Category: Testosterone

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A guy’s guide to sexual health

— What every man should know

Most people know the fundamental sportsmanship rule: hitting below the belt is illegal. The groin is highly sensitive, and a strike here can cause severe injury. While a man’s sexuality is off-limits for low blows, that doesn’t mean it’s off-limits for discussion with your doctor.

Too bad most men don’t see it that way.

Stats About Guys and Sexual Health

It’s not that men aren’t concerned about sexual health. In a 2023 survey, the Cleveland Clinic reported:

• 44% of men are worried about erectile dysfunction.
•39% of men are worried about loss of sex drive.
•36% of men are worried about low testosterone.

But of men surveyed, while 37% reported having experienced issues related to sexual health, only two in five sought professional help.

So, guys, let’s have a frank discussion about your most common sexual health concerns.

– Talking About ED

What is it?
Erectile dysfunction is the inability to get or maintain an erection firm enough to have sex. Many men think ED only occurs in older men, but ED is not exclusive to getting older. There are men in their 40s and 50s who experience ED and men in their 70s, 80s, and 90s with great sex lives.

What are the symptoms?
Failure to reach or sustain an erection more than half of the time, at any age, may indicate a condition that needs treatment. Other symptoms may include decreased sexual desire and less rigid erections.

Who is at risk?
ED has a wide range of causes, from vascular issues and nervous system issues to hormone or psychological issues. Chronic health conditions, which about 1 in 4 guys face in the U.S., also impact erectile function. These include diabetes, heart disease and hypertension, obesity, high cholesterol, and smoking. Many medications that treat these conditions have side effects that contribute to ED. Bottom line: ED is a complex, common medical condition and not one to treat lightly or feel self-conscious about.

What is the most common myth about ED?
That taking testosterone supplements will cure ED. Low testosterone may or may not be what is affecting your erections. Taking supplements with a normal testosterone level will not result in better erections and may cause side effects if not taken appropriately.

What treatments for ED are you most excited about?
Low-intensity shock wave lithotripsy and platelet-rich plasma (PRP) therapy injections. There are also new oral therapies in clinical trials. ED is very treatable. It all comes down to which treatment is right for your lifestyle.

– Talking About Low-T

What is it?
Testosterone deficiency syndrome or Low-T means that a man’s body is not making enough testosterone, the primary male sex hormone that regulates fertility, muscle mass, fat distribution, and red blood cell production.

What are the symptoms?
Reduced sex drive, reduced erectile function, loss of body hair (including facial hair), loss of lean muscle mass, feeling tired all the time, obesity, and symptoms of depression are the specific symptoms most directly linked to Low-T.

Who is at risk?
Data suggests that about 2.1% of men (2 in every 100) may have clinically Low-T, which is a low blood testosterone level of less than 300 nanograms per deciliter (ng/dL). It is more common in men over the age of 80, who have diabetes, or who are overweight. Don’t just assume you have Low-T and start popping pills. Talk to your doctor.

What is one of the most common misconceptions about Low-T?
That it’s a normal part of aging, and nothing can be done about it. If you have clinically Low-T, it is essential to treat it. Testosterone is not just for sexual health. It aids in bone, cardiac, mental, and psychological health. Anyone whose testosterone is in the low-normal range may also benefit from treatment, but a physician should manage it.

What treatment for Low-T are you most excited about?
Bio T Pellets because they quickly get testosterone into the normal and high normal range for men.

– Talking About Peyronie’s Disease

What is it?
Peyronie’s disease is a condition by which a small scar forms in the lining of the penis resulting in penile curvature, loss of penile strength, indentation, or pain.

What are the symptoms?
During the first 12 months of developing Peyronie’s disease, you may experience pain with erections, curvature of the penis, penile shortening, an abnormal shape to the penis, or a lump in the penis.

Many men are worried that Peyronie’s disease will cause issues with getting and maintaining erections. While there is some association between penile plaque and restriction of blood flow in the penis, this is not always the case.

Who is at risk?
Peyronie’s disease typically forms from microscopic trauma that occurs during intercourse. The trauma leads to inflammation and then a penile scar or lump. It is most common in men over the age of 40.

What is the most common misconception about Peyronie’s
That it is a rare condition. It can feel very isolating, since many men don’t talk about it or seek care because they find it embarrassing. In reality, it’s estimated that 6-10% of adult men have Peyronie’s disease.

