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Sex: When Things Go Wrong for Women

June 5, 2001 (Anaheim, Calif.) -- The role male hormones, such as testosterone, play in male sexual desire has long been acknowledged. But new research presented here at the annual meeting of the American Urological Association shows that these hormones, collectively known as androgens, are involved in much more than simple desire -- they are also vital for sexual arousal and sexual performance.

And not only in men.

"Androgens have a very central role in sexual function for both males and females," says Irwin Goldstein, MD, professor of urology at Boston University School of Medicine. "Physicians have studied androgens in men and estrogens in women, but we have never crossed the bridge and studied androgens in women."

Women with insufficient androgen -- which can be caused by taking birth control pills or antidepressants, pregnancy, or stress, among other things -- not only have low levels of desire, they also have reduced feelings or arousal and muted, less enjoyable orgasms, according to Goldstein.

"There is clear and obvious need for research on the role of androgen in the three phases of the sexual response cycle: desire, arousal, and orgasm," he says. "The original concept of pure desire is oversimplified."

At the meeting, Goldstein presented findings from a study showing that women with sexual problems related to low levels of androgen could be successfully treated with dehydroepiandrosterone (DHEA) -- an androgen hormone -- without significant side effects.

But Goldstein strongly cautions women about using DHEA, which is sold commercially over the counter, without first consulting a physician, a warning echoed by other urologists at the meeting.

"While we have this new information -- and the results are phenomenal -- women cannot just go and use this," Goldstein says. "This is a drug, and it can have side effects that we do not yet totally understand."

Among the problems that may be associated with DHEA use are cancer, ambiguous genitalia in offspring, acne, hair loss, and weight gain. These potential problems lead Ira Sharlip, MD, president of the Sexual Medicine Society of North America, to recommend that the sale of DHEA be regulated.

In Goldstein's study, 32 women with low androgen levels received daily DHEA for an average of five months. The treatment seemed to increase their levels of androgens, while improving their self-evaluations of sexual performance.

The most commonly reported changes in sexual function while on DHEA were marked increase in sexual spontaneity, decreased time needed to achieve arousal, a return of sexual fantasies, and an increase in the duration of sexual arousal, according to the report.

Another study presented at the American Urological Association meeting examined male-female couples who came to a male sexual dysfunction clinic. The researchers found that many of the women -- who accompanied their male partners for treatment -- had problems of their own.