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The most common form of female sexual disorder is a sharp decline in sexual desire, a condition known as hypoactive sexual desire disorder, or HSDD. Women’s health organizations fought hard to win approval of a drug to treat HSDD and finally succeeded in 2015 when the FDA approved a drug called Addyi, which purportedly increased sexual desire slightly among premenopausal women treated in clinical trials.
However, Addyi has been slow to catch fire with women suffering from HSDD. Its tepid market reception has been ascribed to a variety of factors, including its high price, its incompatibility with alcohol, insurance reimbursement issues, and adverse side effects that outweigh its benefits, at least for some users.
Could Testosterone Help?
Now comes word from prominent British women’s health expert Nick Panay, M.D., that testosterone supplementation could help fire up the libido in women who’ve somehow lost their desire for sex. Dr. Panay, a consultant gynecologist, is chairman of Britain’s National Association for Premenstrual Syndrome and a past chairman of the British Menopause Society.
As most people know, testosterone is the primary male sex hormone, but it is also present in women, whose levels of the hormone are roughly 10 percent of those in men. However, even at those significantly lower levels, testosterone plays a key role in female sexual desire and function, as well as mood and energy levels.
Dr. Panay says that supplementary testosterone could be particularly helpful for menopausal women, a group for which Addyi is not recommended because it has been clinically tested only among premenopausal women. As women approach menopause, their bodies produce lower levels of all sex hormones, including testosterone. According to an October 7, 2016, article posted at DailyMail.com, many medical professionals believe that testosterone deficiency accounts for some of menopause’s most common symptoms, including hot flashes, weight gain, and depression.
Multiple Benefits
Interviewed for the DailyMail.com article, Dr. Panay said, “I strongly believe testosterone should be made available to all women who would benefit. It’s not just about a lack of sex drive.” He went on to say that he had treated many patients who’ve reported improvements in mood, energy, muscle strength, stamina, and overall well-being after testosterone supplementation. He said women getting supplementary testosterone “go from feeling drained to being able to run marathons again.” He also noted that women with low levels of sexual desire who haven’t responded to normal hormone therapy are likely to benefit significantly from testosterone supplementation.
Testosterone supplementation is not without side effects in women who opt for this form of treatment. Some develop acne, unwanted hair growth and in rare cases blood clots. However, most doctors argue that the amount of testosterone in pills and transdermal patches is too low to cause women to appear more masculine.
It’s Not for Everybody
Also interviewed for the DailyMail.com article was Channa Jayasena, M.D., a senior clinical lecturer in endocrinology at London’s Imperial College and a hospital consultant. He said that he already prescribes transdermal testosterone patches to women who are suffering from low sexual desire. While he acknowledged that this form of therapy doesn’t work for all women, he pointed out that some experienced huge benefits.
WebMD.com notes that the FDA has not yet approved testosterone for the treatment of sexual problems of women in the United States. Those supplements currently on the market are made for men and contain levels of the hormone that are too high for use in women. However, WebMD notes, many American doctors prescribe specially compounded formulations of the hormone for their female patients.
Who Might Benefit Most?
Although testosterone supplementation in women remains an experimental therapy in the United States, WebMD indicates that low-dose testosterone therapy may benefit those women who:
- Have had their ovaries removed, a procedure that causes a sudden drop in testosterone levels, leading to a decline in sexual desire and satisfaction.
- Suffer from a low sex drive that doesn’t appear to be linked to relationship and/or stress-related problems or to adverse interaction with other medications.
- Suffer from hypopituitarism, a condition in which the pituitary gland is underactive, or an adrenal system problem.
Contraindicated for Some Women
However, testosterone supplementation is contraindicated in women who have heart or liver disease or suffer from elevated cholesterol levels, according to WebMD. It is also inadvisable for women who have or have had breast or uterine cancer, as well as women who may become pregnant.
Not all medical professionals are as enthusiastic about the prospect of testosterone supplementation for women. According to an October 10, 2016, article posted at DailyMail.com, doctors explain that it is very difficult to accurately assess testosterone levels in both men and women. And many men with seemingly low levels of the hormone continue to function satisfactorily sexually.
A Building Block for Estrogen
In women, testosterone is produced in the ovaries and is used primarily as a building block for estrogen, the primary female sex hormone. Residual testosterone is believed to give women more energy and greater assertiveness, as well as greater enjoyment of sex. Doctors reluctant to endorse testosterone supplementation in women point out that, just as is the case in men, many women function well sexually and otherwise with unusually low levels of testosterone. All of which calls into question the advisability of giving supplementary testosterone to men and women who may not need it.
Dr. Jayasena, who runs a weekly clinic at London’s St. Mary’s Hospital for women coping with menopause-related problems, said that “low levels of testosterone do not always equate with low libido in women.” However, he said that doctors should be alert for women who complain of symptoms such as a loss of libido accompanied by feelings of distress over this loss of sexual desire. While testosterone might conceivably help some women with a flagging libido, Dr. Jayasena pointed out that women may lose their interest in sex for a variety of other reasons that have nothing to do with their T-levels. Such reasons can include depression, fatigue, and a loss of interest in their partners.
Not a Universal Panacea
Both Drs. Panay and Jayasena agree that testosterone supplementation is not a universal panacea for a loss of sexual desire in women. Dr. Panay pointed out that “women are much more complex creatures than men and do not respond to the on/off button” offered by Viagra and other male erectile dysfunction drugs.
Dr. Jayasena said that he identifies ideal female candidates for testosterone replacement therapy by careful questioning. Such a tactic might be of little use to doctors who haven’t the time to indulge in such time-consuming interaction. “It’s crucial to find better ways to identify women who have a genuine illness and who will therefore benefit from testosterone supplements,” said Dr. Jayasena.
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