What treatments for Peyronie’s disease are you most excited about?
Introducing injectable collagenase into penile plaques has dramatically broadened the options for safe and effective office-based treatment of Peyronie’s. Surgery remains highly effective at correcting the curvature for more severe or bidirectional (S-shaped) curvatures.

The Physical/Mental/Sexual Health Connection

Men, your physical, mental, and sexual health are closely related. Changes in sexual health may indicate underlying medical conditions. Sexual health affects your quality of life and mental health.

A urologist can provide many management options, including observation, medication, injections, surgery, and more. Sexual health is a crucial component of overall health, so if you’re experiencing any issues, it’s time to consider seeking help from a physician.

Complete Article ↪HERE↩!

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Testosterone and Low Libido in Women

— Testosterone plays a major role in a woman’s sex drive. But if that sex drive fizzles, replacing the hormone with a supplement isn’t as simple as it sounds.

One of the issues with testosterone supplements is that they have side effects, such as acne and hair growth.

By Ashley Welch

Testosterone may be known as a male sex hormone, but women need it, too. Testosterone is part of what drives female desire, fantasy, and thoughts about sex. It also plays a role in ovarian function, bone strength, and the overall well-being of women, says Kelli Burroughs, MD, an obstetrician-gynecologist at Memorial Hermann in Houston. Yet while your testosterone level plays a key role in your sex drive, taking it in supplement form to treat low libido remains controversial.

Here’s what doctors know about testosterone’s role in low libido in women and how the hormone might be used as a treatment.

Testosterone Helps Fuel Our Sex Drive

Women’s testosterone levels gradually go down as they age, and lower amounts of the hormone can also reduce muscle mass, affect skeletal health, impact mood, cause fatigue, and decrease sensitivity in the vagina and clitoris, which affects libido, Dr. Burroughs says.

A drop in testosterone levels is believed to be the reason sex drive goes down after menopause, according to the North American Menopause Society.

Research Remains Unclear

Although it’s common for men to take testosterone to treat low libido, the U.S. Food and Drug Administration (FDA) hasn’t approved testosterone replacement therapy for women. Some doctors do prescribe it for women as an off-label use, notes Jenna M. Turocy, MD, an ob-gyn at NewYork-Presbyterian Columbia University Irving Medical Center in New York City. “These products include testosterone skin patches, gels, creams or ointments, pills, implants, and injections, often designed and government-approved for men,” Dr. Turocy says.

Testosterone doses provided by these formulations generally are much too high for females, so women are given a fraction (usually one-tenth) of the dose that men are prescribed, notes Barbara Schroeder, MD, an assistant professor and ob-gyn with UTHealth Houston.

“There is no dose that we can say is absolutely safe for women,” she explains. “There are no large randomized trials that have looked at this.” That’s why Dr. Schroeder says to check baseline testosterone levels and re-check them every three to six months to make sure they’re not too high. “The goal is to aim for testosterone levels that are in the normal premenopausal range,” she adds.

Still, testosterone supplementation for women with low sex drive is rarely recommended in the United States, especially for premenopausal females, given the limited data on safety and efficacy, Turocy explains.

One of the main issues is that testosterone has side effects. Acne and hair growth at the application site are the most common, Schroeder says. Changes in your voice, weight gain, hair loss, oily skin, mood changes, and an enlarged clitoris, may also occur, Turocy adds.

But the biggest concern involves testosterone’s long-term safety in women, as no robust scientific studies have looked at potential lasting effects.

In a review of 36 randomized controlled trials published in the Lancet Diabetes & Endocrinology in October 2019, researchers determined that testosterone therapy is effective at increasing sexual function in post-menopausal women. They noted that when taken orally, testosterone was linked to significant increases in LDL, or “bad” cholesterol, and reductions in total cholesterol, HDL, or “good” cholesterol, and triglycerides. These effects were not seen with testosterone patches or creams. More importantly, the researchers concluded that “data are insufficient to draw conclusions about the effects of testosterone on musculoskeletal, cognitive, and mental health and long-term safety and use in premenopausal women.”

What Else May Help With Low Libido

If you have low libido, testosterone may help, but it’s important to weigh the benefits with the risks. Know that there are other options that may be beneficial.

