What is Testosterone Deficiency Syndrome (TDS)

Testosterone Deficiency Syndrome (TDS) is a collection of symptoms some people recognize as aging, an untreatable condition of humanity. However, many symptoms of aging are treatable and therefore not inevitable!

To learn more about testosterone deficiency, watch this video podcast produced by Dr. Kathy Maupin on the writing her book The Secret Female Hormone, How Testosterone Replacement Can Change Your Life.



Symptoms of testosterone deficiency syndrome in men and women include:

  • Fatigue
  • Poor quality sleep/insomnia
  • Loss of Libido
  • Short term Memory Loss or difficulty thinking
  • Weight gain/belly fat
  • Loss of muscle strength
  • Loss of stamina
  • Loss of muscle size and tone
  • Loss of balance
  • Arthritis
  • Hair loss
  • Hot flashes
  • Anxiety/Irritability/Depression
  • Loss of motivation and quality of life
  • Loss of skin tone, sagging and wrinkles
  • Dry skin
  • Dry eyes
  • Feeling cold when others are hot
  • Loss of Self Esteem
  • Loss of color in the skin of the face
  • Loss of sensation in the nipples
  • Loss of pubic hair

Symptoms of testosterone deficiency syndrome in women include:

  • Loss of elasticity of the vagina and vulva
  • Painful intercourse
  • Shrinking clitoris

Testosterone implants in women: Pharmacological dosing for a physiologic effect – Rebecca Glaser, MD

Abstract (click to read the full article)

Objectives: The objectives of this study were to determine therapeutic serum testosterone (T) levels/ranges and inter-individual variance in women treated with subcutaneous T implants. Study design: In study group 1, T levels were measured at two separate time intervals in pre- and postmenopausal women treated with subcutaneous T for symptoms of androgen deficiency: (i) four weeks after pellet insertion, and (ii) when symptoms of androgen deficiency returned. In a separate pharmacokinetic study (study group 2), 12 previously untreated postmenopausal women each received a 100 mg T implant. Serum T levels were measured at baseline, 4 weeks and 16 weeks following T pellet implantation. In study ‘group’ 3, serial T levels were measured throughout a 26 h period in a treated patient.

Results: In study group 1, serum T levels measured at ‘week 4’ (299.36 ± 107.34 ng/dl, n = 154), and
when symptoms returned (171.43 ± 73.01 ng/dl, n = 261), were several-fold higher compared to levels
of endogenous T. There was significant inter-individual variance in T levels at ‘week 4’ (CV 35.9%) and
when symptoms returned (CV 42.6%). Even with identical dosing (study group 2), there was significant
inter-individual variance in T levels at ‘week 4’ (CV 41.9%) and ‘week 16’ (CV 41.6%). In addition, there
was significant intra-individual circadian variation (CV 25%).

Conclusions: Pharmacologic dosing of subcutaneous T, as evidenced by serum levels on therapy, is needed
to produce a physiologic effect in female patients. Safety, tolerability and clinical response should guide
therapy rather than a single T measurement, which is extremely variable and inherently unreliable.
© 2012 Elsevier Ireland Ltd. All rights reserved.

Systems of testosterone deficiency syndrome in men include:

  • Erectile Dysfunction
  • Shrinking penis

Some diseases begin to develop as testosterone declines to a critical level, and that level is different for every individual. All these diseases are associated with a genetic risk, female or male sex, family history, lifestyle, environmental toxins, and body weight, BMI, diet and exercise levels. The one hormone that is related to the onset of all of these diseases is a lack of testosterone.

The diseases initiated or stimulated by testosterone deficiency syndrome:

  • New onset of migraine headaches after 40
  • New onset of auto-immune diseases e.g. rheumatoid arthritis, M.S., lupus, after
  • Dementia and Alzheimer’s Disease
  • Osteopenia/osteoporosis
  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • Dementia, Alzheimer’s Disease
  • Parkinson’s Disease
  • Sarcopenia and frailty
  • Heart disease and stroke

The difference between TDS in Men and Women

Men and women notice these changes, but they begin at different ages for women and men. Women are ten years ahead of men in this condition. Women begin the onset of these symptoms at age 40 or when their ovaries are removed through surgery. Men begin the condition around the age of 50.

All of these symptoms are associated with the progressive decrease in the level of one hormone—Testosterone. This hormone is integral to maintaining balance and health in our body and mind. When that it disappears, we begin to age rapidly. This “secret hormone” is not acknowledged by the medical community as important to women, and therefore this syndrome has no official name in the medical world. I have named it Testosterone Deficiency Syndrome (TDS), for women. For men it was named Andropause.

