An Australian-based study investigating whether low levels of the hormone testosterone plays a role in premenopausal sexual dissatisfaction shows that in most cases a placebo (fake drug) improves a woman's sexual satisfaction as much as a testosterone spray.
Testosterone is most often recognized as a male sex hormone, but it plays an important role in a woman's healthy sexual function. A woman's testosterone level peaks during her 20s, and then starts to decline.
Many women report decreased sexual interest, arousal, and pleasure prior to menopause, but few treatment options exist. Testosterone replacement therapy appears to improve a woman's sexual satisfaction after menopause, but whether it can do the same in premenopausal women remains unclear.
Susan Davis, MD, of Monash University in Victoria, Australia, evaluated 261 women aged 35 to 46 who had low blood levels of testosterone and admitted to having a decrease in sexually satisfying events. The women randomly received either one of three different doses of testosterone, sprayed onto the skin, or a placebo for 16 weeks.
Women in both the placebo and treatment groups reported an increase in the number of sexually satisfying events.
"Our findings ... do not provide sufficiently strong evidence to support the widespread use of testosterone in premenopausal women," Davis writes in the April 14 issue of the Annals of Internal Medicine. "Further clinical trials of this promising but unproven therapy are warranted."
In an accompanying editorial, Rosemary Basson, MD, of the University of British Columbia, points out that a lack of testosterone does not always equate to sexual dissatisfaction. She urges doctors to more closely evaluate a woman's mental health and relationship issues and treat any problems with behavioral therapy or counseling, rather than prescribing testosterone.