“If concerned about low sex drive, women should consult a knowledgeable healthcare provider who can evaluate their individual medical history, symptoms, and hormone levels,” Turocy says. “It’s essential to take a comprehensive look at their sexual health, considering not only hormonal factors but also psychological, emotional, and relational aspects.”

Other potential causes of low sex drive, such as stress, relationship problems, medication side effects, or underlying medical conditions, like nerve issues or endometriosis, should be explored and addressed before considering hormone supplementation, she says.

Finally, don’t ignore the power of healthy lifestyle modifications. “Implementing healthy lifestyle changes such as diet and exercise can also boost energy levels and self-image perception resulting in increased libido,” Burroughs says. According to a study published in July 2021 in the Journal of Sexual Medicine, regular exercise one to six hours per week was associated with benefits in desire, arousal, lubrication and sex-related distress in women experiencing sexual dysfunction.

Complete Article ↪HERE↩!

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Can Men Get Periods?

— Cisgender men don’t have menstrual periods, but testosterone levels vary from day to day, which may cause some mental and physical effects.

By Kimberly Holland

Like women, men experience hormonal shifts and changes. Every day, a man’s testosterone levels rise in the morning and fall in the evening. Testosterone levels can even vary from day to day.

Some claim that these hormonal fluctuations may cause symptoms that mimic the symptoms of premenstrual syndrome (PMS), including depression, fatigue, and mood swings.

But are those monthly hormonal swings regular enough to be called a “male period”?

Yes, claims psychotherapist and author Jed Diamond, PhD. Diamond coined the term Irritable Male Syndrome (IMS) in his book of the same name, to describe these hormonal fluctuations and the symptoms they cause, based on a true biological phenomenon observed in rams.

He believes cisgender men experience hormonal cycles like women. That’s why these cycles have been described as “man-struation” or the “male period.”

A woman’s period and hormonal changes are the result of her natural reproductive cycle, sex therapist Janet Brito, PhD, LCSW, CST says. “The hormonal changes she endures are in preparation for possible conception. [Cisgender] men do not experience the cycle of producing ovocytes, nor do they have a uterus that gets thicker to prepare for a fertilized egg. And if conception does not occur, they do not have a uterine lining that will be released from the body as blood through the vagina, which is what is referred to as a period or menstruation,” Brito explains.

“In this definition, men do not have these types of periods.”

However, Brito notes that men’s testosterone levels can vary, and some factors can influence testosterone levels. As these hormones shift and fluctuate, men may experience symptoms.

The symptoms of these fluctuations, which may share some similarities with symptoms of PMS, may be as close to “male periods” as any man will get.

IMS is supposedly the result of dipping and oscillating hormones, specifically testosterone. However, there’s no medical evidence of IMS.

However, it’s true that testosterone plays an important role in a man’s physical and mental well-being, and the human body works to regulate it. But factors unrelated to IMS can cause testosterone levels to change. This is thought to lead to unusual symptoms.

Factors that can influence hormonal levels include:

  • age (a man’s testosterone levels start declining
    as early as age 30)
  • stress
  • changes in diet or weight
  • illness
  • lack of sleep
  • eating disorders

These factors can also impact a man’s psychological well-being, Brito adds.

The symptoms of so-called IMS mimic some of the symptoms women experience during PMS. However, IMS doesn’t follow any physiological pattern the way a woman’s period follows her reproductive cycle, as no hormonal basis of IMS exists. That means these symptoms may not occur regularly, and there may be no pattern to them.

Symptoms of IMS are vague and have been suggested to include:

  • fatigue
  • confusion or mental fogginess
  • depression
  • anger
  • low self-esteem
  • low libido
  • anxiety
  • hypersensitivity

If you’re experiencing these symptoms, there is likely something else going on. Some of these symptoms may be the result of testosterone deficiency. Testosterone levels do naturally fluctuate, but levels that are too low can cause problems, including:

  • lowered libido
  • behavior and mood problems
  • depression

If these symptoms persist, make an appointment to talk with your doctor. This is a diagnosable condition and can be treated.

Likewise, middle-aged men may experience symptoms as their natural levels of testosterone begin to fall. This condition, colloquially called andropause, is sometimes referred to as male menopause.

