Several weeks ago, my column, Do you want better sex? struck a resounding note not only with female readers but also with many husbands who wish their wives to have fewer headaches. The general response was, Please write more about testosterone and how it can increase female libido.
Testosterone, the male hormone, has been called the hormone of desire. In males, the Big T builds muscle for boys and ultimately turns boys into sexually well-functioning men. Women also produce testosterone during puberty, but only about one-tenth as much as males. Later in life, they produce less, and this is why some authorities believe women lose interest in sex.
How do women know if they have less testosterone and therefore less tiger in the tank? There's good chance testosterone is lacking if they complain of little sexual desire, lack of energy, loss of height, decreased enjoyment in life, are sad or grumpy, fall asleep after meals and produce inadequate work performance. If the answer is yes to four of these conditions, there may not be enough big T.
Women may lack this hormone for several reasons. In North America, 700,000 hysterectomies are done every year. The ovaries that produce estrogen and testosterone are removed in 50% of these cases between the age of 40-44 years and 80% between 45 to 54 years of age. This sudden removal of hormones can trigger female sexual dysfunction (FSD).
Studies done at McGill University in Montreal showed that women whose ovaries had been removed proved to be more interested in sexual intercourse after treatment with a combination of estrogen and testosterone. So why is this combination, or testosterone alone, not prescribed more often to replace the tiger in the tank?
The problem is not simple. Some doctors are skeptical about the use of testosterone for women. They argue that not enough study has been done to demonstrate its effectiveness and long-term safety, and until research is complete testosterone should be used cautiously, or not at all. For instance, it's been shown that testosterone can have adverse effects on cholesterol levels, primarily decreasing HDL, the good cholesterol.
Other critics point out that FSD can be the result of many medical and psychological conditions such as an unhappy marriage or financial troubles.
Who is right about the use of testosterone will not be solved for many years. After all, the use of estrogen therapy for women has been a controversial subject since 1980. But female advocates of testosterone therapy complain that too many doctors are reluctant even to discuss sexuality, let alone accept the fact that some women would benefit from testosterone.
Dr. Jerald Bain, professor of medicine at the University of Toronto, is an exception. He prescribes testosterone, but with some reservations. He says that testosterone is not appropriate for women of childbearing age as they produce sufficient amounts at that age. And its use is also contraindicated in women who have breast or uterine cancer, liver problems or cardiovascular disease.
And there's another problem. Dr. Bain reports that blood studies to measure the amount of testosterone are not always a reliable indicator for gauging FSD. Ovaries and adrenal glands that produce testosterone do not store it. Once created, testosterone is secreted into the bloodstream where 99% becomes attached to sex hormone-binding globulin. The remaining 1% is known as bio-available testosterone or the working T. As well, some women with low amounts of testosterone have great sex lives while others with high amounts have a lackluster sexual drive.
Dr. Bain stresses that, just as no shoe fits all people, the same applies to the use of testosterone. He claims that some women do benefit from testosterone, but the dose must be tailored to individual needs rather than a “one-size-fits-all” prescription. This allows women to enjoy its benefits without experiencing possible side effects such as facial hair and acne.
Unfortunately, finding a doctor who is well versed in testosterone therapy is easier said than done at present.
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