Testosterone and Decreased Sexual Desire

Decreased sexual desire (Hypoactive Sexual Desire Disorder, HSDD) or low libido is common after natural or surgical menopause. Numerous studies have suggested that low dose testosterone worn as a patch and currently marketed in the UK as Intrinsa® has benefit in the treatment of HSDD. Recent data from the Aphrodite Study in which women, not on hormone replacement, were randomized to either the testosterone patch or a placebo patch for an initial 24 weeks demonstrated significant improvements in the frequency of satisfying sexual episodes for those women on testosterone. This included an increase in sexual desire, arousal, orgasm and pleasure along with a reduction in personal distress. The testosterone patch was well tolerated except for a higher incidence of hair growth. During the study four patients in the testosterone patch group were diagnosed with breast cancer introducing a possible causal relationship with breast cancer.
Currently there is no FDA drug approved for the treatment of decreased sexual desire in the US. Low libido is a complex subject and sometimes a difficult subject to discuss. The different types of female sexual dysfunctional, namely problems with desire, arousal, orgasm or pain should be differentiated from each other during a careful evaluation by a health care provider with expertise in this area. It is estimate that anywhere from 9 to 40% of women experience some form of female sexual dysfunction.
SJ Wininger, MD, FACOG

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