For some, the menopause can spell a loss in sexual desire. Physical effects such as hot flashes, night sweats and vaginal dryness – all as a result of declining oestrogen levels – can bring about a decline in a person’s sex drive.
And testosterone might just be the key to changing that, according to a new study, which found it significantly improved sexual function and sexual wellbeing in postmenopausal women.
Although best known as a male hormone, testosterone is important for female sexual health, contributing to libido and orgasm as well as helping to maintain normal metabolic function, muscle strength, cognitive function and mood. However as women age, their testosterone levels naturally start to dip and they can also drop sharply following surgical menopause.
The new study found postmenopausal women treated with testosterone showed reduced measures of sexual concerns and sexually-associated distress.
However it was noted that oral formulations work best, as non-oral formulations resulted in some side effects such as mild weight gain, acne and increased hair growth.
Previous research has suggested that testosterone therapy can improve sexual function in women, but the available formulations have been designed for men and evidence for their safety or for adverse side-effects in women is scant.
For the study, published in The Lancet Diabetes & Endocrinology journal, researchers conducted a comprehensive systematic review and meta-analysis of testosterone treatment for women, including 46 reports on 36 trials involving 8,480 women.
Senior author Professor Susan Davis from Monash University, Australia, said the results suggest it is time to develop testosterone treatment tailored to postmenopausal women rather than treating them with higher concentrations formulated for men.
“Nearly a third of women experience low sexual desire at midlife, with associated distress, but no approved testosterone formulation or product exists for them in any country and there are no internationally-agreed guidelines for testosterone use by women,” she said.
“Considering the benefits we found for women’s sex lives and personal wellbeing, new guidelines and new formulations are urgently needed.”
As there were few studies available for premenopausal women, the authors noted that no conclusions could be drawn about the efficacy of testosterone treatment for sexual dysfunction in this group.
In studies involving surgically postmenopausal women, consistent beneficial effects were seen for all measures of sexual function. Testosterone treatment resulted in an increase in the frequency of satisfactory sexual events.
Treatment significantly increased sexual desire, pleasure, arousal, orgasm, responsiveness to sexual stimuli and self-image.
Women treated with testosterone also showed reduced measures of sexual concerns and sexually-associated distress.
More research needs to be done to understand potential long-term side effects.
“The beneficial effects for postmenopausal women shown in our study extend beyond simply increasing the number of times a month they have sex,” said Prof Davis.
“Some women who have regular sexual encounters report dissatisfaction with their sexual function, so increasing their frequency of a positive sexual experience from never, or occasionally, to once or twice a month can improve self-image and reduce sexual concerns, and may improve overall wellbeing.”