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Testosterone Therapy can improve sexual function in postmenopausal women

The addition of testosterone to hormone therapy in women after menopause has been found to enhance their sexual performance. However, it may also reduce HDL cholesterol (the “good” cholesterol) in women, according to a recent research.//

Menopause generally begins around age 40, and is characterized by decreased levels of the female sex hormones- estrogen and progesterone that preserve intactness of the vagina and uterus. In addition the hormone is also involved in the health of bones and keeping HDL at healthy levels. Changes brought by menopause can lead to side effects such as “hot flashes” and problems with mood, sleep, memory and joint stiffness.

Sexual function is also compromised in many women. The genital area can become dry and thin during or after menopause, making sexual intercourse painful and undesirable. There is an accompanying decrease in the sex drive (libido), reflected by slower sexual response in some women.

Testosterone is a natural sex hormone produced by the testis. Although it is thought of as a male hormone, women secrete small amounts of it as well. The present study involved the examination of over 1,957 patients who were given testosterone in addition to the conventional hormone replacement therapy for 6 months. The participants were required to fill questionnaires reflecting their sexual activity, libido and side effects if any.

The observed benefits and side effects included a sense of well-being, unexplained fatigue, breast cancer, mood changes, acne and increased hair growth; none were significant enough to be linked definitively to the addition of testosterone to hormone replacement therapy. If the reduction in HDL had been associated with an increase in triglycerides [fatty acids] or LDL cholesterol it would be of great concern. Testosterone has not been found to alter other coronary heart disease risk factors. The researchers have however expressed concern for potential side effects with long term testosterone usage such as voice changes, increased body and facial hair, acne and other undesirable defeminizing side-effects.

The authors do caution that adding testosterone to HT is not a panacea for sexual dysfunction in women and that a comprehensive approach is recommended. “Because of the complex nature of female sexual dysfunction it is often difficult to establish the meaningful steps in treatment,” they write. “Treatment options for sexual dysfunction include identification of correctable causes, education and counseling, and medical therpy.”
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