Testosterone and Low Libido in Women
Testosterone plays a major role in a woman's sex drive. But when that sex drive is low, replacing the hormone with a testosterone supplement isn't as simple as it sounds.
For women, sexual desire, fantasy, being sensitive to sexual touch, and orgasm are all driven in part by natural testosterone. Yet while your testosterone level plays a key role in your sex drive, using a testosterone supplement to treat low libido in women is controversial.
Here’s what doctors know about testosterone’s role in low libido in women and how the hormone might be used as a treatment.
Your Testosterone Level and Low Libido
Testosterone is known as a male sex hormone, but women have levels of the hormone in their system as well. The hormone is part of what drives desire, fantasy, and thoughts about sex, and even helps provide the energy for sex in women, says Linda Bradley, MD, vice chair and ob-gyn for the Women’s Health Institute at the Cleveland Clinic in Cleveland.
Women’s testosterone levels gradually go down as they age, and lower amounts of the hormone can lower muscle mass, affect skeletal health, and decrease sensitivity in the vagina and clitoris, which affects libido, Dr. Bradley says.
Testosterone may explain why birth control pills might cause a drop in libido. The estrogen from the pill may bind to testosterone and lower women’s sexual desire, Bradley says. Lower testosterone levels are also believed to be the reason sex drive goes down after menopause.
The Debate About Testosterone Supplements for Women
Although it’s common for men to take testosterone to treat low libido, the U.S. Food and Drug Administration hasn’t approved testosterone replacement therapy for women. Some doctors do prescribe it for women as an off-label use, Bradley says. Women are given a fraction of the dose that men are prescribed, and therapy can involve oral testosterone supplements, a gel or cream, or a patch applied to the skin. Because giving it to women is controversial, some pharmacies won’t even sell testosterone to women, Bradley says.
Why the controversy? In general, research has shown that testosterone supplements don’t seem to give women the boost in libido that doctors expected to see. As a result, experts have doubted whether testosterone is doing what they think it should do, Bradley says. And because women’s sex drive is affected by so many things, including lifestyle factors such as relationship problems and stress, it can be difficult to measure
Also, testosterone has side effects. Acne and hair growth on the upper lip and chest are the most common; changes in your voice, weight gain, and male-patterned baldness are all known side effects of the hormone, Bradley says.
The biggest concern is testosterone’s long-term safety in women. Taking the hormone can raise the risk of developing high cholesterol. Also, testosterone is converted into estrogen in the body, and there’s concern that increased estrogen exposure could raise breast cancer risk. “It’s not something to be taken lightly,” Bradley says.
In one study of 814 women with low sexual desire who used a testosterone patch or a placebo for 24 weeks, researchers found that at a certain dose the hormone did help improve sex drive. However, four of the women taking testosterone developed breast cancer. Researchers don’t know if the hormone caused the cancer or if it was a coincidence.
If you have low libido, testosterone may help, but it’s important to weigh the benefits with the risks. In the meantime, Bradley advocates working on other ways to naturally increase your sex drive, from having healthy eating habits to turning off your Blackberry and focusing on your partner.
Learn more in the Everyday Health Sexual Health Center.