. And I'm here with Dr. Deb Matthew, who is America's Happy Hormones Doctor, as well as a best-selling author, international speaker, educator, and a wife and mom of over 语法解析
04:37
four boys. After suffering for years with hormone-related issues herself, she developed a system to help resolve this for women all around the world, and she goes deep on this today specific to testosterone. Also stay tuned because we will have a second conversation diving deep on other hormones and what to know if you're navigating testing. 语法解析
04:55
Dr. Deb, welcome. Thank you so much for being here. I'm so excited to be here. Thanks for having me. Well, I'm excited too, and I'm excited to learn from you in this conversation because we're going to get to dive into a topic that I think is really relevant for a lot of listeners, even if we don't realize it's relevant, which is the topic of testosterone for women, because certainly it seems we hear a lot about this related to men. 语法解析
05:17
And it sounds like there's a lot that women can understand that can be really helpful when it comes to the topic of testosterone. So for anyone who's not as familiar with this in the context of for women, can you walk us into why is testosterone important for women? Yeah, well, of course we think about it for men, but women are usually really surprised to know that we have testosterone too. And in fact, we have sometimes up to 10 times more testosterone than estrogen. 语法解析
05:45
It's just that men have a lot more testosterone than women do. But testosterone is really not a male hormone. It's an everybody hormone. And it's really, really important for women for kind of three main categories of things. It's really important for our sexual health. It's really important for keeping our muscles and bones strong. And it's really, really important for how we feel. And so I'd love to be able to dive into all three of those. 语法解析
06:10
I love it. Yeah, let's go deep on each of those because I would guess if people are familiar with testosterone, they are likely aware that there is a connection to sexual health. And I know it goes far beyond that. But maybe let's start there because one thing I do hear from women, especially in the perimenopause age, is that they can encounter some either dips in libido or just changes in their sexual health. And it seems like there's not a lot of consistently great advice out there when people go looking. So let's talk about testosterone and sexual health. Yeah. Okay. 语法解析
06:38
So maybe if we can sort of define a few things first, like libido, what most people mean when they talk about that is the desire, like the idea popping into your head in the first place, like caring about it. And then there comes the arousal and the sensitivity and eventually ultimately having an orgasm. All of those things can be diminished if testosterone is low. But the most common thing that I hear women talk about is the desire really goes down. 语法解析
07:06
And testosterone is very important for all of those things. But we want to talk about more than just what is your testosterone level, because there's all kinds of factors that impact the testosterone. So when we're talking about testosterone, I want to make it really clear. We're not jumping straight to if there's a problem here, you need testosterone replacement. What a lot of women are not aware of is birth control pill. 语法解析
07:28
pills lower testosterone. That's an important part of what they do. And in fact, a lot of times we use testosterone on purpose for that result. So when women have a lot of acne, facial hair, especially women who have something called PCOS, which is a hormone imbalance, we give them birth control pills on purpose because it lowers testosterone and that can help them clear up their skin. It can help minimize, you know, if you've got hair growth on your face and places where you don't want it. 语法解析
07:53
And so if those are your problems, then the birth control pill lowering testosterone can actually be a good thing. But testosterone, because it's so important for our sexual health, it can really dampen your libido. And I had no idea about this. I was on birth control pills for, I don't know, a couple of decades. And 语法解析
08:14
This was really true for me. And there were a lot of things going on at the same time that I think this is a problem for a lot of women. No idea that it had to do with my hormones. I was tired all the time. I have four little kids. And when I'd go pick them up in the afternoon for carpool, I'd have to have a cup of tea before I went because I needed the caffeine. Otherwise, I'd fall asleep at the carpool lane. You know, I was exhausted. I was struggling with my weight. I was cold all the time. But what I didn't know is that my adrenals were shot. 语法解析
08:43
And your adrenal glands, of course, make cortisol. And cortisol is your main stress hormone that helps you cope with stress. But one of the things that happens when you are stressed and your adrenal glands are affected is that it can lower testosterone levels. And it makes us feel different. It can make us feel tired. Of course, it takes out our libido. So stress is the thing that stresses out our adrenal glands. And that's what lowers our testosterone level. So we don't quite feel the same when testosterone is low. And 语法解析
