a young couple being intimate in bed

Q. I have read that testosterone helps revive a woman’s sex drive. How do you find a doctor to prescribe it?

I’ve discussed this with my physician, a nurse practitioner, a urologist and a psychiatrist. The only person who responded said, “Well, if you want to grow a beard…”

The use of testosterone must be a very well kept secret. Is it true that hormone replacement therapy can have an adverse effect on desire?

A. Hormone replacement therapy often includes both estrogen and progesterone. The progesterone component can indeed diminish sex drive in some women. Even birth control pills can have a negative impact on libido. A study in The Journal of Sexual Medicine (Feb. 2012) reported that, “The treatment with Yasmin® (Bayer-Schering Italia) is associated with increased pain during intercourse, with decreased libido and spontaneous arousability, and with diminished frequency of sexual intercourse and orgasm.”

Researchers have discovered that testosterone may improve libido in postmenopausal women. In 2003 researchers reported in the journal Menopause that:

“Testosterone therapy improves well-being, mood, and sexual function in premenopausal women with low libido and low testosterone. As a substantial number of women experience diminished sexual interest and well-being during their late reproductive years, further research is warranted to evaluate the benefits and safety of longer-term intervention.”

A study published in 2008 in the respected Annals of Internal Medicine reported that:

“A daily 90-microL dose of transdermal testosterone improves self-reported sexual satisfaction for premenopausal women with reduced libido and low serum-free testosterone levels by a mean of 0.8 SSE per month.”

Another 2008 study called APHRODITE enlisted 814 women who were randomized to receive either testosterone or placebo. The trial (published in the New England Journal of Medicine) lasted a full year. The researchers concluded:

“In postmenopausal women not receiving estrogen therapy, treatment with a patch delivering 300 microg of testosterone per day resulted in a modest but meaningful improvement in sexual function. The long-term effects of testosterone, including effects on the breast, remain uncertain.”

Despite such data, the FDA has decided not to approve testosterone for low libido or sexual dissatisfaction. That is why health professionals are often reluctant to prescribe testosterone for women. A study is underway to determine the long-term benefits and risks of a low-dose testosterone gel. The scientists will be looking for cardiovascular complications, breast cancer and assessing general safety concerns. It will be several years before the study is completed.

To learn more about the pros and cons of testosterone you may want to download our FREE Guide to Female Sexuality. It will provide information about medications that can dampen desire as well as tips for lubrication.

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  1. Juanita

    How long does it take to see a increase in your libido using testosterone 2% cream??? Where did you apply the cream

    • Cynthia

      Hi, Juanita,
      Well, on 3 percent cream you will notice a difference in a short time. It took me a week or two to feel sexual desires, but everyone is different, and 2 percent isn’t enough for me. I would really talk to your doctor. It’s really your choice about what you want.

      I apply it directly to my clitoris. This is how my doctor told me he wanted me to apply it, and I spoke to others and they said it works best this way. Little strange, but things have been good for me so I won’t change what’s working.

      I’m still taking it. I had an issue with my insurance so I was off it for a little bit, and now I’m back on it. When I was off, I wasn’t the same. Happy I’m back on it.

      Any questions feel free to ask.

  2. Cynthia

    I had a friend recommend taking testosterone because I was always tired, depressed, and everything a mother can be. It was the best advice I ever got.

    I’m 40 now and have been using it for some years. I take the testosterone 3% cream. I have had no side effects but my clitoris is a bit larger which is a great thing because it’s so much more sensitive, and orgasms come very fast and are harder. Sorry to be so graphic but it’s the truth. I think it’s the best thing ever. I feel better, and I have no depression anymore. I’m in a better mood, and husband is happy because I’m happy.

    I originally started at 2% and then I asked the doctor if I can go to 3%, and that gave me much much better results–so much more energy, better mood, nice muscle tone, high sex drive, amazing orgasms, and my body fat dropped. I look so much more fit and have a lean waist line. I look like I’m 15 years younger than all my friends. My husband and I have gotten so much closer because I feel great about myself. I feel sexy, and our sex is great now. Actually, I think about sex more than he does now. Before steroids I lost my sex drive. When I got married in my 20s I had a very high sex drive but after aging and having kids your body changes. I now have more sex drive then I did at 20, which is crazy.

    I think there are much worse side effects with other drugs you take than testosterone. I would recommend taking 3% instead of 2% because it made a big difference, and if you are taking it you may as well work out and join a gym. That’s why athletes take it.

    I don’t see any reason not to at least try it. Once you do you will wonder why you haven’t done this years ago.

  3. Anne

    This is the kind of conversation so many of us need.m

    Thank you.

  4. Jessica w.

    I am on a small dose of a testosterone because I have none, literally. How long til I can feel the difference in my mood-energy.

