Can testosterone help improve sex drive for women?

As a women’s health practitioner for 27 years, Melissa Tharpe gets a lot of questions about sex.

Often, women want to know what’s going on with their sex drive. Why it’s waning. Why having sex is suddenly uncomfortable. Why they just don’t have interest in it anymore.

Sadly, it’s another effect of a woman’s journey through menopause.

Tharpe, a nurse practitioner with Novant Health WomanCare - Winston-Salem, has a passion for treating the life-altering effects of perimenopause and menopause in women. And she wants her patients to know that there are treatments for the challenges that come with menopause. Don’t simply endure, she advises, take action.

And one key strategy, she explains here, is using testosterone to help deal with challenges around sexual health.

Isn’t testosterone just for a male sex drive?

Testosterone is present in both men and women. While men have a lot more, in females it’s produced in smaller amounts in ovaries and adrenal glands that support libido, muscle mass, bone health and blood cell production.

What happens to testosterone levels beginning in perimenopause?

Like estrogen, testosterone levels begin declining 5 to 15 years before menopause, which can lead to dry and thinning skin, loss of muscle mass and dryness of the vaginal area, which can make sex uncomfortable.

We blame estrogen for a lot of problems, but could it be the testosterone levels?

Estrogen loss still primarily leads to the most irritating of menopause symptoms, such as disruptions in sleep, hot flashes and mood changes. But a loss of testosterone levels might lead to women reporting a loss of energy, muscle mass, brain fog and a lack of sex drive.

How do you go about deciding whether a woman needs testosterone treatment?

I first assess a woman’s symptoms and listen to what her needs are. Women might be looking to improve their quality of life, but their needs might be different if they’re younger. The specific treatment will be weighed against other risk factors for a solution.

How do you use testosterone for treating a woman’s sex drive?

A cream, usually derived from a compound at a pharmacy, can be rubbed on a woman’s inner thighs, where fat tissue can absorb it easier, or in the vaginal area. It’s typically a daily application, done at night, but some women will opt to do it a few times a week. It’s also available in an estrogen/testosterone pill.

What changes do women using testosterone treatment expect to experience?

Primarily, women will see increased sexual libido, more energy, or have greater concentration and focus, although doctors or practitioners will closely monitor them to see if they’re getting the desired effects.

Are there reasons women shouldn’t try testosterone treatments?

I don’t recommend testosterone therapy to women who have a history of blood clots, heart attack, liver failure or severe kidney disease. For women who have had breast cancer and are on a hormone inhibitor to prevent recurrence, I consult with their oncologist to see if they would benefit from relief with testosterone cream, and that it would not interfere with any other hormone treatment they’re taking.

What about side effects for women using testosterone?

While women might be wary of taking testosterone, the amounts calculated are designed to minimize side effects such as skin changes, facial or body hair growth, mood changes or in rare cases, voice changes.