Menopause and sexual desire: the role of testosterone

Abstract

The present short review underlines the role of testosterone (T) in the motivational and satisfaction components of women's sexuality and critically discusses the strategies to treat hypoactive sexual desire disorder (HSDD), a condition of low desire associated with personal and/or interpersonal difficulties, which is more common in surgical menopausal women. There are multiple ways androgens target the brain regions (hypothalamic, limbic and cortical) involved in sexual function and behaviour. Even though circulating available androgens have been implicated in several domains of sexual response, they seem to be related weakly to symptoms, such as low sexual desire, poor sexual arousal, orgasm and diminished well-being in postmenopausal women. The possibilities of treating low sexual desire/HSDD are multifaceted and should include the combination of pharmacological treatments able to maximize biological signals driving the sexual response, and individualized psychosocial therapies in order to overcome personal and relational difficulties. Transdermal T has been shown to be effective at a dose of 300 µg/day both in surgically and naturally menopausal women replaced with estrogen or not, without any relevant side-effects. However, the decision to treat postmenopausal women with HSDD with T is mainly based on clinical judgement, after informed consent regarding the unknown long-term risks.

DHEA: a natural steroid for the treatment of menopausal women

“…it is well known that the menopausal hypoandrogenism is at the basis of the loss of libido, typical of physiological or surgical menopause, determining a real disease called hypoactive sexual desire disorder (Hsdd), characterized by the lack or absence of sexual fantasies and desire for sexual activity, in combination with marked distress or interpersonal difficulties, very common expecially after ooforectomy (30). in this case it is necessary to correct the androgens and estrogens deficiency, to improve and positively affect the sexual function and mood, but also psycotherapy plays a crucial role when a personal or interpersonal discomfort is evident.…”

“…in this case it is necessary to correct the androgens and estrogens deficiency, to improve and positively affect the sexual function and mood, but also psycotherapy plays a crucial role when a personal or interpersonal discomfort is evident. A recent study suggests transdermal testosterone at the dose of 300 µg/day as a possible therapy, in combination or not with an estroprogestin treatment, both in physiological and surgical menopause, without any relevant side effects (30).…”

Androgeny u kobiet pomenopauzalnych

“…Inne doniesienia również potwierdzają korzystny wpływ na funkcje seksualne kobiet (wzrost pożądania, aktywności i satysfakcji seksualnej zarówno po menopauzie naturalnej, jak i chirurgicznej) stosujących jako uzupełnienie terapii estrogenowej preparatów testosteronu w formie plastrów [23][24][25].…”

“…polepszenie relacji w związku czy leczenie zaburzeń seksualnych partnera. Jej istotnym elementem jest świadoma zgoda pacjentki ze względu na możliwe skutki uboczne terapii [25].…”

Personality Traits of Postmenopausal Women with Sexual Dysfunction

“…1 Pertaining to the prevalence of female sexual dysfunction, in the year of 2012, Ambler et al 2 estimated that between 68 and 86.5% of postmenopausal women presented with some kind of sexual problem. In 2010, Nappi et al 3 found that the decrease in female sexual desire is associated with personal and interpersonal difficulties.…”