Low libido and testosterone for women
One of the common problems that I see in my practice is lowered libido in women in their 40s and 50s. For some women, this is not a problem but for others it can cause significant distress.
Libido can be affected by a number of factors including (and not limited to!):
energy levels and sleep issues
medical issues
mental health issues such as depression and anxiety as well as stress
medications, drugs and alcohol
pain and discomfort experienced during intercourse
relationship issues
partner’s sexual issues
lack of privacy and time to be intimate as a couple
It can be a complex issue and often there are multiple factors impacting libido that need to be addressed. The women I see are often experiencing lowered libido during menopause and perimenopause and sometimes treating and improving the physical symptoms such as poor sleep and dryness of the vagina can improve their overall wellbeing and then libido also improves.
However, once these factors have been sorted out and if libido is still low, women often wonder if there is any kind of medical treatment available to assist them.
There is now the option of a female testosterone cream being available in Australia with a prescription from a doctor.
This cream is only licensed for use in those post menopausal women who have been diagnosed with ‘Hypoactive Sexual Desire Dysfunction’ (HSDD ) and eligibility for this will need to be explored with your doctor. Based on ICD-11 Criteria, HSDD can be diagnosed when a woman experiences lack of motivation and/or loss of desire to initiate or participate in sexual activity for several months and this causes personal distress.
Women need to be medically assessed as being suitable to use the cream and side effects are possible and can commonly include oily skin, acne, possible small amount of weight gain, increased hair growth eg under arms and on legs.
Women need to have blood tests before initiating treatment as well as regularly during use of testosterone therapy.
It doesn’t work for every women either and when starting treatment, I explain that this is a trial of therapy and if they have no benefit by 6 months, then it is recommended to cease treatment.
As this treatment is relatively new in Australia, not all general practitioners may prescribe this so you may need to ask your doctor to refer you to a professional with expertise in this area.
Refer to this consensus statement for more detailed information
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