09:11
When women lose interest and lose desire, it can have significant impacts on relationships, on families. You know, that's an important bond in a relationship. And so when that sort of goes down, when the intimacy goes down, we feel better. 语法解析
09:26
sometimes guilty about it. Sometimes it hurts our partner's feeling. They feel like it's them, you know, that we're not attracted to them anymore. But, you know, if your hormones are out of whack, then the feelings aren't there. It doesn't feel the same. The desire is not there and has nothing to do with your partner. And it's you, but it's not your fault. It's the sum total of 语法解析
09:48
the stress, maybe you're on birth control pills or there are other medications that can do this too. And then of course, as we enter into perimenopause and our ovaries are less reliable, they're not doing their job as well, testosterone levels can start to trickle down as well. So if your libido has gone out the window, thinking about testosterone, I think is a really important piece if we're trying to get you back to feeling really, you know, back to normal again. 语法解析
10:14
That makes sense. And I'd love to go a little deep on the cortisol and adrenal connection, because I do feel like this topic is starting to get talked about more, especially for women. And we know in the modern world, a lot of women are balancing a lot more than in previous generations we have, and that a lot of us don't necessarily want any of those things to go away. However, like, as you said, stress directly impacts hormones. And seemingly then, 语法解析
10:37
Just based on what you said, it would seem like the solution is not just going straight to testosterone replacement, but to address those underlying factors so our body can come into more of a state of balance. But I would love you to dive deep on that because I do feel like that is especially relevant to women today. 语法解析
10:52
Absolutely. Okay, so when we're stressed and cortisol goes up, it's to help our bodies cope with stress. So blood flows to our muscles so that we can run for our life if we're in danger. All these important things are happening. But when we have chronic stress day in and day out, we're stuck in traffic and all of that chronic stress can cause our cortisol levels to become chronically elevated. And over time, we can't maintain all that chronic stress. 语法解析
11:17
cortisol output. Sometimes it even drops inappropriately and now our cortisol is low and it's not enough even to help us kind of get through our day. So whatever is going on with cortisol on that spectrum from you're making too much to you're burned out and you don't have enough anymore, it's really impactful to the rest of our hormones because cortisol is a regulating hormone. It regulates our sleep-wake cycle so that we have lots of energy in the day and we can sleep soundly at night. 语法解析
11:44
It's really important for regulating our blood sugar and our blood pressure. But really pertinent for the conversation today is that cortisol is important for regulating all of our other hormones. So when cortisol is out of whack, it doesn't just shut down testosterone, it shuts down progesterone so that we get menstrual problems and PMS and anxiety and we don't sleep. It can inhibit ovulation so now we get 语法解析
12:08
issues. It can interfere with how our thyroid functions. And it's not that it makes it so that your thyroid gland doesn't work. It makes it so you can't activate your thyroid hormone into the T3 thyroid hormone we need. So then it feels like you're low thyroid. But when you go to the doctor to get your thyroid lab tested, the screening test looks normal and you're just told everything's fine. So 语法解析
12:28
So it also interferes with insulin, which is the one that regulates our blood sugar and it pushes you towards prediabetes and weight gain. So it's such an important regulatory hormone. And the thing that's setting it out of whack in the first place is our chronic stress. 语法解析
12:45
And I think it's important to say, too, when I'm saying stress, of course, I'm talking about all the things that we're well aware of. We're busy. We're worried. We've got, you know, a million things on our to-do list. We've got our kids are yelling and the spaghetti is boiling over on the stove, like all the stress that we know about. But we also have to include here stress like urinary tract infections or allergies or not sleeping soundly, like physiologic things that are going on in our body that 语法解析
13:11
those count as stress as well. And they all add up together. And then the end result is our poor adrenal glands, which make cortisol for us. They get overworked. They don't do a great job. And we don't feel as good as we could feel. And libido is one of the first things to go down the drain. Because if you imagine, right, in our body's infinite wisdom, if our body thinks that 语法解析
13:31
you know, that there's a very difficult time going on, that's not really the best time to appropriate. And so it sort of shuts those things down. And so libido is out the window. Yeah, I love the way you explain that and talking about cortisol being a regulating hormone and how much it relates to everything else. And also that piece, I think, is really important of it's not just when we mentally feel stressed, because I've talked a lot about, you know, what's in our environment, the things we're coming in contact with on a daily basis. 语法解析
