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TESTOSTERONE FOR SEXUAL DYSFUNCTION

Sexuality is a complex entity. Libido is your desire to engage in sexual behavior. Sometimes libido can be decreased because of hormones. Testosterone, which is present in men and women, is one of those hormones.

Testosterone therapy has been shown to improve sexual function in many postmenopausal women especially the symptoms of sexual desire, arousal and orgasmic response according to the most recent evidence-based Position Statement from the North American Menopause Society (NAMS).

Based on clinical trial evidence, postmenopausal women may be candidates for testosterone therapy, but should first be evaluated for other causes of their sexual concerns, more appropriately treated with alternative approaches.  Conditions that can decrease sexual desire include psychosocial issues (stress, fatigue, relationship conflicts), psychological disorders (including depression or anxiety), medical conditions (such as vaginal atrophy or hypothyroidism), and drug use (including antidepressants and alcohol).

Shots of Depo testosterone 25 mg IM one dose every 4 weeks may be used for physiological replacement in patients with low serum testosterone. Pre-treatment levels should be measured, between 30 and 90 mg/dl is normal. The level should be checked prior to the third shot. Low levels in some postmenopausal women may make the lab results inaccurate.

Oral formulations are available combined with estrogen (Estratest) or special compounding pharmacies can supply it solo.  Only oral and intramuscular (injections) are government approved.

For men, the shots are 200-300 mg every 2-3 weeks, normal levels are 300 - 100 mg/dl and they should have somewhere above 500. Gels are also available for men to apply, as are patches.

For women, creams and patches are also available which contain testosterone. We can order these from a compounding pharmacy. The hormone is absorbed through the skin into the bloodstream.

Mild side effects of testosterone include: excessive hair growth, clitoral enlargement, acne, deepening of the voice, and - rarely - increased cholesterol. We give very low doses to hopefully avoid these symptoms. If you experience any of these, call the office and we will decrease the dose.
  FEMALE MALE
Free 4-23 mg/dl 70-530 mg/dl
Total 25-95 mg/dl 225-900 mg/dl


 





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