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Testosterone Therapy for Frustrating Low Sex Drive.

Testosterone Therapy for Frustrating Low Sex Drive.

Sexual Health
Perimenopause / Menopause Treatments

By Barbra Hanna, DO, FACOG, MSCP, 01/13/2024

Do you pretend to be asleep before your significant other to avoid sex? Fake a headache cause you are not in the mood?  Love your hubby, wife or significant other and frustrated by your lack of desire? You may be suffering from HSDD, hypoactive sexual desire disorder. Testosterone therapy may be your new secret weapon to getting back in the groove if you are perimenopausal or beyond.  

Having a healthy sex life begins with desire. Women entering their 40’s often begin to complain of lower sex drives. Life is complicated for us midlife ladies. You may be busy in your career while caring for children and/or aging parents. Perhaps you feel fatigued from a lack of sleep due to insomnia or night sweats. Life stressors definitely play a role in decreasing your sexual desire. But what if you have life stresses under control?  Your relationship is strong, your house (both personal and physical) is in order, yet you still feel low desire?  You may be suffering from HSDD.

Want to find out? Ask yourself a few yes or no questions:

  1. In the past, was your level of sexual desire good and satisfying to you?
  2. Has your level of sexual desire/interest decreased?
  3. Are you bothered by your decreased sexual desire or interest?
  4. Would you like your level of desire to increase?

If you answered yes to all four questions, you qualify for the diagnosis of HSDD.

Testosterone therapy may be your answer!

A woman’s testosterone levels naturally decrease with age. By the time you are 40-50 years old, according to the medical literature, your testosterone level is about half of what they were in your 20’s.  Common sense would say that supplementing a woman’s testosterone would improve her sexual desire but until recently, this practice was not supported in the medical literature. I am so excited The International Society for the Study of Women’s Sexual Health has finally published their office guidelines for the use of testosterone in women with HSDD!

The North American Menopause Society recommends the use of topical testosterone for the treatment of low desire in women.  Topical testosterone therapy is safe and effective for women in small doses, doses much less than a man’s. While there are no FDA approved testosterone formulations for women just yet, the new guidelines provide guidance on how to safely prescribe a man’s prescription for a woman. Some providers may recommend compounded testosterone or testosterone pellets.  The guidelines are clear to stick to FDA approved products to ensure purity.

Topical testosterone therapy is a game changer for women with low desire. It is exciting to finally have a great evidence based treatment option to offer women who are frustrated with their sex life!


The content is meant for educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Please seek the advice of your physician with any questions you may have regarding a medical condition.