Testosterone for Women: Miracle Drug or Bogus Science?
Testosterone. That lovely hormone of desire, of sex, of muscles and power and strength. We think of manly men with hairy chests when we think of testosterone. But did you know women have testosterone too? They even make more testosterone than they do estrogen. Testosterone is one thing that controls sex drive in women and does a whole host of other things. It starts to decline in your late 20s. This can contribute to low libido in women. So should testosterone be replaced? I hope to answer this question for you with answers based on scientific studies- not bogus internet marketing claims. Does testosterone make for better sex?
If you are a midlife woman, peri or postmenopausal, then in some instances the answer is yes! Testosterone has been shown to definitively improve several aspects of sexual functioning. Testosterone improves sex drive, arousal, helps you have more and better orgasms, and increases pleasure and responsiveness.
Testosterone. That lovely hormone of desire, of sex, of muscles and power and strength. We think of manly men with hairy chests when we think of testosterone. But did you know women have testosterone too? They even make more testosterone than they do estrogen. Testosterone is one thing that controls sex drive in women and does a whole host of other things. It starts to decline in your late 20s. This can contribute to low libido in women. So should testosterone be replaced? I hope to answer this question for you with answers based on scientific studies- not bogus internet marketing claims. Let’s get started.
Does testosterone make for better sex?
If you are a midlife woman, peri or postmenopausal, then in some instances the answer is yes! Testosterone has been shown to definitively improve several aspects of sexual functioning. Testosterone improves sex drive, arousal, helps you have more and better orgasms, and increases pleasure and responsiveness. Who wouldn’t want all this at a time when your sex life tends to get a little dull and unsatisfying and in some women, a whole lot of work as well. When a midlife woman is suffering from low sex drive, testosterone can be used to improve it. This is a big deal for many women because low sex drive is uber common in midlife women and many are very distressed by it. Low drive can add a lot of stress to a relationship.
What are the benefits of testosterone?
Apart from improving your sex life, some data shows that testosterone may also help build muscle mass, improve fatigue and help with weight loss. The data isn’t definitive though and it isn’t recommended to use testosterone for these reasons.
What are the risks of testosterone?
There are no medicines without risks or side effects so don’t believe anyone who tells you a medicine has no risks. Testosterone is a hormone. It gets converted to estrogen in the body. Like estrogen, it increases your risk of blood clot. The medical term for a blood clot is deep venous thrombosis (DVT). DVTs can be quite dangerous because the clot can break away from the blood vessel and travel to your lungs and prevent you from getting oxygen. Good news though, if you don’t have a clotting disorder, are a normal weight, don’t smoke and don’t have certain other medical conditions, your risk of having a blood clot is very low. It is much lower than when a woman is pregnant or on birth control pills.
What about bioidentical hormones? Do they have risks?
Even “natural” things have risks, so don’t be fooled by the term bioidentical. Bioidentical means that whatever you are getting has the same chemical structure as the hormones that your own ovaries used to make or are currently making. Compounded “bioidenticals” are no safer than standard prescription hormones and on the flip side, there are prescription hormones that are bioidentical. Stick with the prescription ones. The companies that make them have to prove to the FDA that they are effective and safe. Compounding pharmacies don’t.
What are the side effects?
When appropriately replaced, some women on testosterone will develop acne or a little bit of facial hair. If the testosterone level in the blood gets into the male range, way too high, there can be some significant and permanent side effects like a lot of facial and body hair, deep voice, male pattern balding, and an enlarged clitoris. Your prescribing physician should be checking your blood levels to make sure you stay in the correct range. Most women do not have these side effects.
How should testosterone be given?
Testosterone should be given in a topical form, either a gel or a cream that gets absorbed through the skin daily. I prescribe testosterone as a topical cream for my patients. Women put some of the cream on their calf. This mode of delivery gives a very steady blood level of testosterone and if there is a bit of local hair growth, you can just shave it off. I don’t like the intramuscular injections of testosterone because they give you a very high dose right after you inject, then your body metabolizes it and the level goes down until your next dose when you get a whopper dose again. This creates a lot of ups and downs in your hormone levels. Not my favorite.
What about hormone pellets?
