Testosterone for Sexually Frustrated Women
07 Sep 2009
Three weeks ago my column, “Do you want better sex?” struck a resounding note with female readers. But also with many husbands who want their wives to have fewer headaches! The general response was, “Please write more about testosterone and how it can increase female libido”.
Testosterone, the male hormone, has been called “the hormone of desire”. In males the “Big T” builds muscle for boys and ultimately turns boys into sexually well-functioning men. Women also produce testosterone during puberty, about one-tenth as much as males. Later in life they produce less, and this is why some authorities believe women lose interest in sex.
How do women learn whether they have less testosterone and therefore “less tiger in the tank”? There’s a good chance testosterone is lacking if they complain of decreased or little sexual desire, if they have less orgasm, lack energy, or decrease in strength and endurance, loss of height, decreased enjoyment in life, are sad or grumpy, fall asleep after meals and inadequate work performance. If the answer is yes to four of these conditions, there may not be enough big T present.
Women may lack this hormone for several reasons. In North America 700,000 hysterectomies are done every year. The ovaries that produce estrogen and testosterone are removed in 50 percent of these women between the age of 40-44 years and in 80 percent between 45 t0 54 years of age. This sudden removal of hormones can trigger female sexual dysfunction (FSD).
Studies done at McGill University in Montreal showed that women who had ovaries removed proved to be more interested in sexual intercourse after treatment with a combination of estrogen and testosterone. So why is this combination, or testosterone alone, not prescribed more often to put more tiger in the tank?
The problem is not that simple. Some doctors are skeptical about the use of testosterone for women. They argue that there have not been sufficient studies to demonstrate its effectiveness and long-term safety. Moreover, until research is complete testosterone should be used cautiously, or not al all. For instance, its been shown that testosterone can have negative effects on cholesterol levels, primarily decreasing HDL, the good cholesterol.
Other critics point out that FSD can be the result of many medical and psychological conditions. It can be due to an unhappy marriage, or financial troubles.
Who is right and who is wrong about the use of testosterone will not be solved for many years. After all, the use of estrogen therapy for women has been a controversial subject since 1980. But female advocates of testosterone therapy complain that too many doctors are reluctant to even discuss sexuality, let alone accept the fact that some women would benefit from this hormone.
Dr. Gerald Bain, one of Canada’s leading endocrinologists and professor of medicine at the University of Toronto, is an exception. He has an open mind about prescribing testosterone, but with some reservations. He says that testosterone is not appropriate for women of childbearing age as they produce sufficient amounts at that age. And its use is also contraindicated in women who have breast or uterine cancer, liver problems or cardiovascular disease.
And there’s another problem. Dr. Bain reports that blood studies to measure the amount of testosterone are not always a reliable indicator for gauging FSD. Ovaries and adrenal glands that produce testosterone do not store it. Once produced, testosterone is secreted into the blood stream where 98 percent becomes attached to sex hormone binding globulin. The remaining one percent is known as “Bio-available testosterone” or the working T. As well women with low amounts of testosterone may have great sex while others with high amounts have lackluster sexual drive.
Dr. Bain stresses that, just as no shoe fits all people, the same applies to the use of testosterone. He claims that some women do benefit from testosterone, but the dose must be tailored to individual needs rather that a “one-size-fits-all” prescription. This allows women to enjoy the benefits without experiencing unwanted but possible side-effects such as facial hair and acne.
Unfortunately, finding a doctor who is well versed in testosterone therapy is easier said than done at the present time.
