Female Sexual Dysfunction
Testosterone Patches Can Help Revive Women’s Sex Drive
By By Melissa Schorr ABC news
Feb 20, 2003, 8:54pm

Researchers are reporting new evidence confirming the theory that testosterone replacement in post-menopausal women can help bring back the libido.
The study, reported in the current issue of the New England Journal of Medicine, tested testosterone patches on 75 sexually disinterested women who had had their ovaries removed — a condition known as surgically induced menopause — causing them to stop producing enough of the hormone thought to be crucial for a sex drive.
The women on the testosterone patches were two to three times as likely to have sexual thoughts and actions than those who were not, the researchers say.
Testosterone Products Increasing
This testosterone patch, the first being tested for use in women, is not commercially available yet, but is being tested for its effectiveness. It is one of a growing array of testosterone creams, gels and tablets aimed at relieving the common complaint of a low libido in many post-menopausal women.
Although testosterone is thought of as the “male” hormone, women’s ovaries produce it, as well. When a woman reaches menopause, or has menopause surgically induced, testosterone levels drop, which many researchers believe may cause a lack of interest in sex in nearly half of these women.
Just as estrogen replacement therapy can relieve post-menopausal symptoms such as hot flashes caused by the drop in estrogen, testosterone replacement is thought to be able to recharge a stalled sex drive.
“[Those] women who have experienced a loss of sexual functioning may benefit from returning their testosterone levels to normal,” explains Dr. Jan Shifren, a reproductive endrocrinologist at Massachusetts General Hospital in Boston, the paper’s lead author.

Testing the Patch
To test the patches, the study enrolled women aged 31 to 56 who’d had their ovaries and uteruses removed for medical reasons such as fibroids or persistent bleeding. The women were also taking estrogen replacement therapy.
The women who were accepted into the study were unhappy with the lowered interest in sex they had encountered since their operations free mature dating.
Each woman was given a skin patch that contained either a high dose of testosterone, a low dose of testosterone, or no dose at all.
Every three months, the woman switched patches until they received each of the three doses, never knowing which they were receiving at the time.
The women completed sex diaries at the end of each rotation, evaluating their levels of desire, arousal, activity and pleasure.
At the higher doses of testosterone, the women were much more likely to report they were “in the mood” — having sexual fantasies, masturbating, or having sex at least once a week — than those not on testosterone.

Sex on the Brain
For example, the percentage of women who reported masturbating once a week went from 3 percent at the beginning of the study to 10 percent while taking either dose of testosterone.
The women who reported having sexual fantasies at least once a week went from 12 percent to 24 percent while taking high doses of the hormone.
And the women who reported having sex at least once a week went from 23 percent to 41 percent while receiving the high doses of testosterone.
However, the researchers concede they also found that even the women who unknowingly were receiving the dummy patches reported feeling more sexually charged.
For example, the percentage of women who reported having had sex at least once a week, which was 23 percent at the beginning of the study, rose to 35 percent among those wearing a dummy patch.
The researchers theorized this may be because the women were highly motivated to increase their sex drive, or that seeing the patch on their stomach served as a constant, visible reminder to the women to increase their sexual activity.
“The very intervention used to measure improvement — questioning subjects about their sexual experiences — enhances their sexual interest,” notes Dr. Jeanne-Marie Guise, an assistant professor of obstetrics and gynecology at the Oregon Health Sciences University in Portland.
Still, the study shows the patches are safe and effective, says Dr. Louann Brizbendine, director of the women’s sexual health program at the University of California at San Francisco, who often treats women with testosterone replacement therapy.

For All Post-Menopausal Women?
Although the study only looked at women who had their ovaries surgically removed, Brizbendine suggests that testosterone treatments will be effective in women who have gone through menopause naturally as well.
“These patches will be a wonderful option to treat women who have lost interest in sex, either from having their ovaries removed or from normal menopause,” she says.
Testosterone treatments for women have been around for the past decade, in tablets, injections and implants.
Early versions of testosterone replacement often resulted in too high levels, causing adverse side effects such as increased facial hair and lowered voice.
The new patches aim to keep testosterone levels similar to that of a young healthy woman to prevent such adverse effects, although the users of the patch did report some higher amounts of facial hair and acne.
The patches are being developed by Watson Laboratories in Salt Lake City and by Proctor & Gamble Pharmaceuticals in Cincinnati.
Other companies are developing various testosterone products for women as well. Cellegy Pharmaceuticals in South San Francisco is currently testing a testosterone gel for women called Tostrelle.
“The good news is that pharmaceuticals are finally paying attention to this area of women’s health,” says Brizbendine. “All of a sudden, people have discovered the women’s market for this.”
Cellegy estimates there are 11 million to 16 million women with a “testosterone deficiency” in the United States, but only 5 to 10 percent of the market is being served.
Brizbendine predicts that testosterone replacement therapy may soon be as big as traditional estrogen replacement therapy. “It should be the part of the assessment for every woman who has her ovaries out or goes through natural menopause,” she says.

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