Testosterone helps libido in menopause – can it deal with different signs?

Temper swings, mind fog, plummeting libido – menopausal signs might be debilitating. Many ladies flip to hormone alternative remedy for reduction. These therapies virtually completely concentrate on restoring the plummeting oestrogen and progesterone ranges ladies expertise in mid-life. But research now counsel one other hormone might have advantages too: testosterone. Whereas most analysis has checked out its impact on libido and sexual well being, preliminary proof signifies testosterone might assist with a variety of menopause signs, from temper adjustments to muscle loss.

We frequently consider testosterone as a male hormone, however it’s also present in ladies, simply often at a tenth of the extent as in most males, says Sarah Glynne on the Portland Hospital in London, who has labored as an adviser on menopause remedy tips for the British Society of Sexual Drugs. Due to this false impression, analysis on the way it influences ladies’s well being has been restricted, she says. However that’s beginning to change. Extra proof is revealing the hormone’s essential position within the feminine intercourse drive, and a few early research point out it’s even essential for mind, muscle, bone and bladder well being.

Roughly half of testosterone in ladies comes from the ovaries. The remainder is made within the adrenal gland, positioned atop the kidneys. Ranges are inclined to peak throughout a girl’s 20s after which progressively decline beginning of their 30s. By center age, ovarian manufacturing of testosterone is about half what it was once, says Sharon Parish at Cornell College in New York. Whereas this tends to happen round menopause, it most likely isn’t a direct results of it, she says.

Little is understood about how this drop-off impacts well being, however what is evident is it could result in low libido. “[Testosterone] has a vital profit for sexual operate,” says JoAnn Pinkerton at UVA Well being in Virginia. It performs a task in sexual arousal, need and vaginal lubrication. So it is smart that practically half of menopausal and postmenopausal ladies within the US report battling libido and ache throughout intercourse, largely because of hypoactive sexual need dysfunction (HSDD), a situation during which an absence of sexual fantasies or need for not less than six months causes misery. In the meantime, a survey of greater than 1800 postmenopausal ladies in Europe discovered greater than a 3rd reported decreased intercourse drive and greater than half had been much less focused on intercourse.

The concept declines in testosterone ranges drive lack of libido dates again to the Nineteen Forties. Since then, examine after examine has proven testosterone alternative remedy improves sexual operate in menopausal and postmenopausal ladies. As an example, a 2005 examine of 533 ladies with HSDD attributable to surgical removing of their uterus and ovaries discovered these handled with a twice-weekly testosterone patch alongside oestrogen remedy reported extra satisfying sexual experiences than these on oestrogen alone. A 2010 examine confirmed related outcomes amongst 272 menopausal ladies.

In 2019, a meta-analysis of greater than 80 research comprising 8480 ladies discovered treating postmenopausal ladies with testosterone considerably elevated sexual need, the frequency of satisfying sexual actions, pleasure, arousal, orgasm and self-image. Consequently, a couple of dozen skilled medical organisations, together with the Worldwide Menopause Society, the Royal School of Obstetricians and Gynaecologists and the North American Menopause Society endorsed using testosterone for HSDD.

One cause testosterone heightens libido is as a result of it interacts with mind receptors that activate neural pathways governing need, says Parish. Up to now, solely 4 international locations have permitted a testosterone product designed for girls: Australia, New Zealand, South Africa and, as of July, the UK. The US Meals and Drug Administration (FDA) hasn’t adopted go well with attributable to considerations there isn’t sufficient information monitoring potential long-term unwanted side effects. However Parish believes that is misplaced, noting some research have adopted contributors for years and located no elevated danger of coronary heart, breast or uterine points.

“Most suppliers who handle menopausal ladies would like to have an FDA-approved, protected and efficient transdermal [testosterone] remedy for girls,” says Pinkerton. “We actually assume there’s a want for it, notably within the libido area.”

The fitting mix

Some medical doctors counsel the remedy might have advantages past the bed room, too. A 2023 evaluation of seven research on testosterone in postmenopausal ladies discovered it might enhance muscle mass, decrease physique fats and enhance insulin sensitivity and ldl cholesterol. In 2024, Glynne and her colleagues evaluated use of the hormone in 510 perimenopausal and postmenopausal ladies additionally utilizing oestrogen. After 4 months of remedy, about half the contributors reported fewer nervousness assaults and crying spells. About 40 per cent additionally reported enhancements in despair, focus and fatigue, and greater than a 3rd noticed reminiscence enhance and irritability lower. “What I hear most frequently is ladies saying they really feel extra like themselves. They really feel stronger. They really feel extra strong,” says Glynne.

However others are sceptical. Pinkerton notes these research don’t embrace a management group and depend on self-reported enhancements, elevating doubts about whether or not it’s testosterone or the placebo impact driving them. “Mainly, there may be some analysis on cognition, temper, muscle power and cardiovascular and bone [health],” says Parish. “Whereas these present promising outcomes, we don’t have efficacy or security information in any substantial randomised managed trial to warrant suggestions for these indications.”

Most research use testosterone remedy together with oestrogen, however some have discovered testosterone alone nonetheless meaningfully improves sexual operate. Nonetheless, there’s a larger incidence of unwanted side effects comparable to zits and extra hair progress, so it isn’t often really helpful. Glynne says she often treats her sufferers with oestrogen first after which tacks on testosterone if signs nonetheless persist.

Researchers agree that scientific trials investigating testosterone’s results past libido are desperately wanted. Plus, there are nonetheless questions concerning the influence of timing, dose and length, says Pinkerton.

What is evident is present menopause therapies aren’t adequate for many individuals, particularly these with a historical past of hormone-sensitive breast most cancers who can’t or don’t need to danger oestrogen remedy, as it could spur the expansion or recurrence of those most cancers cells. “It’s a huge black gap in the mean time that we want heaps extra information on,” says Glynne.