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It always amazes me that there is no FDA-approved testosterone-only treatment option available for women.

We produce testosterone in our ovaries and our adrenal glands – a doctor can measure our testosterone levels with a simple blood test.  We know as we age testosterone levels decline and yet there is no FDA-approved treatment option for women.

What role does testosterone play in women’s health?
Women need testosterone, too! It is not just men who need it. As mentioned above, testosterone is found in the ovaries and adrenal glands and is part of the combination of hormones that impact our mood, energy level, and sex drive, as well as some bodily functions.

In women, testosterone:

  • helps to keep our bones healthy. Testosterone supports bone growth and strength – too much or too little can be harmful.
  • supports cognitive function. Testosterone has a neuroprotective effect in women. In a recent study of postmemopausal women, researchers found lower levels of testosterone and estrogen in women with Alzheimer’s disease than in the control group. 
  • plays an important role in our sexual health. Testosterone is not just a male hormone – testosterone drives desire and thoughts of sex, as well as provides energy for sex in women. Low levels of testosterone can lead to sexual dysfunction in women.
If low levels of testosterone negatively impact women’s desire or ability to have sex, why is the topic of testosterone replacement therapy such a controversial one?

I have been in rooms with the world’s leading medical experts, listening and watching them debate both for and against treating women with testosterone.  Part of the problem with testosterone therapy for women is that it has been the wild wild west. Pop up hormone shops have been careless with testosterone therapy treatments, often pushing female levels sky high – which can have detrimental effects for women. When testosterone levels are too high in women, it can lead to unwarranted side effects including acne, hair growth, elevated lipid levels, and increased risk of blood clots. Very high levels of testosterone can also cause the clitoris to enlarge, which is a condition called clitromegaly.

What is the medical world now saying about testosterone replacement therapy for women as a treatment option for sexual dysfunction?

A consensus statement was finally produced last year when a few of the nation’s experts sat down and looked at the data of testosterone levels and women. They stated the following:

  1. Testosterone therapy can be beneficial in postmenopausal patients for arousal, orgasm, desire and decreasing distress about a women’s sexual dysfunction.
  2. As long as levels are checked and not pushed to supratherapeutic levels, but simply replaced to levels that were normal prior to menopause, there was no increased risk of breast cancer or elevated cholesterol.

Testosterone therapy can be beneficial in premenopausal patients as well – but there is limited data. Therefore, more studies need to be done to assess the impact of testosterone replacement therapy on this subset of women.

Unfortunately, that is where women’s healthcare always meets a hurdle. We need more funding, more research dollars and frankly more insurance coverage of medications and therapies for women, especially when it comes to sexual health care.

It is only when these things happen, that the medical research community can truly get the research studies and data needed to provide FDA-approved treatment options for women.

As a women’s healthcare practitioner, I deal with insurance denials of medications and treatments on a daily basis – it is heartbreaking and infuriating. We as women should not stand for this. The issues of our health, our bodies, and our sexuality are too important to be ignored. We can be invisible no longer. It is HER time in health care.

Somi Javaid, MD

Dr. Somi Javaid is a board-certified OB/GYN, leading women’s sexual health thought leader, and menopause advocate. She is the Founder and Lead Chief Medical Officer of HerMD.

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