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Testosterone is Your Friend
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Chapter 11: Female Sexuality______________________________________________________
Women looking towards using testosterone as the Magic Answer to their sexual concerns are looking in the wrong place. Sexuality for women is a multifactoral, and very emotional affair with far more psychology than biology. Female sexuality is such a complex and multifaceted phenomena that no amount of hormones could be the single answer to dysfunction. Good sex is a reflection of total physical, mental and emotional health, and not just youthful hormone levels, important as that is. Youthful testosterone levels are not even required for sexual desire as demonstrated by prepubertal girls, postmenopausal women and those who have had hysterectomies. Some women with low testosterone levels have very rewarding sex lives. Yes, some women are testosterone deficient, but still have satisfying sex lives.
Having said all that, we find that men are not as hormonally affected as women are either physically or psychologically. While many male studies will only show a 10% improvement in male sexual performance in hypogonadal men who receive testosterone supplements, you see far more dramatic improvement in women who are testosterone deficient. Women are simply more hormonally driven than men are. Fortunately, there has been some important research done - especially very recently - on improving women’s sexual satisfaction with testosterone therapy. Please notice when we talk about men we speak of “performance”, and when we talk about women we speak about “satisfaction”. In a search of the entire published literature of the world less than two dozen studies were found for women, while there were hundreds of male studies. Certainly a lot more research is needed on the effects of giving women natural testosterone in small doses for their sexual and other problems and conditions.
We first need to realize that women can have too many or too little androgens in their system. Androgens basically include DHEA, androstenedione and testosterone. Women with too much androgens (androgenicity) suffer from many conditions including facial hair, polycystic ovaries, and various forms of cancer. As always, women need to measure their levels of free testosterone, free androstenedione and DHEA or DHEA-S (sulfate).
A placebo-controlled study at McGill University in Canada (Psychosomatic Medicine 47 ,1985, pp. 339-51) looked at women who suffered from surgical menopause after having a hysterectomy (again, the ovaries always atrophy and die even if they are not removed). Most all of these women were now testosterone deficient and responded very dramatically to supplementation. “It was clear that exogenous testosterone enhanced the intensity of sexual desire and arousal and frequency of sexual fantasies in hysterectomized and oophorectomized (no ovaries) women.” The doctors further said, “The major finding that emerged in this study is that on all three measures of sexual motivation, scores increased concomitant with circulating levels of testosterone.” Of course the incompetent doctors injected these unfortunate women with 200 mg of enanthate and should have been imprisoned for such reckless endangerment. They did monitor their blood levels. Coital frequency and orgasmic frequency were not affected however. The truth is that 99% of hysterectomies are completely unnecessary in the first place, but that is another matter well discussed in my book, No More Horse Estrogen!
Another study at McGill University (Psychoneuro-endocrinology v.18, 1993, pp. 91-102) studied the sexual behavior of younger women and their estradiol, progesterone and free testosterone levels. They found that, “free testosterone was strongly (notice the word ‘strongly’) and positively associated with sexual desire, sexual thought, and anticipation of sexual activity.” They also found testosterone was positively related to attention to sexual stimulation. They concluded, “These results are consistent with the hypothesis that testosterone may enhance cognitive aspects of women’s sexual behavior.” This is a good and well done study and we need many more like this to understand the effects of hormones in general on the sexual behavior of women.
Further insight on hormones and female sexuality was provided by work at the University of North Carolina (Demo-graphy, 23 ,1986, pp. 217-27). Here female adolescents were studied. Levels of testosterone predicted frequency of masturbation (but not frequency of intercourse) for the girls. It was DHEA that did predict how sexually experienced they were. They said, “These (sexual behavior) effects are associated primarily with androgens.” And “Hormone effects on female sexual motivation are substantial. These effects are also associated with androgens.” However, it was social pressure that determined female sexual behavior more than anything.
Another study at the University of North Carolina (Psychosomatic Medicine 59 ,1997, pp. 161-71) did the politically incorrect thing of studying the differences between young black and white teenage girls and their sexual behavior. And guess what? They found there are actually racial differences in them! Surprise, surprise! In this study they found that testosterone did predict whether the girls had intercourse earlier in both groups. “Testosterone and changes in testosterone were significantly related to the timing of subsequent transition to first coitus for blacks and whites.” They found, “the pubertal rise in testosterone is associated with subsequent increases in female sexual interest and activity.” With the white girls again they found social pressure was the controlling factor, and the more the girls attended church the less sex they had and the later they had it. This factor was not significant with the black girls who also had more sexual partners and started at an earlier age. Both groups often denied masturbating which is contrary to known statistics. Testosterone levels actually had predictive value for initiation and frequency of intercourse. Parents may want to saliva test their daughters’ levels and keep them locked up if they are on the high side!
