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Will Testosterone Help Women Feel Strong and Sexy?

Will testosterone help women maintain a strong sex drive after menopause? It may benefit some women, but not others. Sex is complicated!

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 improves their sex lives.

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?

Another woman wrote:

“My libido had dropped to zero after menopause. A new doctor prescribed testosterone cream specially formulated by a compounding pharmacy.

“I was like a teenage boy until I found the right dose! It doesn’t take much. My bone density is excellent, and I now have an active sex life.”

A. The FDA has not approved testosterone for women. The FDA cautions that:

“prescription testosterone products are approved only for men who have low testosterone levels caused by certain medical conditions.”

The only way to get this topical medicine is with a prescription at a compounding pharmacy. Doctors are allowed to prescribe drugs “off label” if they feel the benefits outweigh the risks. The FDA does not approve of such actions, especially in the case of TRT (testosterone replacement therapy).

TRT & Libido?

Can testosterone help women with sexual arousal and satisfaction? A review in the journal U.S. Pharmacist (Aug. 19, 2019) reports that:

“TRT has been shown to be effective for improving libido, sexual desire, arousal, sexual frequency, and sexual satisfaction in women.” 

The long-term effects of this off-label use, have not been well studied, though, and safe dosing guidelines are not well established. 

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.

Share Your Experience:

Have you ever used TRT? If so, please share your story in the comment section below. 

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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