“When it comes to andropause, which does show up in the [anecdotal] research, the symptoms tend to be fatigue, low libido, and [it] tends to affect middle-aged men due to low testosterone levels,” Dr. Brito says.

Lastly, the term male period or man-struation is used colloquially to refer to blood found in urine or feces. However, Brito says, bleeding from the male genitals is often the result of parasites or an infection. No matter where the blood is located, you need to see your doctor for a diagnosis and treatment plan as soon as possible.

IMS isn’t a recognized medical diagnosis, so “treatment” aims to:

  • manage symptoms
  • adapt to the emotions and mood swings when they
    occur
  • find ways to relieve stress

Exercise, eating a healthy diet, finding ways to relieve stress, and avoiding alcohol and smoking may help stop these symptoms from happening. These lifestyle changes can also help a variety of physical and mental symptoms.

However, if you believe your symptoms may be the result of low testosterone, see your doctor.

Testosterone replacement may be an option for some men with low hormone levels, but it does come with risksTrusted Source.

If your doctor suspects another underlying cause, they can schedule tests and procedures to help rule out other problems.

If you believe your partner shows signs of severe hormonal changes or low testosterone, one of the best ways to help him is to have a conversation. You can help him seek out professional help and find ways to manage any symptoms, regardless of their underlying cause.

Bad days that cause crabby attitudes are one thing. Persistent emotional or physical symptoms are something entirely different, and they’re a possible indication that you should see your doctor.

“[Symptoms] are serious if they are bothering you. See a doctor if your symptoms bother you. See a sex therapist if you need help revitalizing your sex life or see a mental health professional if you are experiencing depression or anxiety,” Brito says.

Likewise, if you’re bleeding from your genitals, you should seek medical attention. This isn’t a form of a male period and instead may be a sign of an infection or other condition.

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As menopause hit, my libido waned, my brain felt dull.

So I gave testosterone a try.

By Tara Ellison

As menopause hit, I found I wasn’t as interested in intimacy as I used to be. Sex started to feel like a box that needed to be checked a couple of times a week, and that was causing problems in my marriage.

But it wasn’t just sex. I felt was slowing down in many areas. After hot flashes in my 40s had sent me running to the gynecologist for help, I’d been using bioidentical creams to balance my declining hormones.

When, at 51, I confided to a friend that I’d had limited success with what my doctor prescribed, she said that she was thriving on something called hormonal “pellets.” I grilled her about them and then made an appointment with her practitioner, an internal medicine doctor.

He ordered extensive lab work, which showed that my testosterone levels were very low, which can happen with aging. The doctor said I had two options: do nothing, which he said would eventually likely lead to loss of muscle, decreased bone density and a host of other health complications. Or up my testosterone.

Testosterone therapy for women is a hotly debated subject. Studies suggest that testosterone can heighten libido in women with hypoactive sexual desire disorder (HSDD), at least in the short term. A recent statement by a group of international medical societies involved with women’s health endorsed the use of testosterone therapy in women for HSDD, and specifically excluded pellets and injectables as “not recommended.” It also cautioned there was not enough data to support the use of testosterone therapy for cognitive performance.

Women make between four to 10 times as much testosterone as estrogen, which the body can convert to estrogen. Despite its significance, no testosterone products designed for women are on the market and approved by the Food and Drug Administration. (Two non-testosterone, libido-focused drugs are available for premenopausal women.)

For men, the benefits of testosterone are well-documented — improved mood, sexual function and stronger bones — and more than 30 FDA-approved products are available, according to the agency. But long-term studies in women are lacking, including the effects on those who have a history of breast or uterine cancers and liver or cardiovascular disease. Although studies say testosterone is widely used in women, its use is considered off-label.

The pellets my doctor proposed are unregulated, and not recommended by the North American Menopause Society (NAMS) because of their high doses of testosterone and unpredictable absorption.

“There are a lot of misconceptions for the potential benefits of testosterone,” said Cynthia A. Stuenkel, clinical professor of medicine at the University of California at San Diego’s School of Medicine and past president of NAMS. “You’re going to lose fat mass. You’re going to gain muscle mass. You’re going to think more clearly. You’re going to reduce your risk of breast cancer. You’re going to improve your mood, and I think the global consensus pretty much dispels those proposed benefits.”

