Testosterone makes women friskier -- but should it be prescribed?

Testosterone ramps up women's sexual desires, according to a study just published in the New England Journal of Medicine.

The Procter & Gamble-funded study -- with the acronym APHRODITE -- involved 814 women treated at 65 different locations in the U.S., Canada, Australia, Sweden and the U.K. All of the women had what is medically referred to as "hypoactive sexual desire disorder" -- a chronic lack of interest in sexual activity. Study participants received 150 micrograms or 300 micrograms of testosterone a day delivered via a patch, or a placebo patch with no testosterone in it. Nobody (clinicians or women) knew who got what until the end of the study.

Other stats: The study ran for 52 weeks, and the effectiveness of the treatment was evaluated up to 24 weeks into it. The scientists gauged effectiveness as a change in frequency of "satisfying sexual episodes" within four-week periods. Safety was monitored for the entire 52 weeks and a subset of the women were tracked for even longer. None of the women took estrogen; all had passed menopause.    

The results: The group given 300-microgram patches experienced an uptick in satisfying sexual episodes that was measurable as early as the second month of treatment. They had, on average, 2.1 more such episodes per four-week period (compared with 0.7 more for the placebo group)--almost a doubling. But both testosterone groups said they felt more sexual desire than the placebo group did, as well as less distress. The results, to the authors, indicated a "modest but meaningful improvement in sexual function" for the 300-microgram group.

That doesn't mean the patch should be handed out willy nilly. There do appear to be some side effects: irritation where the patch is applied, and when the patch contained testosterone, increased facial hair growth. Four patients getting testosterone developed breast cancer, but the authors say it's not clear that this was due to chance or was related in some way to the hormone: one of the woman had symptoms before she began the trial.

Earlier studies had shown that testosterone can increase sexual desire in women taking estrogen: this one shows that it helps for those who do not. This was a longer trial than most have been as well.

In a related editorial, Julia R. Heiman of the Kinsey Institute for Sex, Gender, and Reproduction at Indiana University writes that the sexual improvements were "good news" and notes that the facial hair side effects didn't seem to lead to women dropping out of the trial. But the breast cancer cases are of concern, she says. "The apparent excess of cases in the testosterone groups could simply be due to chance (the size of the groups is too small to allow for analysis) but this potentially worrisome signal cannot be ignored," she says. She suggests a "need for caution in using testosterone until we understand more about its possible link with breast cancer and are better able to predict which patients are more likely to be subject to negative effects."

Heiman's editorial also mentions that estimates of low sexual desire prevalence in women range from 25% to 53%. She also notes that it's not always a problem for those who report it. How many do get upset? Here's a recent blog entry on a study examining that.

-- Rosie Mestel

Comments

[Rose]

I'm a widow, and I've lived alone for over ten years. I'm healthy, I'm enjoying my work, I have a wonderful community of friends and a close-knit family. But single men are pretty scarce. I found menopause and the diminished desire for sex that came with it a big relief. Why get upset because you don't want what you don't have?

[NotAgain]

Has anyione every considered the possibility that it is perfectly okay to simply grow old, that maybe it is perfectly NORMAL for anyone (male or female) to not feel sexual?

I can see post-menopausal women all over the country heaving a big sigh as their partners grab their own little blue pills and push for their other half to slap on a patch. And it won't be a sigh of relief.

[Hank]

Women protested insurance coverage of Viagra and have damned testerone and angrily blamed it for anything objectionable to women. Now they want it for themselves to make them more frisky? No so fast.

Where was your interest and "friskiness" when you and your men friends were younger? Now that you have aged, and need something to perk you up, what are you going to do with the men you turned down decades ago? What are you going to do to help those of no longer capable of normal sexual relations?

Nothing! You will go off and find yourself a young "stud" of the same age group with whom you refused sex many years ago.

I say no to administering testerone to women. It's a male hormone. Leave it that way, and in the future, think (a new wxperience for many of you) before you protest.

[Rosie Mestel]

Hank, thanks for commenting.
Women's bodies naturally make small amounts of testosterone, so it isn't an exclusively male hormone.
--Rosie Mestel

[JP]

NotAgain, don't confuse normal with desirable. Joint pain may be "normal" too. Only being able to afford 1 vacation a year may be normal - it doesn't mean I wouldn't enjoy 4. -JP

[KT]

Have you ever thought that there may be those of us out there that are suffering with decreased libido and young? I am a 40-ish woman with a husband who would appreciate a cure for my dysfunction. (And so would I for that matter!) This is due to other physical issues. This problem is not limited to older folks. I want t keep my husband, thank you!

[Allison]

I am 20 years old and have been having sex for 1 year. My boyfriend and I have been dating for 5 years and bought a house a year ago. In my opinion, most 20 year olds love sex. I hate it. Not because of my boyfriend, but sex in general. I want to like it because it is causing problems for us and I find it reasonable for my boyfriend to want sex all the time. He is 22. I have "virtually no testosterone" according to my Gyno. Any ideas? Oh, and my doctor suggested Mirena, but I already have some cysts on my ovaries. Any advice?

Allison

[Lori]

I agree with KT & Allison. I am in between their ages at 30 & I to have no libido. I am worried how bad it will get postmenopausal. They say women reach their sexual peak in their 30's. I'm waiting...I am afraid of the testosterone's side efects.I have already been plucking chin hairs since high school. Does that mean my testosterone levels are already high? I am also scheduled to start the Mirena IUD. Will that help?