Geoffrey Redmond did an interesting review (International Journal of Fertility, v.44, 1999, pp. 193-7). He found that high estrogens can actually decrease libido in women, while androgens are very important for sexual satisfaction. While he prefers over-priced and unnecessary testosterone patches, he doesn’t understand that methyl testosterone (!) and injections of salts (50 mg per month!) are Stone Age treatments. Not one time does he realize the need for measuring their free levels by blood or saliva analysis and prefers, “monitoring symptoms.” He also recommends estradiol supplements generally, although western women generally have excessive estrogen levels. As women age they often find a drop in sexual desire and satisfaction in contrast to when they were younger, and doctors who feel like this sure can’t help them much.
At the famous Karolinska Institute in Sweden (Climacteric, v. 5, 2002, pp. 357-65) the doctors poisoned women 45 to 60 years old with oral 40 milligram (about 200 times what they needed in their blood) doses of testosterone undecanoate (this is in 2002, remind you) in a double blind study. (Please remember women only produce about 300 micrograms of testosterone a day and need only 150 to 300 mcg of supplemental). All of the women had hysterectomies and/or oophorectomies (removal of the ovaries). One of the most famous clinics in the world isn’t competent enough to give women transdermal or sublingual testosterone in normal 150-300 mcg amounts? Nevertheless, they found dramatic effects for sexual relations, especially for satisfaction, frequency and interest in sex. They used the standard McCoy scoring for sexual functioning. They also used the Psychological General Well Being Index and found equally dramatic effects for feelings of well being and self esteem. They said, “The addition of testosterone undecanoate improved specific aspects of sexual function.” If they had used natural testosterone transdermally or sublingually they would have done much better.
At Utrecht University in the Netherlands (Archives of General Psychiatry, v.57, 2000, pp. 149-53) a unique double blind, placebo study was done on women who were not known to be low in testosterone and were functioning normally. Surprisingly these modern doctors used sublingual testosterone. Only one dose was given to study the effects on physiological and subjective sexual arousal. They gave the women testosterone and then showed them erotic films of couples having intercourse. “The authors found a statistically significant increase in genital responsiveness. Furthermore, on the day of testosterone treatment, there also was a strong and statistically significant association between the increase in genital arousal and subjective reports of genital sensations and sexual lust.” Now this is just with one single dose on normal women not known to have any testosterone deficiency at all. This is not to infer that any woman with normal levels should in any way consider raising them to supraphysiological (i.e. excessive) levels. High levels of androgens cause serious conditions in women just as deficient levels do.
A very surprising study was done almost 30 years ago at three hospitals in the United Kingdom (British Journal of Psychiatry, v. 132, 1978, pp. 339-46). Sexually unresponsive women were studied along with their husbands and given counseling since sexuality is more psychological than physiological. Amazingly enough they were given sublingual testosterone! The fact that women were given the proper sublingual form almost three decades ago is a credit to these researchers. Unfortunately, however, they were given huge, toxic 10 mg doses -about thirty times too much- but only for ninety days. One third of one milligram would be good. The results were nothing less than dramatic, including frequency of orgasm, arousal, erotic feelings, and satisfaction. “Those receiving testosterone did significantly better on a number of behavioral and attitudinal measures….” Not only was their sexual happiness greatly improved, but their overall psychology as well.
A dozen doctors from around the country collaborated (New England Journal of Medicine, v. 343, 2000, pp. 682-8) to study women after removal of their ovaries. There is very little testosterone produced by the adrenal glands after a hysterectomy or oophorectomy. Sexual functioning in these women is severely impaired. One third of all American women will suffer unnecessary hysterectomy at an average age of only forty years. The women were given 150 to 300 mcg of transdermal testosterone daily since their rate of production is only about 600 mcg a day. “In women who had undergone oophorectomy, transdermal testosterone improves sexual function and psychological well being.” The doctors went on to say, “…as reflected by scores on the Brief Index of Sexual Functioning for Women, the dimensions of thoughts - desire, arousal, frequency of sexual activity, pleasure and orgasm - were most affected.” While sexual satisfaction was dramatically improved, their general psychology was equally affected. “In regard to psychological status, testosterone replacement had a beneficial effect on well-being and depressed mood.” When natural testosterone is given in natural ways the effects are no less than stunning.
NIMH (National Institutes of Mental Health) sponsored a study almost three decades ago (Archives of Sexual Behavior, v. 7, 1978, pp. 157-73) showing the relationship of testosterone levels in women to sexual satisfaction. Young, healthy married couples were extensively studied with in-depth psychological tests as well as hormone measurements. “The wives’ self-rated gratification scores correlated significantly with their own plasma testosterone levels….that high baseline testosterone level was significantly related to high self-rated gratification score and to ability to form good interpersonal relationships.” Not only was sexual satisfaction related to testosterone levels but the very ability to have a better relationship with other people. It was also pointed out that low testosterone was related to anxiety and high testosterone to freedom from anxiety.
There’s not much more the worldwide published literature over the last three decades has to offer us on the influence of testosterone for female sexuality. This is changing and most of these studies were done in the last five years. Ladies, you don’t need any more studies. Just test your free testosterone and supplement it if you are low. If you are too high just change your diet and lifestyle to lower your level. Please read my No More Horse Estrogen! and Zen Macrobiotics for Americans.
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