Question

I am a 60-year-old woman, and suffer from a very low libido. My gynecologist found my testosterone level was almost non-existent, and suggested a 1-month course of testosterone. She only wanted me to take a short course as it can sometimes damage the liver. My family doctor told me to try an herb - Horny Goat Weed.

That worked quite well, but I had to stop as I started to bleed while taking it; the bleeding was like a normal period, but was continuous. Should I try testosterone?

Answer

While testosterone is primarily a male hormone, women also produce testosterone from the ovaries during their reproductive years. Therefore, testosterone is lost as well as estrogen and progesterone when a woman enters menopause. Testosterone contributes to the libido, or sex drive. In the United States, there is a commonly prescribed medication called Estratest. It should be prescribed along with progesterone, and this makes up a very good hormone replacement therapy regimen for most women. Estratest contains estrogen as well as a small amount of testosterone, and both of these are balanced so as to not be a large amount, but simply to attempt to replace the amount that the woman was making during the reproductive years. It has been demonstrated to be safe, and can be administered on a long-term basis without any significant concern for liver problems. Therefore, I would recommend consulting a knowledgeable gynecologist, and discuss whether you would be a candidate for a medication such as this, which in general I would consider clearly superior to the other remedy you mentioned.

The use of hormone replacement therapy must be reconsidered in the light of recent findings from the Women's Health Initiative Study. The potential risk of breast cancer and other side effects has been determined fairly conclusively - see link below "Hormone Replacement Therapy (HRT) - Now What to Do?" (Robert Griffith, editor)