I don’t recommend certain hormone pellets-namely BioTe. Some of these tend to give women very high levels of hormones. I have seen numerous women with the same blood levels of testosterone as a man would have. At these levels, women grow beards, have deepening of the voice, male pattern balding and the clitoris grows. These changes can be permanent.
Also, pellets have not been studied in women in peer reviewed published medical studies. They haven’t been proven to be any better, safer or more “natural” than anything that has been studied. The North American Menopause Society and the American College of Obstetrics and Gynecology specifically do not recommend treatment with pellets because their safety has not been proven. For BioTe, go to their website and check out the disclaimer at the bottom of the website. It says these are not intended to treat or cure anything!
I will say women come to me feeling fantabulous on their testosterone pellets. They have amazing libido! That is because they have as much if not more testosterone floating around in their blood as their male partners and maybe as much facial hair too. Just keep in mind the permanent changes pellets may cause.
What's the best way to find out if testosterone is a good option for me?
If you are in your 40s or 50s, peri or postmenopausal, testosterone may be a good choice for you to boost your libido, barring certain medical conditions. Make sure to see a provider with experience in treating sexual conditions. A sexual medicine specialist will also look for other factors that may be contributing to your low libido like a not-so-nice partner, depression or certain medications. Testosterone is not going to improve your libido if your partner is a jerk.
TO SEE IF TESTOSTERONE IS RIGHT FOR YOU CLICK HERE
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click click here to schedule.
Why can't I climax anymore?
Menopause can wreak havoc on your sex life. Difficulty with or inability to reach orgasm is just one thing menopausal women face. Great news though there is a way to get back to your normal sexual self again!
Why can’t I climax anymore?
“I just have to work sooooo hard to reach orgasm nowadays”, said my patient. My husband thinks it is him and it’s not. “I just don’t know what is wrong with me”. I hear this from my menopausal patients day in and day out. They feel bad, they are worried something is wrong with them, it is causing concern in the relationship.
You can blame menopause.
Difficulty reaching orgasm or inability to orgasm is super common during menopause. During menopause your ovaries pretty much stop making estrogen and by this time they aren’t making much testosterone either. Both the vagina and the clitoris need these hormones to function normally. So, reaching orgasm requires a lot more work, for some women. Some women then decide to forgo that elusive orgasm (or they fake it). “oh, don’t worry about taking care of me” my patient says to her partner. “You can get me next time”.
The problem with this scenario is that for the woman, the sex isn’t always that great when she doesn’t get that pleasure release of orgasm. When a woman reaches orgasm, she gets a flood of dopamine in her brain. Dopamine is that feel good hormone, it is the one that is released if you do heroin or cocaine that keeps you coming back for more. (NO, don’t do heroin or cocaine). After orgasm, your body releases oxytocin, the cuddle hormone, that makes you want to curl up next to your partner. A good orgasm is an important part of good sex. When sex starts to become not so good, sex drive decreases too. In order to want to have sex, it has to be sex worth wanting.
We just don’t learn about this stuff!!
Did anyone tell you this was going to happen during menopause? Heck, no!! Women’s sexual pleasure is a bit hush in our culture. Well, it shouldn’t be. All women should know that there is treatment for difficulty with orgasm due to lack of necessary hormones. Low dose vaginal hormones can be used and these do NOT increase your risk of breast cancer, stroke, heart attack or blood clot. I repeat, no increased risk when used vaginally. Low dose vaginal hormones bring the healthy blood flow back to the vagina. They allow the vagina to make the cells that make moisture and they allow the vagina to be stretchy again, so sex is much less likely to hurt- another menopausal trouble, to be discussed in another blog.
I have to mention that there are a variety of other things that can affect a woman’s ability to orgasm and the list is long. If you are having trouble, see your doctor. No let me change that, see your sexual medicine doctor!
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed in Missouri, Tennessee and Illinois. Call today to schedule your appointment. (314) 934-0551 or Click here to schedule an appointment.. If you are not located in Missouri, Tennessee or Illinois, Dr. Lynn offers an E Health. Click here to learn more about E Health and meet with Dr. Lynn today!
Check out our website today for more information.