Testosterone what is the connotation of this word and what does it mean for women in particular? When we think about testosterone we think about masculinity, muscles, sex and increase desire. We think of manly men with huge muscles and even lots of hair! However, did you know women have testosterone too and that women make more testosterone than they do estrogen? Testosterone can help with sex drive for women with low desire but it can do a lot more than just that. Unfortunately testosterone starts to decline in the late 20s and this can be one of many factors of low libido in women. So I am often asked should testosterone be replaced? Let’s dive into this discussion in more detail.
Will my sexual encounters be better on testosterone?
Testosterone can improve sex drive and lead to better sexual encounters for some. For the midlife woman who is transitioning into menopause it may be life changing. Testosterone has been studied widely in men but not as much as women. Some of the studies done around female sexual dysfunction, arousal and desire have shown that testosterone can improve sex drive, arousal, and increases pleasure and responsiveness. When a woman is suffering from low sex drive and has a desire discrepancy with her partner testosterone may be an option. You are not alone, for many women low sex drive is common especially in midlife women and also it can be an issue for younger women as well. This is something I often hear that is very distressing for women and can add a lot of stress to a relationship.
What are the benefits and risks using of testosterone?
As discussed above it may be a key to improving your sex life and some data shows that testosterone may also help build muscle mass, improve fatigue and help with weight loss. However the data is scattered and few and testosterone would not necessarily been given for the latter. As with any medicine there are always risks, some greater than others. Testosterone is a hormone and it converts to estrogen in the body. Estrogen can increase the risk of blood clot and can be serious and life threatening. However, the risk is low and a good medical history with your healthcare provider is key to see if you might be at risk before you even start. Some things to keep in mind if you do not have a clotting disorder, are a normal weight, do not smoke and do not have certain other medical conditions, your risk of having a blood clot is very low. The risk of a blood clot is much lower on testosterone than when a woman is pregnant or on birth control pills.
What are some of the side effects of testosterone?
Again like risk, all medication can have side effects. Some women on testosterone will develop acne or a little bit of facial hair. If the testosterone levels in the body get to 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. It is necessary that your prescribing provider check your blood levels regularly to make sure you stay in the correct range, it is also important to check other components of the blood to make sure there are no effects on the liver or that the dosage is not working. Most women do not have these side effects if they are well controlled and with a provider who is knowledgeable about use of testosterone.
How should testosterone be given?
There are many ways to deliver testosterone. Some will do creams, gels, shots, pellets, troches, and drops. Testosterone for most women should be given in a topical form, either a gel or a cream that gets absorbed through the skin daily. I often prescribe testosterone as a topical cream for my patients and go over how to put it on and any precautions. This mode of delivery gives a very steady blood level of the hormone. There are other options as mentioned above but I talk about the different modes of delivery in detail with my patients and prefer topical means as it gives less ups and down and the roller coaster effect than can happen with injections and pellets.
Is testosterone right for me?
If you are in you midlife in your 40s-50s, testosterone may be an option to help with low libido and desire discrepancy. Make sure to see a provider who is specialized in sexual medicine. A sexual medicine provider takes a multifaceted approach and will look at other factors that may be contributing to your low libido.
As many of you know, I am a nurse practitioner who specializes in sexual problems in patients assigned female at birth and those that identify as women. My office is located in Georgia, and I see patients for telehealth as well that live in Georgia or Minnesota. Check out my blog on telehealth and you can read more about it in my teleahealth section under patients at the top of my webpage. There are certainly times when you might need an exam, we can coordinate with your local doctor or for local patients I have a local office. If you live outside of Georgia or Minnesota I offer counseling, coaching, and education appointments. During an appointment such as this I can discuss your sexual health concerns and share my knowledge and treatment options to help you have the conversation with a local provider. In this type of visit I cannot be your actual provider, or prescribe you medicines or specific treatments because legally, I have a license to practice medicine in Georgia and Minnesota only where I am bound by my licensing. Everyone deserves to have a healthy, vibrant sex life! Please take a look around my site and reach out if I can be over more help.
Shine brightly,
Dr. Quaile