Since women are living for
longer and longer they wish their lives to be happy. The desire to have a happy
sex life is one such prerequisite. Many women suffer from what is called
HYPOACTIVE SEXUAL DESIRE DISORDER (DYSFUNTION) (HSDD). This is
attributed to be many causes, however one such reason is supposed to be testosterone
deficiency. This happens in young as well as older women. Besides estrogens and progesterone women have
small amounts of testosterone in their bodies, much less than men. One of the
functions of this is to give us hairiness, muscle mass, help with fertility, menstrual
cycle and last but not the least with sexual feelings (Libido). The testosterone comes from the ovaries and adrenal
glands in different chemical forms and converted to testosterone at area of
need, within the body and inside the cells. As we age the testosterone levels
decline causing difficulty in women’s sexual desire. This is in addition to the
anatomical changes that are happening at the same time in post-menopausal women.
To some extent the clinicians have improved the anatomical difficulties of genitourinary
syndrome of menopause (GUS). However HSDD needed to be solved. There are many
reasons for HSDD to happen such as psychosexual problems in the relationship,
drugs, diseases such as Diabetes, thyroid disorders, local genital tissues damage.
HSDD leads to relationship distress, depression, poor self-image and fatigue.
After a fair bit of work it was decided to give testosterone therapy to these women,
only for HSDD not for muscular strength, cognitive improvement or any other
problems. Special suitable testosterone preparations were prepared for women. After
a proper history, investigations, counselling; after it was made sure that the
real cause of HSDD is lack of testosterone.
It was then offered as treatment. A testosterone preparation was offered
as dose of 0.5 ml of a cream containing 5 mgm of testosterone. The women are
advised to use it once a day in a measured amount and it is applied to thigh or
torso as a cream. It will take 4 to 6 weeks for it to take effect. If it doesn’t
help within six months it should be discontinued. Before starting the
testosterone other causes of HSDD, should be excluded. The side effects of
testosterone, can be acne, loss of hair, small gain in weight, deepening of the
voice and increased hairiness. The women should be observed for any excess of
testosterone. Hopefully along with the treatment of genitourinary syndrome of menopause
(GUS) and testosterone for HSDD, post-menopausal women can have a happier time
with their sex life.
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