Testosterone Therapy: Does it increase sex drive?

What causes a decreased libido?
Many women experience a decreased libido for a range of reasons. Low testosterone levels can be one reason a woman may experience decreased libido. Other causes include depression or emotional distance between sexual partners. Antidepressants (especially Prozac and Zoloft) commonly have the side effect of decreasing a person's sexual drive. A more obvious reason for why a woman may not desire sex is because she simply does not desire the person she is considering having sex with. Sex is both a mental and physical activity, as is often the case in the reasons for not having sex.

Will testosterone help?
Testosterone will work to increase a woman's sex drive, but other treatments should also be looked into because testosterone therapy has some risks. If decreased libido is of concern to a woman she should explore the causes with a doctor or health care provider before jumping into testosterone therapy. Testosterone is only prescribed for decreased libido due to menopause. It is also only used short term and should not be considered a permanent solution, as little research has been done to confirm its effectiveness or safety in women.

How does it work?
A woman's body naturally produces small amounts of testosterone that work in combination with the production of estrogen, among other hormones. Frequently when a woman reaches menopause, she ceases to produce as much testosterone and progesterone, and in turn may experience a decreased sex drive. These hormones can be replaced and managed through hormone replacement therapy (HRT). But when a woman chooses to elevate her levels of testosterone, she also counteracts some of the protective qualities of HRT. HRT has been found to carry its own risks (such as an increased risk of breast cancer), but it also greatly decreases the risk of heart disease, which is a leading cause of death for women.

The Risks
Side effects include facial hair growth and acne. Weight gain and liver damage could also result, although since the testosterone used in this therapy is a fairly low dosage, these more severe side effects are much less common.

Women with elevated levels of testosterone also have higher blood pressure and increased risk of heart disease. If a woman chooses to raise her levels of testosterone she should first be screened for signs and symptoms of heart disease. High levels of estrogen relative to progestin levels may be associated with a loss of libido. However, estrogen replacement can also result in a decreased risk of osteoporosis and possibly slow the development of Alzheimer's. For menopausal women who choose testosterone therapy, they may desire sex more frequently, but they will also experience the symptoms of menopause more intensely.

The Bottom Line
Testosterone levels can be raised in women through patches applied to the skin or through injection. A woman should ask her doctor about starting with a very small dose, as this often causes the desired effects without the risks. Adjusting the dose can individualize treatment.

It is important to remember that the relationship between sexual drive and testosterone has not been extensively explored. It has been shown to increase libido, but researchers are still unsure about what other variables are at work. Other ovarian hormones, including estrogen and progesterone may also play a role, despite the lack of strong evidence at this point. There are also questions about whether testosterone effects only sexual motivation, or whether it also effects sexual activity. Sexual desire is most probably an interaction between hormones and a woman's emotional, physical, and psychological situation at any given moment.

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