But I was desperate to feel better and at the time wasn’t deterred by some possible side effects, which included acne, facial hair growth and a lowered voice. And my friend was clearly convinced testosterone had helped her. The tiny dissolvable pellets, containing estrogen and testosterone, were inserted beneath the skin on my mid-buttock and would last between three to five months. If I developed any side effect, on the next re-up date we could adjust the dose or discontinue, my doctor said.

The insertion process took less than 10 minutes and about five days to kick in. I didn’t have to wait long to see improvement.

Within weeks, I was feeling good — my brain felt clearer — and my libido was in full swing again. It was hard to pass my husband in the kitchen without reaching over to touch him.

I can’t rule out a placebo effect of course, but having a jolt of testosterone seemed to make me more focused — I got things done. One morning in the magnifying mirror, however, I noticed a definite uptick in facial hair.< My husband liked the increased sexual activity and joked that he didn’t have to endure discussions about my feelings anymore since I had gotten more direct in my conversations with him. I also found I was more driven to work. Just generally, I felt more confident and it seemed like people responded to me differently because of that. And rather than being finely attuned to my spouse’s desires, I was pursuing my own. Was all this biochemical or, again, could it have been a placebo effect? “There are strong placebo effects for sexuality in research on aids for sexuality and research on testosterone,” she said. “Our culture has long painted women’s sexuality as a problem; when women have lower desire than men, the women’s desire is seen as too low or ‘hypoactive’ and, when their desire is higher than male partners, the women’s desire is seen as too high or ‘out of control.’ As a result, medical and other interventions for women’s sexuality, especially desire, are best viewed with a healthy skepticism: Are these interventions addressing a problem within the women or a problem created by gendered norms? Should the solution address women and their bodies or gendered prescriptions?” Women and the waxing and waning of sexual desire is a complex and tricky subject. But I was starting to wonder why there seemed to be fewer options available for women and less research about those options. Was the gender disparity slowing down progress for women’s sexual health? There seems to be an attitude of, “You’re past menopause, you’re not making babies anymore, what does it matter?” said Sharon J. Parish, a professor of medicine in clinical psychiatry and of clinical medicine at Weill Cornell Medical College. James Simon, clinical professor at George Washington University and a past-president of both the International Society for the Study of Women’s Sexual Health and NAMS, said “a lot more money” is available for research into men’s sexual health and “where there’s money, you have direct-to-consumer advertising. You have additional research and development. You have glitzy ads and promotions, et cetera., this is not a new subject for men or men’s sexual health.” Viagra, he said, which men can take for their sexual performance issues, just had its 23rd birthday. He added, “I think women’s sexual health has been largely neglected or put aside or denigrated or minimized because it took more time, was harder to measure, had less money and cachet involved, and it was easy for many in the medical community to do that, and women did not, and still to some degree, do not demand more, and that allows this to perpetuate.” Six months later, when I saw my gynecologist and said that I was using pellets, she looked alarmed and advised me to get off them as soon as possible. “They’re scary,” she told me and referred me to a recent article and study about worrisome side effects, among them mood swings, abnormal uterine bleeding and also greater likelihood of having to undergo hysterectomy when on the hormonal therapy.

Where you get into trouble is when women are given super high doses of testosterone.

“Keeping the total testosterone in the physiologic range, closer to where women were pre-menopause, without exceeding that level and giving excess testosterone, is the goal,” Parish said. “Pellets are extremely problematic; we don’t support those, because they result in what’s called super-physiologic ranges and can result in toxicity, and we don’t have safety data supporting that.”

Susan R. Davis, an endocrinologist and director of the Women’s Health Research Program in the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia, said instead of pellets women seeking help “would be better off using a testosterone gel or equivalent that’s approved for men and using a micro dose or a fraction of the dose. . . .

“You can do a blood test to make sure [a woman] is not going over the female limit,” she added. “You can vary the dose, and you can cut back the dose if she starts getting side effects” — unlike pellets, which stop working only after they’ve slowly disintegrated. Once a pellet has been inserted, it’s very hard to get it out if an issue develops.

“I think testosterone is important for women,” Davis said, “but we’ve got to be very cautious how we administer it and we need products approved for women. That’s what we need. It’s a bit like Goldilocks: there’s too much, too little, and just right, and if you use too much it’s bad. Higher doses are actually worse for sexual function. Women start to feel agitated, irritable, negative mood, so too much is bad. So, there is a ‘just right’ dose.”

