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Estrogen is not
the only hormone that can effect how women feel. Testosterone can
also play an important role in mood, energy, and muscle and bone
strength. Testosterone is most widely known for its effects in the
area of sexual health for both men and women. Testosterone
production peaks in our twenties and decreases about ten percent
per decade in both sexes. For many women this hormone can decline
in the PeriMenopause much earlier than estrogen and can be a cause
for declining libido as well.
Another cause
that is often overlooked is hysterectomy. A large percentage of
women who have had a hysterectomy will have lower levels of
testosterone, especially (but not only) if the ovaries have been
removed along with the uterus. Resolving this imbalance may be a
simple matter of restoring hormonal levels back into their normal
range.
Both sex
drive (libido) and sexual function can be affected by lower
testosterone levels. Did you know that up to 25% of women
experience symptoms of a syndrome called “Female Sexual Arousal
Disorder (FSAD)?” Women may experience being uninterested in sex,
unable to get “turned on,” vaginal dryness, not feeling “excited,”
or loss of sensation in the genitals or the nipples. The most
common causes of the syndrome are hormonal loss as with menopause
or as a medication effect with a class of antidepressant drugs
known as SSRI’s (Selective Seratonin Reuptake Inhibitors, like
Prozac and Zoloft). As many of these symptoms are complex, we
cannot ignore the personal, social, energetic, or relationship
issues that contribute to this situation. Sometimes, sex therapy
is also helpful.
Testing
levels of testosterone is a simple matter of a morning blood or
saliva collection. This can be ordered during your health visits
to PMCM.
Treatment
usually involves some trial experimentation to find out what will
work for you. If levels are low, natural bio-identical hormone
supplementation may be tried. This treatment is done with
individually compounded transdermal creams, sublingual tablets or
drops, a skin patch, or oral capsules. Some women may want to try
an herbal or nutritional approach, which can be quite effective.
There have
been a few studies using sildenifil (Viagra) for women who have
experienced FSAD caused by SSRI drugs. Results of the 2003 trial
at UCLA Medical Center showed better arousal, lubrication, sexual
satisfaction, and orgasm. Specially compounded forms are available
in sublingual or topical gels for the benefit of lower dosing and
decreased side effects.
If you are
experiencing any of these sexual symptoms, please talk to your
health care provider because you may be able to get help.
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