If we say low testosterone, you might think of a TV ad starring a middle-aged man worried about “low T.” But even though testosterone is the quintessential “male” hormone, women make it too. Could a prescription for testosterone help women feel better? Some women have told us it does.
Does Testosterone Help Women, Too?
Q. After a friend told me that she had great success with testosterone cream, I asked my gynecologist about it. She prescribed a low-dose cream and I have been using it for years.
I am happy with the results. I have more energy, better mood, a high sex drive, amazing orgasms and less body fat. My husband is happy because I’m happy and our sex life is great. Why don’t more women know about this?
A. The FDA has not approved testosterone for women. The only way to get this topical medicine is with a prescription at a compounding pharmacy.
An oral medicine, Estratest, was once prescribed to treat symptoms of menopause. This is now only found as a generic pill, esterified estrogens with methyltestosterone. Like other estrogen replacement pills, it carries a black box warning about endometrial cancer and cardiovascular complications. That might help explain why many women haven’t considered whether they might need testosterone.
When Could Testosterone Help Women with Low Libido?
Most doctors will consider testosterone for a woman only if she has persistent difficulty with libido. However, measuring testosterone levels to make a diagnosis does not seem to be straightforward (Journal of Obstetrics and Gynaecology Canada, March 2017). Women’s sexual desire is not a simple barometer of testosterone in their systems. Psychological well-being and the state of the relationship also have strong effects on a woman’s interest in sexual activity (Journal of Sexual Medicine, March 2017).
A group of women approaching menopause reported on their libido and symptoms and provided blood for testing (Menopause, Nov. 2018). Those whose testosterone levels fluctuated most were more likely to report diminished interest in sex. Women who were depressed, those who reported vaginal dryness and those whose children were living at home were more likely to report decreased libido regardless of their testosterone levels.
Side Effects of Testosterone:
In some cases when testosterone levels are low, we expect that a cream or patch providing modest doses of this hormone might help women reclaim their libido. Excess testosterone may lead to irreversible side effects, including a deeper voice and enlarged clitoris. Some women may experience hoarseness, acne and growth of unwanted facial hair. Women who are still menstruating may notice changes in their periods. Liver problems and blood clots are other potentially serious reactions to testosterone.
Does Testosterone Help Women Athletes?
A study in the British Journal of Sports Medicine reveals that elite female athletes who have naturally high testosterone perform better than those with normal androgen levels. The investigators analyzed data for both male and female athletes from the 2011 and 2013 track and field world championships (Bermon & Garnier, British Journal of Sports Medicine, online, July 3, 2017 ).
Male sprinters tended to have higher free testosterone levels than men in other events. On the other hand, those in throwing events averaged lower testosterone than men in other events. Testosterone levels in women didn’t appear to vary by the event.
How Does High Testosterone Affect Competition?
When women with high testosterone were compared to those with low levels of this male hormone, performance differed slightly. Nonetheless, the small differences were significant.
Although the improvements in events such as pole vault, 400 meter hurdles, 800 meter runs and the hammer-throw were modest, at this level of competition, even a small advantage can lead to a championship. The women competing in the hammer-throw did 4.53 percent better if they had elevated testosterone levels. That was the greatest difference among all the contestants.