13:56
Even if we don't emotionally feel stressed, our body might be interpreting that as a stress signal. And so that's a great reminder to like audit kind of the personal care products we're using and the things we're coming in contact with and making sure our diet is nutrient dense enough. But I also think this seems really important because 语法解析
14:12
with this cortisol piece, it feels like this could be the missing piece and why perhaps even women who supplement with testosterone or like are given exogenous testosterone, if they're not addressing that cortisol piece, I would guess it's still not necessarily going to be as effective because your body's still in that cortisol cycle. But is that accurate? Is like, even if we were to take the hormones without addressing the stress factor, it wouldn't necessarily work as well as it could or should? Exactly. And you know, 语法解析
14:37
I remember one time in a Facebook group, there was a 21-year-old woman who, it was a Facebook group about hormones, and she was writing in to say, like, I had low libido. I didn't feel great. I went to my doctor or, you know, she went to a hormone clinic, I guess, and they gave her some testosterone and she's not feeling better and she's confused because they gave her the testosterone and it's not helping. So the first thing that I would say is if you're 21 years old and you don't feel good, it's fine to have your hormones tested. But if your hormone levels are low, we want to know why. 语法解析
15:06
that's not perimenopause. So whenever somebody is having a problem with hormones, the first we want to define is that the problem, is it a hormone issue? But then the very next question we want to ask is why? And so if the why is because you're very stressed, then the treatment isn't give you more hormones, it's help you find healthy ways of coping with stress to help protect your body from the harmful effects of stress. We can't make all the stress go away, but if we can help you to have 语法解析
15:33
healthier ways of buffering the effects of stress on your body, then the rest of the hormones can kind of just get back to doing their thing. So I think that stress is a really, really important cause of hormone imbalances. And it's really important for women to know that this is something, this is exciting, this is empowering to know that 语法解析
15:52
there are things that you can do for yourself in order to try to help get your hormones back into balance. And the younger you are, the more likely it is that some external factors are knocking your hormones out of whack. So if you're 55 and your ovaries are done, well, that's a different story. But if you're 25, 35, even if you're 45, there's still a lot of things that we can do in order to help bring hormones back into balance. 语法解析
16:17
And I definitely want to get into solutions and kind of root cause things to work on. But before we get there, though, can we touch on the other things related to testosterone that you mentioned, the bones and then like how we feel and our energy? Yeah, I think this is really, really important because when you're younger, testosterone is part of what helps you to maintain your muscle, your muscles, your strength, your skin tone and your bone health. So it helps to maintain your physical body. 语法解析
16:42
As we age and our testosterone levels go down, we gradually lose bone density. So our bones get more brittle so that they break when we fall down. We gradually lose our muscle mass. So we become weaker. Also, because muscle drives our metabolic rate, we burn less calories even at rest. And so our metabolism slows down. That's one of the reasons that as women get older, it gets harder to maintain their weight. They tend to get less muscle and more body fat. 语法解析
17:09
But basically, testosterone prevents frailty. And we're not thinking about that when we're younger because we're not frail. 语法解析
17:16
frail now, but healthy testosterone levels are healthy to have a good starting point. You want to have good, strong, healthy muscles and bones when you're young so that as they are gradually diminishing with time, you've started off from a good, healthy place. And testosterone, while it helps to maintain your muscle mass, we still need to be eating enough protein in our diet. We still need to be doing resistance exercise, muscle building exercise in order to build up our muscles. But 语法解析
17:44
But when testosterone levels go down for whatever reason, birth control pills, stress, perimenopause, whatever, you know, toxins in the environment is another one that gets in the way of how our hormones function. But what women often notice is that the muscle tone goes down. Even if they are trying to build muscle, they're just not seeing the results that they get. They just don't see the shape anymore. So that's an important thing to know about. 语法解析
18:08
And then the other one that is so, so important and so not known about is how testosterone makes us feel. 语法解析
18:17
I heard another practitioner on another podcast one time call testosterone our CEO hormone. And I love that because testosterone is the hormone that gives us confidence, self-esteem, motivation, get up and go, be efficient, get things accomplished, make decisions, like self-esteem. It helps us to feel strong and resilient on the inside. 语法解析
