Review on January 25, 2008
Menopausal women typically experience low libido (or "hypoactive sexual desire disorder") when the ovaries and adrenal glands (primary production sites of sex hormones) significantly decrease hormonal production. 40% of postmenopausal women are said to experience loss of libido. The problem is even more dramatic in surgically menopausal women, who experience a 50% decrease in testosterone after the removal of the uterus and/or ovaries.
Estrogen therapy can help to relieve sexual issues such as vaginal dryness and vaginal atrophy after oophorectomy, but this alone will not necessarily reverse loss of libido. It seems that healthy amounts of testosterone are also essential for women to sustain healthy sexual activity.
Diverse types of testosterone therapy have been developed for women with diminished sexual drive, such as oral administration (pills) and injections. John Buster et al carried out a study published in the journal Obstetrics and Gynecology testing the effectiveness of a low-dose testosterone patch, and conclude that this is a particularly promising alternative for improving low libido in postmenopausal women.
The study tracked 533 women who complained of loss of libido after undergoing hysterectomy and oophorectomy, and had already been receivingtestosterone plays vital role in female loss libidoestrogen therapy for the past 3 months. Subjects were all in a steady, long-term relationship with a sexually functional partner. 266 women were placed in the control group, while 267 test subjects received the testosterone patch.
Results were tested by having the subjects complete a Sexual Activity Log diary over a 24 week period, to be measured against the Profile of Female Sexual Function, which tested 7 different levels of sexual function: sexual desire, sexual pleasure, sexual arousal, orgasm, sexual responsiveness, sexual concerns, and sexual self-image. Blood tests gauged testosterone and estrogen levels. Participants were also monitored for androgen affects such as facial hair, acne, and headache.
The trial concluded that the testosterone patch produced markedly positive results in terms of enhancing libido after 24 weeks. Optimal results were observed after 12 weeks and persisted through the rest of the 24-week period. By week 24, women in the test group noted improvement in all 7 categories of sexual function. Sexual desire increased on average by 49%, while total orgasms increased 68%.
Typical adverse side effects included headaches, increased facial hair, and skin reaction to the application of the patch, but incidence was infrequent and reported as mild. Furthermore, because the study lasted only 24 weeks, safety of the treatment beyond this period cannot be assured. It should also be noted that test participants were also undergoing estrogen therapy, which may have guarded against some of the androgen affects of testosterone.
The researchers also concluded that administration of testosterone by patch is most likely superior to other forms of administration (such as by injection or implant), because the patch delivers constant and controlled amounts of the hormone, which is optimal for keeping hormone levels balanced.
- Buster, John, M.D. et al. "Testosterone Patch for Low Sexual Desire in Surgically Menopausal Women: A Randomized Trial." Obstetrics & Gynecology 2005;105:944-952.