What about Testosterone Use for Women for Low Libido?
Low desire or female sexual dysfunction affects up to 50% of women depending on the study. Surgical and natural menopause as well as aging affects sexual desire. Testosterone has been used for years to treat women with sexual dysfunction and has been shown to improve sexual desire, arousal, pleasure, and overall satisfaction.
Testosterone therapy has been shown to improve female sexual functioning in both pre-menopausal and post-menopausal women. So why don’t physicians just put women on Testosterone therapy that have low-libido? Well…I don’t have a great answer. The two most common side-effects of testosterone therapy in women is excessive hair growth (hirsutism) which happens in 3% to 8% of women on testosterone therapy and acne which occurs in less than 10% of women on this therapy. This usually occurs in women receiving high doses of testosterone. The facial hair growth usually happens 4 to 6 months after testosterone therapy is started. On very high doses, a woman’s voice can change and deepen, and she may have enlargement of the clitoris. There is a theoretical risk of causing uterine cancer or other hormone related cancers because testosterone can be converted to estrogen in the body. This has not been proven in clinical studies. Another problem is that there are no studies longer than 4 years to see what the effect of long-term testosterone does to women, and we do not have reliable tests to measure testosterone levels when they are at very low concentrations. There is no agreement among physicians about what is the lower limit of normal testosterone levels, and the amount of fat a person has and insulin levels may affect the levels.
Have I answered the question? No.
Why don’t physicians put women on Testosterone therapy for low-libido? It’s complicated.
Physicians like to follow the rules, and there are just no rules when it comes to testosterone therapy in women. There is no reason that a physician cannot prescribe it for “off-label” use for low-libido. The physician takes a risk in not following FDA guidelines, he or she has to decide what “levels” of testosterone are acceptable, and…your physician does not want to do anything to hurt you. Despite all of this, in 2011, there were 4.1 million testosterone prescriptions written off-label for women in the US. You have to sit down and talk to your physician about trying this therapy. If you take the medication, you have to abide by your physician’s testing schedule and probably sign a statement that you understand that you are using it against FDA Approval. If your physician is not comfortable with writing a prescription for testosterone, he or she may feel comfortable recommending a physician who they trust to follow you appropriately.