18:41
And so when our testosterone levels go down, how women describe themselves as feeling is just kind of flat, kind of blah, like not necessarily sobbing and hopeless in the corner like a full-blown depression, but just this… 语法解析
18:56
They've lost the zest. And so they'll find that they're kind of putting one foot in front of the other and making their way through the day. And they're kind of just going through the motions. So whatever has to happen today, you'll make it happen, right? You have to get food on the table. You have to get the groceries unloaded when you get home, you know, get the food in the freezer. But if it doesn't have to happen today, a lot of times we just kind of procrastinate because we're not really feeling it. Like, 语法解析
19:21
The laundry sits in the laundry basket and maybe the box of crackers sits on the counter and doesn't quite make it into the pantry. The projects that we imagine we'd love to do for our kids, they don't get done. Or we'd love to go out. We used to love to socialize with our friends and go out and do things. And now we're sort of like, eh, just rather sit home and watch Netflix. And we worry more. We second guess ourselves. It's harder to make decisions. Like, 语法解析
19:46
We just don't quite feel the same. And how women often describe it is, I just don't feel like myself. Like something's wrong. I've had women come in and say, like, I just want Lori back. Like, this isn't me. And more often than not, they have no idea that it's their hormones that have anything to do with it. They think, of course, I'm tired. I'm a mom. I've got kids. Or of course, I'm tired. I've got a job and it's busy. And we sort of write it off to like, why can't I be more self-disciplined? 语法解析
20:15
Like, why do I feel so lazy? Like, we look for reasons within ourselves to sort of blame ourselves for why we're not behaving the way that we wish we would be. But it's a hormone problem a lot of the times. And so if we can just get your hormones balanced, you can just feel like yourself again, get that zip back in your step. 语法解析
20:34
Well, I know we're going to get to talk about testing because that's, I'm sure, the way to know exactly what's going on with your hormones. But before we get to that, I would love to also, can you run us through a list of symptoms that kind of are right on track for low testosterone and or I would guess it's not as common, but for high testosterone as well? 语法解析
20:53
Okay, so for low testosterone, some of the common things that we see is sort of less muscle tone or feeling like you're not as strong as you used to be or not having the results that you're looking for at the gym. So we're not talking about like the women who take testosterone injections to become big, muscly bodybuilders, but just to be normal. So that sort of changes. 语法解析
21:14
Skin can change so we can get more like saggy, jowly kind of skin because testosterone is important for skin tone so it can age our skin when it's slow. Testosterone is important for hair growth. So too much testosterone can be too much hair growth. It can be hair growing where you don't want it, you know, on your face, around the nipples, you know, too much body hair. 语法解析
21:36
But if testosterone is low, hair growth goes down. So you might notice that you have less hair on your arms and legs, even less pubic hair than you used to. So nobody complains about that, right? Nobody comes in to say, oh, I don't really have to wax my mustache anymore. But it's just a clue. If you've noticed that something has significantly changed, it could be a sign that something different with testosterone. So 语法解析
21:57
So the low libido, mostly the desire goes downhill, but sensitivity, arousal, and lubrication is really important. Testosterone kind of puts oil and lubrication to our tissues so we can have more vaginal dryness. Vaginal dryness doesn't only have to do with estrogen. Testosterone is really important, especially if you're premenopausal, your estrogen might be fine. But if you're testosterone low, you can still have vaginal dryness. 语法解析
22:22
And the estrogen, if you take estrogen, it might not fix the problem because you're fixing the wrong problem. But it also puts lubrication in our eyes so you can have more dry eyes. It puts oil to our hair so your hair gets dry. Of course, if you have too much testosterone, your hair can get oily. Same thing with your skin. Not enough testosterone, you can be dry. Too much testosterone, you can have oily skin and acne breakouts, especially along the jawline is kind of typical for if acne is hormonally related. 语法解析
22:50
Low testosterone goes along with flat mood, lack of motivation, just kind of feeling sort of blah. You lose that competitive drive, feeling more tired. And then even menstrual problems, migraines, you know, there's a whole battery of symptoms. The too much testosterone symptoms would be the acne, oily skin, oily hair, hair growing in the places where we don't want it. 语法解析
23:16
If it gets bad enough, even sometimes can cause a little bit of hair loss, especially sort of at the temples. And there's a specific condition that gets… 语法解析
23:27
