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Project Answer for Paper 2


The Global Open University

Chapter 3, Project 3 page 64

Effect of Testosterone and estrogen on hair and skin growth

Possible side effects of too much or too little testosterone

Sources relating estrogen to healthy skin

Towards partial fulfillment


Master of Philosophy
Dr. Atulkumar K. Shah
January 2009
On average, an adult human male body produces about forty to
sixty times more testosterone than an adult female body, but
females are, from a behavioral perspective (rather than from an
anatomical or biological perspective), more sensitive to the

Hair Growth

• Altered Androgen Metabolism - The skin and fat cells of the

body can convert weak forms of androgens (male hormones) into
more potent ones. Altered Androgen Metabolism causes abnormal
hair growth when the skin and fat cells convert testosterone into
dihydrotestosterone (DHT).

• Increased Androgen Production - The ovaries produce

testosterone as a part of normal developmental function. Likewise,
the adrenal glands naturally produce dehydroepiandrosterone
sulfate. When either of these glands over-produces their respective
androgens abnormal hair growth can result. The cause is more
often the fault of the ovaries than the adrenal glands, but there are
several recognized instances where the adrenal gland causes such

• Decreased Androgen binding in the Circulation - The hormone

levels in the body are regulated and balanced normally. The liver
produces a substance called Sex Hormone Binding Globulin (SHBG)
which binds testosterone into an inactive form. Estrogen stimulates
the liver to produce SHBG which in turn reduces the amount of free
androgens in the blood. Androgens decrease SHBG in the blood. A
decrease in estrogen will also decrease SHBG production, therefore
increasing the amount of free androgens available in the blood, and
only free androgens are biologically viable. With more free
androgens there is an increase in hair growth.

• Exogenous Androgens - Sometimes a person taking

medications for hormone therapy (Estratest, danazol), body
development (such as anabolic steroids and body-building
supplements) or to control pregnancy (birth control pills containing
norgestrel) can develop abnormal hair growth. Even certain
hormone-containing skin creams (used to treat specific conditions)
can be absorbed into the bloodstream and result in hair growth.

In order to establish an accurate determination of how much
testosterone is bioavailable what needs to be measured is the "free
androgen index" or FAI. This is calculated by the total testosterone
level in the blood divided by the SHBG level multiplied by 100.
Pathology labs will automatically do this calculation and the result
will be the FAI reading. Generally a FAI of less than 2 indicates
there is very little bioavailable testosterone and is a likely cause of

Changes in Skin and Hair with Menopause and Aging

During normal aging, the skin becomes thinner, looser and less
elastic and hair growth lessens and the hair shafts become thinner.
In men, this is a fairly gradual effect which accelerates after age
45. In women however, the abrupt hormonal changes at
menopause are more sudden and drastic. The decreases in
estrogen levels can cause a thinning and drying of the skin which
can produce more wrinkles. Hair follicles tend to shrink and the hair
shafts become thinner.

Estrogen and Hair Growth

Menopause changes the balance between body's levels of female

hormones and male hormones (androgens) which in turn affects
hair. There is a relative increase in the level of male hormones in
female body due to the decrease in estrogen. At times, the fine,
light hairs covering face tend to darken and thicken. Estrogen
therapy will reduce this excessive hair growth.

The hair on scalp begins to thin, as does the hair in the pubic area.
Estrogen replacement therapy reduces this hair thinning. Products
such as minoxidil and Folligen also improve hair growth in women.
They often work better restoring hair in women than in men.

Estrogen to Prevent Wrinkles

The drop in estrogen production makes skin thinner and less elastic
which produces more wrinkling and sagging. Skin is producing less
collagen and elastin, the supportive and elastic proteins in the
skin. As the skin becomes more delicate, it is more susceptible to
damage from the sun. To help reduce wrinkle formation, reflective
sunscreens (not chemical sunscreens) with a sun protection factor
(SPF) of at least 15 should be used to protect your skin when

Estrogen helps aging women have a younger looking skin, helps
maintain skin’s collagen, thickness, elasticity and ability to retain

DHEA for Moisturizing Skin

Dry skin is an increasing problem with age. DHEA

(Dehydroepiandrosterone) is a hormone that is used to manufacture of
many other hormones that improve body's function. Because DHEA
decreases with age, both with normal aging and particularly after
menopause, many physicians supplementing their patients' diets
with DHEA. Interestingly, DHEA turns on oil production by the skin.
Skin creams containing DHEA have been reported to be very
effective in increasing skin oil production on dry skin.

Effects of Low Testosterone Levels in Men

These include fatigue, lethargy, mood changes, ill tempered, sexual

dysfunction, poor erectile function, loss of sexual interest, diminished
muscle strength, osteoporosis and anaemia.

