What is the effect on the testosterone/SHBG ratio during menopause?

During menopause, the physiological changes that occur can affect hormone levels, including testosterone and SHBG (sex hormone-binding globulin). While testosterone levels tend to decline with age, especially during the transition into menopause, SHBG levels often increase due to factors like changes in liver function and the body’s overall hormonal balance.

The testosterone/SHBG ratio is important because it indicates the bioavailability of testosterone in the body. In this context, it is essential to note that although testosterone levels decrease, the concurrent rise in SHBG does not lead to a significant change in the ratio itself—this is why it remains relatively stable or unchanged. The balance between these hormones reflects the body’s adaptation to the hormonal changes occurring during menopause.

Thus, understanding that the testosterone/SHBG ratio does not significantly alter during menopause helps in evaluating and managing potential symptoms associated with decreased testosterone, such as mood changes, decreased libido, and other quality-of-life factors. This nuanced perspective is crucial for healthcare providers working with menopausal patients.