Facts about Women and TDS

  • It occurs about ten years before Menopause, or immediately when ovaries are removed
  • TDS happens to everyone eventually
  • TDS has variable severity in individuals, e.g. some women notice the changes dramatically and have many symptoms, and others do not. TDS does occur in every woman as she ages.
  • TDS is inevitable but is treatable
  • Testosterone is a necessary hormone for health in women
  • Testosterone is only produced in the ovaries in women
  • Oral testosterone replacement is transformed into estrogen in the liver
  • Non-oral testosterone is the safest and most effective method of delivering testosterone to both men and women (Pellets under the skin, or vaginal tablets)
  • Testosterone must be replaced in order that women look and feel young and healthy as they age
  • Testosterone stimulates the production of growth hormone, and makes women leaner
  • Testosterone protects (but does not completely prevent) both sexes from dementia, Alzheimer’s, heart disease, diabetes, autoimmune diseases, and cancers.
  • Testosterone prevents osteoporosis and frailty
  • In our youth, women have 1/10 the testosterone compared to men
  • In our youth women have 3 times as much testosterone as estradiol
  • Testosterone causes women to have positive and pleasant moods

What TDS is Not

There are a lot of rumors of what TDS might be, created by uninformed lay people and doctors. These rumors have nothing to do with the truth, and originate in old wives tales and assumptions made by people who are very sure of what they say, but have no research to back them up. What TDS is not:

  • TDS is not a psychiatric condition
  • Symptoms of “Testosterone Deficiency Syndrome,” are not imagined.
  • TDS is not a symptom of menopause
  • TDS has nothing to do with Estrogen
  • Symptoms of TDS are not separate entities but symptoms of the loss of one hormone
  • TDS cannot be avoided
  • Libido has nothing to do with estrogen, but everything to do with Testosterone
  • Testosterone replacement does not make women angry or violent
  • Testosterone is not just a male hormone!

TDS or Andropause In Men

The new name for andropause is the phrase “Low T”. This refers directly to low testosterone as men age, and leads the way to a commercial that sells a synthetic testosterone replacement for men. There are now many medications that are made just for men and their low testosterone problem, but they all have very low recommended dosages, and therefore do not recreate the testosterone environment of youth, and health. This is a pharmaceutical company error. In an effort to be safe they have made the dose too low to be effective in resolving all of the symptoms of andropause. In addition, the synthetic nature of the testosterone and the delivery systems offered cause a high level of DHT and estrone, which increase the risk of prostate enlargement and breast enlargement. These side effects are generally not found if a man is treated with adequate doses of pure bio-identical testosterone in pellet form every 6 months.

If you have tried other forms of testosterone replacement and have one of the above side effects, or no resolution, then testosterone replacement with sub-dermal pellets may be your answer.

Other men’s symptoms testosterone pellets have reported resolved:

  • Hot flashes
  • Anxiety attacks
  • Emotional outbursts
  • ED
  • Lack of Ejaculation
  • Loss of morning erections
  • Enlarged Prostate
  • Abilities that have returned after Testosterone replacement with Pellets:
  • Organizational ability
  • Spacial ability (viewing of architectural plans)
  • Coordination
  • Athletic ability
  • Decreased Blood pressure
  • Sexual attractiveness
  • Ability to sell
  • Social skills
  • Courage
  • Executive abilities

What about Prostate Cancer and Testosterone?

One of the issues I frequently discuss with men is their fear of prostate cancer and testosterone replacement. This is one of those questions that takes some time to discuss. The short answer is, testosterone replacement does not cause prostate cancer. Don’t blindly take that claim as truth from this website. Our research that backs up that statement.

I am confident in my statement above, based on the research that has been done by Dr. Morganthaler, the chief of Urology at Harvard Medical School. He has done more prostatectomies for prostate cancer than anyone else in the US. He has also done extensive research with prostate cancer cells in the laboratory and in volunteer patients. Here is what he found:

Low testosterone and not normal or high testosterone causes prostate cancer. Both by retrospective studies of men with prostate cancer and their pre-cancer testosterone levels as well as their testosterone levels as the time of diagnosis (no replacement), he determined that it was very risky to have a low testosterone level, without replacement, because that was the highest risk factor for men who got prostate cancer. That makes sense in many ways, because men do not get prostate cancer when they are young, they get it when they are old, which is when their testosterone levels drop to a very low level.

Dr. Morganthaler followed his clinical results with a laboratory test to confirm his suspicions. He retrieved prostate tissue from young men and old men, and then placed both types of tissues in a low testosterone environment, and high testosterone environments. What he found was contrary to what is being relayed to us by urologists throughout the country; the young cells remained cancer free in the high T environment, but became pre-cancerous and even cancerous in the low T environment. The old prostate cells became cancerous in the low testosterone environment, but remained normal in the high testosterone environment! This study has been repeated by others with the same results.

His recommendation for men without prostate cancer is to keep their testosterone at optimal levels to avoid prostate cancer. The recommendation for men with prostate cancer was to treat it and replace testosterone to avoid recurrence. In the case of prostate cancer, I believe his results, but men must make their own decision with their primary urologist, and discuss these findings with him or her before beginning testosterone treatment.

Another vagary of treatment is that the doctor who delivers testosterone should also monitor the two bi-products of testosterone, estrone and DHT, which can stimulate the growth of abnormal cells, and can be managed with enzyme blockers. Blood tests as well as free PSA should always be done to monitor testosterone treatment especially in men.

Learn more about Testosterone Deficiency

Dr. Maupin’s book, The Secret Female Hormone, includes in-depth information on the symptoms, effects, and solutions of Testosterone Deficiency.