  5. kd

    How long does it take for the testosterone to work for improved sexual arousal? Also, my doctor prescribed viagra for me. I’m post menopausal since about 2 yrs. ago. I have been nervous about using it. Has anyone used viagra? How did long (hrs or min) did it take to kick in and how long did it last. I have had a low libido for many years, unless I work out daily, which I don’t anymore.
    Thank you,

  6. AF

    I think it is horrible that women are being denied access to testosterone. It is like any other drug. It is needed by some and not others. It has side effects and benefits. Until its benefits are recognized the side effects will not be fully understood and characterized.
    It was a godsend for me. After the birth of my children I felt asexual and there was pain with sex. The idea of sex turned me off. Finally I found my estrogen was very low. Adding estrogen ended the pain but did not bring back the libido. Within a week of starting testosterone my libido was back. It only took a couple of weeks of testosterone to jumpstart my libido. Educate yourself.
    There is bio identical testosterone and synthetic methyl testosterone. Methyl testosterone is very strong and normally given in too large a dose for most women. I took 1 mg of bio identical testosterone compounded in a oral sublingual pill. Screaming to be Heard by Elizabeth Vliet has a good section on testosterone. Based on my experience you may know whether it is working in days and may only need to take it for days. It is so condescending of the FDA to say we cannot take testosterone safely when there are thousands of drugs approved that have serious side effects. Why did they get all cautious with this? It does not make any sense.

  7. s.h.

    In 1980, at age 29, I had to have everything removed, including ovaries. After a short time, after fat-stored estrogen left my body ( hot flashes were horrid), I complained to my obgyn about the problems. First thing he said was, “That’s just like a woman, if she can’t have it perfect, she doesn’t want it at all!”
    He then wrote me an Rx for premarin/testosterone mix. I began taking them, according to the directions of the obgyn. I had strange changes in my body. Facial hair, body hair, low voice. I even began to walk differently. It helped some with “drive”, but it was awful, and i felt less and less feminine and more masculine. I hated it. I even got acne.
    I would never recommend it to any woman, even like me, who has no ovaries!

  8. KH

    I have been using a low dose testosterone cream (in combination with a low dose progesterone and estrogen) for a couple of years with very good results.
    When I previously used a higher dose of testosterone, I did see some unwanted dark hairs, but I have not experienced that with my current dosage.
    Getting my hormones in balance has tremendously helped my libido and sexuality — at 54 and being postmenopausal, I feel pretty “normal” sexually, although admittedly not at the level of my 20’s and 30’s.
    I have found that the most efficient way of finding a physician who prescribes bioidentical hormones or other compounded prescriptions (uniquely prepared for your body’s needs) is to locate a reputable compounding pharmacist in your area and ask him/her for the name of the physicians for whom he/she fills prescriptions.

    • Deborah
      United States

      I take compounded testosterone cream 2.0 milligrams a day. I have not had any side effects at all. I t just make me feel better plus adds to my libido.

      • Jessica w.
        United States

        When did you start feeling the difference.

  9. fbl

    My muscles wasted pretty badly after taking a new blood thinner called Xarelto. My family Dr. prescribed hormone cream that I apply to my labia daily. After a few weeks my muscles did start coming back. Strength isn’t quite “there” yet but close. Unfortunately the muscle pain hasn’t stopped eight months after stopping the drug…sigh… I’m doing fine on Nattokinase, Ginko Biloba and vitamin E for the blood flow.
    I wasn’t aware of the effect on sex drive until it happened, but I’ve have no complaints-nor has my hubby!
    Also NO excess hair growth.

  10. senior citizen

    In response to milkat55 — the hair growth mentioned in my comment was from testosterone cream, applied locally, directly to the appropriate area. A small amount of the cream proved helpful, and the hair growth is primarily facial–and worth the trade off for the result. So far, after a couple of years of use, have not noticed other unpleasant effects.

  11. Dr. Judi

    Considering what milkat55 said about hair growth where the patch was placed, could this be a treatment for men for their baldness?

  12. happy to be a guinea pig

    I have been taking android (testosterone) since my histerectomy/oophorectomy 19 years ago at age 40. I had an extremely difficult time finding a hormone replacement therapy that made me feel better and that I could tolerate. Luckily, I had a very patient gynecologist who was willing to work with me to find the right combination. After doing much research, I asked him to prescribe testosterone.
    After much trial and error we finally settled on estradiol (estrogen) and a 10mg. capsule of powdered android which I empty into a small container and take just a trace amount of daily. My body knows if it needs more or less and the dosage is easily adjusted. There clearly is a need for more research because menopause and especially surgical menopause is often very difficult to go through.

  13. milkat55

    I use transdermal estrogen and oral progesterone. When I asked about lost libido, I was given transdermal testosterone. It worked, but, unfortunately wherever I applied it, grew hair. In my case, on my lower abdomen. I would guess the mustache and beard growth, mentioned in the comments, came from oral testosterone.

  14. senior citizen

    It is a matter of priorities like the choice presented with many medications and treatments. Testosterone cream is helpful in boosting libido as well as ability for orgasm, but it does increase hair growth. So, if the former is the more important, then the tweezers stay handy to pluck out unwanted hairs.
    One’s gynecologist is the ideal source for information, and if agreed upon, prescription for testosterone. Of course, other possible side-effects, and long term problems should be thoroughly investigated, and discussed before use.

  15. Dr. Judi

    In the country where I live, in the 1960s testosterone was frequently prescribed for older women. Their initial response was favorable, but soon they developed mustaches, and the beard quoted above. And these changes were irreversible. ALL of them were quite angry and upset at this side effect.
    I never prescribed it, primarily because it made them so very unhappy about the hirsutism (hair growth).

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