Stuenkel, past president of NAMS, added: “If you’re going to do it, I think the transdermal preparations [patches that stick on the skin] make sense [since they] are FDA approved” — although for men’s dosing. “And so that’s not great, but I think in many ways it’s safer.”

Yet, for many women, dissatisfied with gels and the like, pellets can seem worth the risk — at least for a trial run.

In my case, I had gone from having no interest in sex to wanting lots of sex. But it hadn’t been the salve that I had imagined.

My relationship with my husband was undergoing a systems update. While I was feeling much better and my behavior reflected that, there were some things about the old operating system that my husband missed. Our relationship had always been a bit “old school” — my world revolved around keeping my man happy. I could take his emotional temperature at a glance. I tried to match his hectic pace, even when I knew I needed rest, and I had always been willing to put his needs before my own. But that wasn’t sustainable over the course of a marriage.

I wondered what if my lack of sexual interest before pellets wasn’t just physiological but reflected the result of needing something different from my relationship to fuel and sustain our intimacy?

Low testosterone didn’t create the problems in my relationship but it made us more aware of them. We had long standing dynamics that needed to shift and change. We needed to have some difficult conversations to help us develop a deeper connection. A more satisfying emotional intimacy that could then naturally lead to increased sexual desire.

Testosterone may make you feel like having sex again but I discovered it’s not a magic bullet to solve everything.

It has been two years and given the long-term safety concerns about the pellets, I’ve decided to give them up when the current batch melts away — but I’m not giving up testosterone entirely. I’m considering using a patch or gel next.

The absorption might not be as effective, but at least I’d have more control over the dosage.

It may not fix everything, but finding the right balance between estrogen and testosterone — one that feels right in both my body and my marriage — seems worth it.

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Is Testosterone Therapy Safe for Women?

Testosterone is often prescribed to boost a low sex drive, but the research on its long-term effects remains questionable.

by Sarah Ellis

The hormone testosterone (called “T” for short in medical circles) has long been associated with the male physique, athleticism, and a heightened sex drive. But now, there’s an idea making the internet search rounds that testosterone therapy may be the secret sauce to revamping a woman’s shuttered sex drive.

Even health-conscious celebrities have gotten in on the hype. In 2011, Jane Fonda told The Sunday Telegraph that she started taking the hormone in her 70s to boost her sex drive. But before you run to your doctor to ask for a prescription, you should know that testosterone therapy is a controversial approach that is not FDA-regulated for women at this time. Despite its mythical reputation, this hormone isn’t a cure-all for sexual dysfunction, and it could even be dangerous for your health if not taken carefully. Let us explain.

How Does Testosterone Work in Women?

Testosterone may be known as a male hormone, but women’s bodies naturally produce it, too. It’s one of many hormones that work together to control our mood, metabolism, sexual desire, bone and muscle growth, and reproductive system. As you age, your hormone levels change, with one of the biggest shifts occurring during menopause when your menstrual cycle stops for good. Menopause causes your estrogen and progesterone levels to decrease, but interestingly, it is not associated with a sudden decrease in testosterone, according to the North American Menopause Society.

That said, there is evidence that testosterone decreases throughout your life. “Testosterone drops with age more than with menopause,” says Margaret Wierman, M.D., professor at the University of Colorado Anschutz Medical Campus in Aurora, CO and former Vice President of Clinical Sciences at the Endocrine Society. This may explain why testosterone pills, gels, and patches are sometimes touted by drug marketing campaigns (and celebs) as a sex drive booster for older men and women whose testosterone is naturally lower than it used to be.

The problem with this approach, according to Chrisandra Shufelt, M.D., associate director of the Barbra Streisand Women’s Heart Center at the Cedars-Sinai Smidt Heart Institute in Los Angeles, CA, is that testosterone is not necessarily the miracle drug you may be reading about on the internet. “If you search online, it seems like testosterone could be the panacea of all hormones, relieving everything from fatigue to weight gain to depression,” Dr. Shufelt says. But interestingly, she notes, there is no scientifically proven list of symptoms directly correlated to low T in women. Everyone’s hormone levels are naturally different, and what looks “low” on a testosterone test for one woman may be a perfectly normal T level for another.