where people get too much testosterone, and that's called PCOS, polycystic ovarian syndrome. And this is a condition that goes along with having insulin problems, even pre-diabetes. And you can have cysts on your ovaries, but you may not have any symptoms. You may not have that or know about that, but it goes along with the 语法解析
23:46
oily skin, oily hair, acne pimples, struggling a lot of times with your weight, although you do not have to have a weight problem for this to be an issue, and often irregular periods. So skipped periods, heavy periods, periods coming too often, any kind of menstrual problems. So if you have a lot of menstrual problems and you struggle with your weight and you have acne and hair growth, 语法解析
24:09
Probably you'll be able to get a diagnosis of this, but it's about one in 10 women who have PCOS. So this is really, really common. The vast majority of women are not diagnosed. They have no idea. And especially if you're not one of the people who's overweight, then a lot of times doctors don't even consider it in the diagnosis. Okay, that's so helpful. 语法解析
24:32
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24:55
And this fluid balance depends on many factors, including the intake and excretion of electrolytes, which many people don't get the right amounts of. Electrolytes are charged minerals that conduct electricity to power your nervous system. I talk a lot about nervous system on this podcast. They also regulate hydration status by balancing fluids inside and outside of our cells. 语法解析
25:15
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25:42
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25:52
Electrolytes are also important for maintaining blood pressure, regulating digestion and proper fluid balance, keeping skin hydrated, which is a big one that I feel like often gets missed, and so much more. I feel like proper electrolytes is a missing piece for a lot of people, and I love Elements new canned drinks, which are sparkling water with all the same ratios of minerals I just talked about, and they are delicious. 语法解析
26:15
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26:38
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27:03
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27:18
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27:44
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28:13
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28:36
I'm curious. I want to talk about testing now and then also like solutions, both natural lifestyle things we can do and if or when there's a place for hormones. But as we get into testing, can you walk us through what tests are available and what kind of numbers would a woman want to ideally see when it comes to testosterone? 语法解析
28:54
Yeah, so this is actually kind of controversial. So for testosterone, it's okay just to do blood tests. There's saliva tests, there's urine tests, but for testosterone, that's not really necessary. When we do testosterone, we often order what we call a free and total testosterone. So the total testosterone is the amount that your body is making. And the free testosterone is the fraction that is not bound to a protein in your bloodstream, but that's the part that you actually feel. 语法解析
29:23
When it's helpful to have both of those markers is because, especially for women on birth control pills, one of the side effects of the birth control pills is your liver makes a whole bunch of this protein called SHBG, sex hormone binding lobulin. And this is a protein that grabs hold of testosterone and it inactivates it. So now there's less of that 语法解析
29:45
free testosterone left over. And that is one of the ways in which birth control pills lowers the, you know, how you feel. It lowers the absolute testosterone level, but it also inactivates the testosterone that's left over so you don't feel it as much. So it's kind of a double whammy. 语法解析
30:01
We can measure your SHBG level, especially if you're on birth control pills. That kind of helps us to see because if we just ordered your total testosterone level and it looked totally fine and we didn't know that most of it was getting inactivated, we might miss that there really is a problem. But blood testing is fine. And 语法解析
30:20
The question then is, well, what is the normal range? Like what's normal? When should you be concerned? And there's a lot of controversy here because every lab makes up their own normal range. So if you go to this lab and get your labs done, it'll have this normal range. And if you go to that lab, it's going to have a different normal range. And they're really different. So LabCorp most recently sort of depends on your age. They're stretching it a little bit. But for the longest time, their range was 4 to 40. I think it was 4 to 44. 语法解析
30:49
So anything lower than four, you would be told you were low and anything above 44, you were told you were high. Other labs, the normal range goes up to 80. So there's a lot and starts higher. So there's a lot of disagreement. 语法解析
31:03
But the lab has a very, very low level. Like you have to be way low in order to be flagged as low. And on the free testosterone, it literally goes down to zero. So there is no way that it will ever come up saying that you are low because nobody cares if it goes down to zero. It's just accepted. 语法解析
31:23
