Low libido is the No. 1 complaint of women experiencing sexual problems, and studies show that struggles with arousal are not rare: Between 30 and 43 percent of women experience some form of sexual dysfunction.
Symptoms include loss of sexual desire, vaginal dryness, painful or uncomfortable sex, poor arousal, inability to orgasm, loss of sexual motivation, loss of enjoyment of sex, and/or lack of sexual thoughts and fantasy. Even in a loving relationship, suffering from low libido or sexual performance dysfunction can harm your sense of well-being and create complications with your partner. To address these issues, we must consider the role testosterone plays and see if it can, in fact, rescue your libido.
What does testosterone have to do with it?
For many women, a loss of sexual motivation can be distressing. You may think that you are falling out of love, but this feeling might actually be due to a hormone imbalance—one that can be treated to get your body and your love life back on track.
Women need three key hormones to maintain hormonal balance: estrogen, progesterone, and testosterone. These hormones are produced naturally by the body. For a multitude of reasons, incorrect levels of these hormones disturb the balance, creating side effects such as endocrine disorders, hot flashes, cognitive decline, mood swings, weight gain, and decreased bone density. Low libido and reduced sexual desire may indicate low levels of testosterone production.
Testosterone is an androgen hormone that controls sexual desire, bone metabolism, and energy in both men and women. In men, testosterone is produced naturally by the testes; in women, by the ovaries and adrenals. Testosterone replacement therapy—also known as TRT—is an increasingly popular adjunct therapy for women who suffer from low libido, particularly among premenopausal, menopausal, and postmenopausal women.
The aim of TRT is to restore testosterone blood levels to within the normal range.
Isn’t testosterone a man’s hormone?
To some people, the word testosterone conjures an image of sweaty men in the gym. Although this stereotype does fit some men, it tells only a small part of the testosterone story. Testosterone is an essential hormone for both men and women. Women produce between 5 and 10 percent of the amount of testosterone that men do. However, it plays exactly the same important role in women as it does in men.
How is testosterone made?
The hypothalamus gland (in the brain) tells the pituitary gland (also in the brain) to release leutenizing hormone (LH), which in turn stimulates the testes or ovaries to produce testosterone. Testosterone then circulates in the blood, acting on cells throughout the body.
The brain has a high concentration of androgen receptors upon which the testosterone acts. The outcome is stimulation of the centers in the brain that motivate us sexually.
Is TRT right for me?
At various points in life, the body can face an internal fight against hormonal balance. Certain hormones decline as we get older, and this leads to a range of symptoms associated with aging for both men and women. For women, hormonal changes are typically associated with menopause; hormone replacement therapy (HRT) is often prescribed to help calm symptoms and restore quality of life.
A decade ago, HRT was largely a synthetic hormone based treatment. In 2002, the Women’s Health Initiative (WHI) study turned HRT on its head. Today, the preferred HRT option for managing menopausal symptoms is to use the natural hormones estradiol, progesterone, and testosterone.
If you have had your ovaries removed (oophorectomy), uterus removed (hysterectomy), or are going through menopause/postmenopause, and you have low libido, it is not unlikely that your testosterone levels are also low. For confirmation, consult with your doctor and arrange blood tests.
The following symptoms are related to low testosterone levels:
- Low libido
- Reduced sexual performance
- Low motivation
- Unexplained fatigue
- Reduced muscle strength
- Loss of concentration
- Decreased bone density
- Changes to body shape
If you feel that these symptoms relate to you, then you may have low testosterone levels. You can take a free online self-assessment test to further explore your symptoms, as well as diagnosis and management of testosterone deficiency. For a quick and easy assessment, check out the Female Sexual Function Index on the Hormone Solutions Blog.
Depending on the results, it’s worth going to see your doctor for some blood tests to confirm testosterone deficiency and explore testosterone replacement therapy options. Testosterone in blood can be measured by free and bound testosterone. (Bound testosterone is the hormone that has been bound to the carrier molecule—in this case, SHBG, or sex hormone binding globulin.) Testosterone levels should be tested in the morning, when levels are at their highest.
Some medications can also affect testosterone levels and sexual motivation either directly or indirectly. These include antidepressants, oral estrogens (the Pill and tableted HRT), thyroxine, phenytoin, some anti-inflammatory medications, antihistamines, and appetite suppressants, among others. A comprehensive list can be found by downloading the free booklet “Understanding Low Libido in Women.”
Which TRT method should I choose?
If your sexual desire and performance issues stem from low testosterone, there are a number of testosterone replacement therapy (TRT) treatments available to you.
>> Compounding formulas – A compounding pharmacy produces a custom formula for each patient based on a doctor’s prescription. Custom compounded formulas are often expensive and may not carry a standard or consistent dose.
>> Off-label use of men’s testosterone products – Some doctors prescribe male strength testosterone products (such as AndroGel and Testim) and adapt the recommended dose for female patients. Male testosterone therapies are available as pills, injections, pellets, patches, gels, and topical creams. Although they can be effective, these products have typically not been tested on women.
>> Look abroad for approved female products – Currently, the only testosterone product formulated for, and tested on women, is the Australian product AndroFeme. It is the first testosterone replacement product of its kind to undergo clinical trials to determine the correct dose.
When using any form of TRT, it’s important to monitor progress with your doctor regularly to make sure that the dose is sufficient and does not raise your testosterone to higher-than-normal levels.
What are natural treatment options for low libido?
If your sexual desire and performance problems are not linked to low testosterone levels, you can try increasing libido using these natural remedies.
>> Herbal supplements that regulate and nourish the endocrine glands also promote natural hormone production. This helps to restore hormonal balance. I recommend Macafem, a 100-percent natural supplement made from a special selection of Lepidium meyenii, a plant that is able to grow in the high altitudes of the Andes Mountains—thus, the herb is able to extract from the soil many nutrients with hormonal stimulating properties.
>> A change of diet may also help. Eating more foods containing zinc, magnesium, phytoestrogens, and protein can help encourage hormone production.
>> Changes in lifestyle, including exercise, yoga, kegel exercises, aerobics, and stretching, are beneficial on their own and in conjunction with other treatments.
The Food and Drug Administration (FDA) has approved very few therapies for sexual dysfunction in women specifically. Currently, only Australia has approved and tested a testosterone cream—AndroFeme—designed specifically for women.
In America, men have more than 24 FDA-approved sexual dysfunction drugs to choose from; this includes pills such as Viagra. Women, on the other hand, have zero FDA-approved testosterone therapies to choose from. Throughout the past 15 years, many drug companies have tried to get FDA approval on female libido treatment drugs, but so far all advances have been rejected.
There is a powerful global movement initiated by the International Society for the Study of Women’s Sexual Health to bring about a change to this imbalance on testosterone treatment options available to women. The Your Voice Your Wish online petition can be signed at yourvoiceyourwish.com.
By Michael Buckley, MPS, CD