Testosterone therapy for women: Can it improve your sex life?

When it comes to hormone therapy, estrogen gets all the attention. But testosterone is also a player in a woman's sexual response, and testosterone therapy is occasionally considered as a way to treat low sexual desire in postmenopausal women if there is no other treatable explanation for the problem, such as conflict in the relationship, fatigue, depression, or vaginal dryness.

It's important to note, however, that although testosterone may influence certain aspects of sexual response, large studies in women of all ages have not identified a clear link between testosterone levels and sexual desire and satisfaction.

Given the limited effectiveness of testosterone in women and the difficulty of proving long-term safety in a research study, it is unlikely that a testosterone product ever will be approved for use in women. Specially formulated testosterone lotions and gels for women are available nonetheless, but the quality and dose of these compounded products, which are made to order at special pharmacies, are inconsistent.

Be aware of possible side effects

Side effects of testosterone products can include mild acne, liver problems, and a slight drop in HDL ("good") cholesterol, as well as a deeper voice and facial and body hair. Women who do choose to use compounded testosterone therapy should have a blood testosterone level checked periodically to ensure it doesn't get too high, since the actual amounts of testosterone in these products are unreliable.

Other potential problems could develop in the long run. Testosterone use has been associated with an increased risk of breast cancer, heart disease, and stroke. In fact, one study found that the risk of breast cancer was nearly 2.5 times greater in postmenopausal women who took hormone pills combining estrogen and testosterone than in those who didn't take the medications.

Over-the-counter DHEA (dehydroepiandrosterone) supplements are promoted as another way to boost testosterone levels, since DHEA converts to testosterone in the body. However, there's little reliable evidence that the supplements reduce menopausal symptoms or improve sexual function in healthy women. 

To learn more about how sex can change for older adults and how to realize the full potential of later-life sex, read Harvard's Special Health Report, Sexuality in Midlife and Beyond. 

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