So I'm going to tell you my opinion, and this is just my opinion. If a woman has a testosterone level that is under 20 and she's having symptoms, she's tired, low libido, you know, no motivation, can't make decisions, you know, just feels really blah, et cetera. 语法解析
31:44
If she's under 20 on a blood test and has symptoms consistent with low testosterone, I just tell her that she's low and we need to do something about it. If she's in the 20s and she's having symptoms, I sort of call that borderline. And if she's above 30 and she feels fine, then I sort of say that she's okay. Not all practitioners would agree exactly with that, but the gist is that the blood test is not everything. So if you go to your doctor and you ask for a blood test and they tell you that you're normal, 语法解析
32:13
Okay, but that doesn't necessarily mean that you're optimal. Yeah, I think that's a big key with any labs like normal versus optimal. And I've heard similar things even in like thyroid labs, for instance. 语法解析
32:23
And the labs creating their own ranges and being told normal, it does not necessarily mean that you are where you'd want to be necessarily. So like the importance of asking those follow-up questions. And so I'm curious for women who come in and are maybe in that borderline range or definitely look low on a test and are having symptoms, what are kind of like the triage of what are some of the first things that you suggest to them? What are things we can do in our diet and lifestyle to bring testosterone into more balance? And or when do you say, okay, let's also look at hormones? 语法解析
32:52
Okay, so the first thing that we want to do is we want to understand the factors that could be making their testosterone less than optimal. So we want to look at stress, we want to look at cortisol levels, and we want to make sure that we're trying to optimize the cortisol levels. And we can do that through exercise. 语法解析
33:08
Stress management techniques, gratitude journal, breathing exercises, yoga, being outside in nature. I'm sure you've talked a lot about all the different things that we can do in order to help buffer the effects of stress on our body and calm down our sympathetic nervous system, our fight or flight response. Those things sound so simple, don't they? Like it seems so like. 语法解析
33:29
Almost unsatisfying, but that's such powerful medicine and can't be overlooked. Like if you are in a crazy, chaotic situation, I don't know if you're a single parent or your boss is just 语法解析
33:43
drowning you in work, if you have a sick child or, you know, a special needs child, like if your life is just so overwhelming and we don't take that into account, even if we were to give you a whopping big dose of testosterone, we're not going to be able to fix the problem. So we just have to make sure that we're taking stress into account as one of the very first things that we do. Another thing that happens on our adrenal glands make 语法解析
34:07
the cortisol, but they also make another hormone called DHEA, dihydroandroepisterone. I think I said that totally wrong. I think I butchered it. DHEA. And this is the precursor hormone to testosterone. So when your adrenal glands are stressed and cortisol goes up, that inhibits testosterone production and inhibits 语法解析
34:28
your body puts all the resources into making cortisol, which is a survival hormone, at the expense of the DHEA. So this one goes down. And because the DHEA is one of the things that your body can use to make testosterone, now your testosterone level goes down again. So half of your testosterone comes from your ovaries, but half of it comes from your adrenal gland. And so when you're chronically stressed, 语法解析
34:50
it knocks both of those sources down. So one of the things that can be done is if we know that you are low in DHEA, because we can do a test for that too, it's available in blood, urine, and saliva, then we can give you DHEA. It comes in the United States. We can get it over the counter as a nutritional supplement. We can prescribe it from a compounding pharmacy. It's available now in vaginal creams. So 语法解析
35:17
If we can supplement with DHEA, that can help your body naturally make more testosterone. And then at the same time, we're working on your adrenal health so that we're going to calm things down and then your body maybe can naturally make more DHEA. So if you are younger, if you're in your 20s or your 30s, this can work really nicely. If you're in your 50s or 60s, then this strategy may or may not really fix the problem. And we may ultimately need to give you some testosterone replacement therapy. 语法解析
35:42
That makes sense. And it seems like this really centers on the idea of we've got to address stress or at least our perception of stress and how we handle it and or remove factors that are physically stressing our body, even if we don't feel stress. So I love that that's an important message, probably one that will serve women across the board, aside from even just testosterone, but in so many areas. 语法解析
36:02
I'd also love to touch on, I feel like big topics I see, especially with women in the perimenopause age and see if any of these factors also directly impact testosterone, which would be things like our light exposure and getting enough natural light, sleep quality, of course, which you already mentioned. I feel like sleep is the one factor every single person who's ever been on this podcast agrees is important. Like nobody says sleep's not important, but also things like sleep. 语法解析