Does Testosterone Impact Sex Drive?

To some extent, yes—but it’s not the end all, be all. Dr. Wierman explains that there are many different causes of sexual dysfunction (the term for when you’re no longer craving or enjoying sex). “There are mechanical hardware causes, there are relationship causes, there are mood causes,” she says. “There are rarely hormonal causes, and [in those cases] it’s usually estrogen deficiency that is causing abnormalities.”

What Is Testosterone Therapy?

Testosterone products are supplemental versions of the hormone that people take to increase their existing T levels. They come as a patch, gel, pill, tablet, or injection. Prescription testosterone products are FDA-approved for men whose bodies cannot produce adequate testosterone, due to genetic conditions like Klinefelter syndrome or damage from infection or chemotherapy. Testosterone products are not–we repeat, not!–approved for people whose testosterone is decreasing with age.

Nevertheless, this hasn’t stopped people from taking T (and doctors from prescribing T) for reasons other than it is officially intended. This practice has become so widespread, in fact, that the FDA issued a safety announcement in March 2015 urging doctors not to prescribe testosterone to anyone other than men with testosterone-lowering medical conditions. The statement noted that testosterone therapy could possibly increase your risk of cardiovascular problems or stroke.

For women, the risks of testosterone therapy are even less clear. “What we know about safety and what has been studied in women is the short-term effects, up to two years,” Dr. Shufelt says. “Longer effects are not known, and we do not know the effects in women who have risk factors for heart disease and breast cancer.” She stresses that longer-term studies will be necessary to determine whether low-dose testosterone therapy has detrimental effects on a woman’s body.

When testosterone is taken in excess quantities, Dr. Shufelt explains, it can lead to some pretty severe medical issues for women. “Too much testosterone in women can result in deepening of voice, hair loss, acne, anger, and negative changes to the cholesterol panel,” she says. Dr. Wierman remembers seeing a perimenopausal patient who had been given testosterone pellets at an anti-aging clinic. The high levels of T caused an increase in bad cholesterol, increase in blood pressure, excessive body hair growth, and loss of scalp hair.

Yikes! Are There Any Medical Guidelines for Women and T?

In September 2019, the Endocrine Society, International Menopause Society, European Menopause and Andropause Society, and others got together to publish a global consensus statement on the safety and efficacy of testosterone therapy for women. Dr. Wierman, one of the principal authors, explains the major takeaway: testosterone therapy has only proven to be useful for one specific subset of women–post-menopausal women with hypoactive sexual desire disorder.

Hypoactive sexual desire disorder (HSDD) is characterized by an absence of sexual desire, to an extent that it causes emotional distress and relationship problems for a couple. HSDD can be caused by a variety of factors, from medication use and chronic health conditions, to chemical imbalances and hormone deficiencies. It is diagnosed by a healthcare provider using a questionnaire and treated with anything from counseling to hormone replacement therapy, depending on the situation.

Dr. Wierman says that for post-menopausal women with HSDD, “controlled studies showed that getting high physiologic doses [of testosterone] increased satisfying sexual relations by one per month, with some other potentially good effects on sexual function,” such as arousal and ability to orgasm. The consensus statement specified that these doses should mimic – not exceed – natural levels of testosterone in premenopausal women. The statement authors urged that more research be done on testosterone therapy for women, and that testosterone products for HSDD should be created specifically with women in mind.

So, What Does This Mean for Me?

If you’re curious about testosterone therapy and wondering if you fit into the subset of women who may benefit, Dr. Wierman suggests talking to your regular women’s healthcare provider. “I think that most providers, whether they’re gynecologists or endocrinologists or primary care doctors who specialize in menopausal women, can discuss the issues related to testosterone pros and cons,” she says.

But before you walk away with a prescription, keep in mind that your low sex drive may not have to do with your hormones. “The first thing when someone has abnormalities in their sexual function is to discuss all the different other causes of it, and try to be a detective,” Dr. Wierman says. “If she is having painful intercourse, maybe it’s local vaginal estrogen she needs. If there’s stress in the relationship, maybe therapy is what they need.” Testosterone therapy is one option to increase libido, but it’s certainly not a foolproof key to amazing sex. And unless you’re a postmenopausal woman with HSDD, you probably want to steer clear.

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