Causes of Low Testosterone

• Acute critical illness, burns, major trauma or surgery

• Drug use (eg, opiates, glucocorticoids, anabolic steroids)
• Chronic disease and its treatment
• Alcohol abuse
• Smoking
• Ageing

Effect of high Testosterone level in Men

• Acne
• change in sex drive or performance
• hair loss
• headache

Effects of Low Testosterone Levels in Women

• Loss of sexual desire

• Tiredness and fatigue
• Mood changes
• Sleep disturbances
• Reduced motivation and
• Body shape changes

Causes of Testosterone Deficiency in Women

These are pre-existing illnesses, physical, hormonal, psychological,

relationship issues and mental health problems. Medications which
may interfere with proper testosterone level in women are

Medication Use
SSRI's, tricyclics Depression
Oral oestrogens Oral contraceptive pill, HRT
Medroxyprogesterone Contraceptive, HRT
Clonidine Hot flushes
Medroxyprogesterone Contraceptive, HRT
Spironolactone, Androcur Hirsutism
Danazol Endometriosis
Benzodiazepines Anxiety, insomnia
Beta blockers Hypertension
H2 antagonists Oesophageal reflux
Ketoconazole Vuvlo-vaginal candidiasis
Gemfibrazol Hyperlipidaemia

Effects of High Testosterone in Women

The most serious side effect of these drugs is hypercalcemia, a

condition in which too much calcium circulates in the blood. This
occurs because these drugs liberate calcium from bones. Calcium
levels are monitored regularly, and the drug is discontinued if
hypercalcemia occurs.

Another serious (but less common) side effect is the development

of tumors in the liver. Other side effects include deepening of the

voice, development of facial hair and acne, fluid retention, and
nausea Abnormally high testosterone levels in women can lead to a
variety of symptoms. Most often, women with high testosterone
levels develop male pattern hair growth (hirsutism), especially on
their faces and chests. More rarely and over time, some women
may experience virilization, which is increased muscle mass,
redistribution of body fat, enlargement of the clitoris, deepening of
the voice, male pattern baldness, acne, and/or increased

Testosterone Replacement Therapy (TRT)

Testosterone is the male sexual hormone, and is made mainly in

the testicles. Testosterone is administered with a gel or patch is
used on the surface of the skin. This hormone helps prevent skin
damage and maintain the pattern of beard and body hair, as well as
maintaining male sexuality, muscle and bone strength, and
preventing osteoporosis and heart disease. Testosterone may
influence the brain's learning skills, and visual and perceptual
abilities. If a blood test indicates that levels are low, some longevity
doctors will use the supplementation for men over 40.

In men, testosterone is not secreted steadily but varies with the

peaks release early in the morning, then falling to the lowest ebb in
late evening, before rising through the night. With testosterone,
there is a heavy influence from the brain that controls testosterone
production. Life enhancing experiences such as success in daily
work or in the romantic realm will raise testosterone levels. On the
other hand, setbacks in these same areas lower testosterone
production further complicating these difficulties.

Some researchers have recommended that men on testosterone

replacement should take 160 mg of Saw Palmetto with Pygeum
twice daily to block the conversion of testosterone to
dihydrotestosterone (DHT) which affects hair loss and prostate

Sources relating estrogen to healthy skin

A good diet can reduce the formation of unsafe estrogen. Indole-3-
carbinol from cruciferous (or more specifically brassica), vegetables
such as cabbage, broccoli, Brussels sprouts, and cauliflower plants
has special role in doubling blood level of “safe” C-2 estrogen while
cutting in half blood level of unsafe C-16 estrogen.

Other protective substances from plants in addition to I-3-C are

now known to be most effective when they are bound to one of the
forms of vitamin C. These substances include pectin, bioflavinoids,
and a form of vitamin C is called isoascorbate.

There is also a substance called sulforaphane, found especially in

Brassica vegetables such as broccoli that stimulates enzymes in the
liver to break down such dangerous carcinogens as aflatoxin and
polybrominated biphenyls. Limonene, found in citrus fruits, and
lignan, found in whole grains, have also been observed to slow,
stop, or even reverse the growth of steroid-involved malignant

Some foods have high levels of phytoestrogens, or plant estrogens.

These phytoestrogenic compounds are found in soy foods, flax
seeds, and some herbs and called isoflavones and lignans. One of
the first phytoestrogens to be studied was in red clover. Soy
products (soybeans or tofu) are particularly abundant in
isoflavones, such as genistein and daidzein, which are weak
estrogens. Women in Asia, where the diet is high in soy foods,
usually consume more than 35 grams of soybeans or soy-derived
food per day as opposed to the American woman who may only get
1-2 grams per day. Soy foods also appear to be useful in preventing
or lessening the risk of osteoporosis and heart disease.

Estrogens in cosmetics
Some hair shampoos on the market include estrogens and placental
extracts; others contain phytoestrogens. There are case reports of
young children developing breasts after exposure to these
shampoos. These products are often marketed to African-American