36:25
nutrients in our diet, like getting enough protein and healthy fats. I wonder if the trend of low fat and low calorie for women, especially when they start hitting perimenopause and are worried about weight gain, if that's actually counterproductive to supporting our hormones. 语法解析
36:38
and or any kind of other needle movers that we have, you know, kind of direct control over in our daily life. Because I know anecdotally, when I started really prioritizing nutrient-dense foods and getting enough protein every single day, my hormone levels improved. So I'm curious if there's any other levers we can play with. Yeah. So yes to all those things. A lot of these hormones, especially testosterone, tends to be released at night when we're in a deep sleep. So if you're not in a deep sleep at night, then you may not be making the testosterone as well as you could. 语法解析
37:05
The testosterone, like many other hormones, including cortisol, is actually made out of cholesterol. So they are made out of fat and we need enough of the healthy fats in our diet in order to be able to make these hormones. So we need healthy fats. Absolutely, we need proteins and all of the micronutrients, the vitamins and minerals that are available. 语法解析
37:26
ovaries need that our adrenal glands need in order to be able to make our hormones so having a nutrient poor you know sort of fast food low quality diet is absolutely going to have an impact on all of our hormones including testosterone piece that we haven't really talked about today is toxins in the environment because of course we're all exposed to so many different chemicals 语法解析
37:48
And many, many of them are hormone disruptors. And so they get in the way, they muck up how our hormones work. And so doing our best without becoming completely neurotic and losing our mind, but doing our best to try to minimize exposure to toxins is another really important way to make sure that our hormones are doing what we need them to do. 语法解析
38:06
I love that. And I know this will also be a springboard into our next conversation. So you guys stay tuned. We're going to do a follow-up episode about hormone testing and what to know about all the other hormones and how they interact with testosterone as well. But I would guess many women listening have received 语法解析
38:21
really resonated with parts of what you said or maybe recognize like, oh, this could be something that's going on with me that I had not considered it until now. So for anybody who is in that curiosity stage and wants to dive deeper on this topic with you, where can they find you online and how can they keep learning and or get tested? 语法解析
38:37
Yeah. So our website is signaturewellness.org and we're in Charlotte, North Carolina, and we have people flying across the country to come and see us. So we're happy to do a free conversation just to see if we're the right fit. We've got tons of information on the website. I've also written a book to help women because the first question is, is it my hormones, right? Like, 语法解析
38:57
You're not even sure if that's causing the problem for you. So I wrote a book called This Is Not Normal, A Busy Woman's Guide to Symptoms of Hormone Imbalance that has a lot of checklists. So you can go through and sort of see, does it seem like it's a low testosterone problem or is it a cortisol problem or something else? And then it's got some tips on how you can naturally start getting your hormones into balance, but it also has tips on how to talk to your doctor so that you know what to ask for. And it's available free. The link we'll give to you to be in the show notes. You can just download a free copy. 语法解析
39:25
Amazing. Well, all those links will be in the show notes for you guys listening on the go. And Dr. Dud, this was so fascinating. I definitely learned a lot in our conversation today, and I'm excited for our next conversation that goes deeper on other hormones as well. But for this episode, thank you so much for your time. Thank you. And thank you for listening. And I hope you will join me again on the next episode of the Wellness Mama podcast. If you're enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? 语法解析
39:54
Doing this helps more people to find the podcast, which means even more moms and families can benefit from the information. I really appreciate your time. And thanks as always for listening. 语法解析
Edit:2025.04.30
《Wellness Mama Podcast》中Katie与Dr. Deb Matthew（被称为“美国快乐激素医生”）访谈主题为女性睾酮的重要性、测试方法、症状识别及优化策略。访谈深入探讨了睾酮对女性性健康、肌肉骨骼健康和情绪活力的作用，以及影响睾酮水平的因素（如压力、避孕药、环境毒素）。
开场与背景介绍（00:01 - 04:55）
主持人Katie的开场：
Dr. Deb的回应：
女性睾酮的重要性（04:55 - 06:10）
Katie的问题：
Dr. Deb的回答：
睾酮与性健康（06:10 - 10:14）
Katie的问题：
Dr. Deb的回答：
皮质醇与肾上腺的关联（10:14 - 15:52）
Katie的问题：
Dr. Deb的回答：
睾酮与肌肉骨骼健康（15:52 - 18:08）
Katie的问题：
Dr. Deb的回答：
睾酮与情绪活力（18:08 - 20:34）
Katie的问题：
Dr. Deb的回答：
低睾酮与高睾酮的症状（20:34 - 24:32）
Katie的问题：
Dr. Deb的回答：
睾酮测试与理想范围（28:36 - 32:23）
Katie的问题：
Dr. Deb的回答：
<20 ng/dL + 症状（疲劳、低性欲、无动力）= 低，需干预。
优化睾酮的策略（32:23 - 37:48）
Katie的问题：
Dr. Deb的回答：
其他影响因素（36:02 - 38:06）
Katie的问题：
Dr. Deb的回答：
资源与总结（38:06 - 39:54）
Katie的问题：
Dr. Deb的回答：
Katie的总结：
Edit:2025.04.30
