TestosteroneÂ plays a major role in sexual desire and performance, therefore testosterone replacementÂ therapyÂ is veryÂ effectiveÂ when used a slow low libidoÂ treatmentÂ in women
Testosterone and Women
Most women recognize testosterone is a male hormone that helps produce sperm and is responsible for the male secondary sex characteristics, such as large muscles, deep voices, and beards.
However, women also need testosterone as a precursor hormone to help make estrogen in their ovaries. Testosterone is the principal hormone governing female sexuality including desire, arousal, fantasy, frequency, pleasure and orgasm. In addition, testosterone is important to the functioning of the brain, the heart, blood vessels, oil (sebaceous) glands in the skin and is involved in fat distribution. Testosterone has a positive effect on metabolism (energy), mood and stimulating memory. It also aids in producing a general feeling of well-being.
The ovaries make 10 to 20 times less testosterone than men’s testes. Women’s adrenal glands also produce moderate amounts of testosterone, but they are unable to make up for ovarian failure.
Factors that may lower testosterone levels include:
Acute critical illness, burns, major trauma or surgery
Drug use (e.g. opiates, glucocorticoids, anabolic steroids, some anticonvulsants)
Chronic disease and its treatment
Most of the above cause an increase in sex hormone – binding globulin (SHBG). SHBG is a transporter protein found in the blood. SHBG acts as a carrier to move hormones around the body. Up to 99% of testosterone produced is bound to SHBG. Once bound to SHBG, the testosterone is inactive. Testosterone to which SHBG does not attach is the biologically available testosterone that is free to act on cells throughout the body – free testosterone.
The ovaries and adrenal glands produce testosterone. Women who have their ovaries removed (as part of a total abdominal hysterectomy with bilateral salpingo-oophorectomy or TAHBSO) immediately loseÂ 50% of their testosterone production capacity. Oophorectomized women become testosterone deficient when their adrenal glands cannot compensate for the loss of the ovaries. Women who have their adrenal glands removed (adrenalectomy to control cancer) lose up toÂ 50% of their testosterone.
Women who sustain damage to the pituitary gland in the brain lose all of their testosterone production capacity, because the pituitary stimulates both the ovaries and adrenals. Low testosterone levels are also associated with both Parkinson’s and Alzheimer’s disease.
Most gynecologists prescribe estrogen after a complete hysterectomy (TAHBSO), but often fail to prescribe testosterone replacement. Hence, the hysterectomized woman may develop profound fatigue and lose her libido. Adding testosterone to the estrogen will maintain her libido, increase concentration and prevent her osteoporosis.
In women, testosterone levels are at their highest around the age ofÂ 20 years. Levels steadily fall with age. At the age of 40 years women’s serum testosterone levels are approximately half what they were at age 20. This level continues to fall with age. In a peri-menopausal woman low sexual desire, unexplained fatigue and lack of energy are commonly due to low testosterone.
Women can be prescribed reduced-dose testosteroneÂ as a lowÂ libido treatment. This is a common off-label practice among doctors in the USA and worldwide, where no testosterone product is government approved for use by women. The situation in Australia is distinctly different.
Using Testosterone in Women’s Options?
Pharmaceutical-grade testosterone products have been available for use in men for the past 60 years. These products come in many dose forms including injections, patches, pellets, gels and creams. They are specifically designed for use in men and the amounts of testosterone they provide are generally too high for use in women.
Worldwide, there is only one pharmaceutical-grade testosterone product specifically designed for use in women – AndroFemeÂ® testosterone cream (Lawley Pharmaceuticals, Australia). Clinically trialled and available since 1999, it provides an effective and reliable mode for the safe administration of testosterone to women with low libido. Other delivery methods such as lotions, gels, sprays, troches and capsules made by compounding pharmacies have not been clinically tested, manufactured to approved standards or proved to be as effective as testosterone cream for the management of low libido.
The AndroFemeÂ® testosterone cream has virtually replaced other forms of testosterone previously used.
Older forms of testosterone: Some obstetricians and gynecologists (OBGYN’s) will try patients on monthly testosterone injections to see how they respond. Women who use testosterone injections for an extended time (6 months) may develop acne, balding, male pattern hair growth on the face, chest, and limbs (hirsuitism), and voice deepening. This is because the testosterone blood concentration is usually too high. Additional side effects can include headache, nausea, fluid retention, mood swings and anxiety.
Some compounding pharmacies make testosterone gels, creams, lotions, sprays, implants and troches. However, these products are highly variable in their quality, have not been tested for efficacy or accuracy of dosing and have not been subject to the rigorous checks and balances of government regulators. These can be used as a treatment for low libido but it’s advisable to use a pharmaceutical grade cream instead.
Additional Treatment Options
Your doctor must treat the underlying reason for your lack of desire. It must be tailored to your specific case. There is no Ã¢â‚¬Ëœone size fits allÃ¢â‚¬â„¢ cure for low libido.
Testosterone for low libido due to menopause and hysterec- tomy and testosterone deficiency
Progesterone, estrogen and testosterone for Turner syndrome, a genetic disorder
Surgical repair of a damaged vagina with vaginismus
Insulin for diabetes
Radioactive iodine for goiter
Kidney transplant for kidney failure
Psychiatric care for post traumatic stress disorder resulting from rape
Alprostadil for blood vessel problems in the groin
Psychotherapy for poor body image
Group counseling for low self-esteem
Physiotherapy for vaginismus is muscle retraining with Kegel exercises, sensate focus, and a series of lubricated, plastic vaginal dilators of gradually increasing widths. It usually takes three months for the PC muscles to benefit from exercises. Psychotherapy with a properly qualified counselor can help if the cause of vaginismus is past sexual trauma. You may fear pregnancy, or control by your sex partner, or losing control during orgasm.
A significant proportion of women who complain of low libido have underlying low testosterone levels. Determining if testosterone levels are low is a very important first step in addressing low libido in all women.
What About Homeopathic and Herbal Treatments?
Homeopathy is a complementary therapy. Homeopaths claim that like cures like. Essentially, homeopaths believe if a substance causes a disease, then you can cure it by taking a very minute, diluted amount of the same substance.
Homeopathic treatments contain NO testosterone, nor have they been demonstrated to cause any change in testosterone hormone levels. Be very careful when ordering products online that claim to contain testosterone, because usually they contain homeopathic forms of testosterone which are ineffective.
Additionally, the herbs tribulus, horny goat weed, tongkat ali extract (Eurycoma longfolia) and mucuna pruriens extract have not been shown in scientific testing to increase blood testosterone levels despite extravagant marketing claims.
Understand more on low libido in women:
The information in this article has been taken with permission from the official Lawley booklet onÃ‚Â Understanding Low Libido in Women.