Whether it be for our skin, our hair, or our vaginas, we are always in search of the Fountain of Youth. You know, that product or device that will keep everything looking and feeling young. In the land of sexual dysfunction, testosterone was thought to be just that. The magic medication that would keep us like our 20-year-old self—need we say more? And while it certainly can do the trick for some women, it has probably gotten much more press than it deserved. Let us explain…
As women age, androgen levels decrease. As androgen levels decrease, so does sexual desire. This connection led scientists to study the impact of androgen replacement treatment on sexual dysfunction, specifically hypoactive sexual desire disorder (Sexual Dysfunction). And like all good competitions, the results were split. Some studies showed improvements in sexual functioning, and others showed no change. And because there was no good tiebreaker for the long-term use of testosterone to treat sexual dysfunction (a.k.a. a prospective randomized controlled study), doctors were hesitant to prescribe it.
Furthermore, due to the limited data, the FDA was not willing to put their stamp of approval on testosterone treatment. For this reason, transdermal testosterone is only used to treat hypoactive sexual disorder in the short term, that is, no greater than six months. Long-term use is not recommended, no matter how hypoactive your sexual desire is.
We tread lightly when using testosterone because it is teeming with negative side effects. Think acne, facial hair growth, deepening of your voice, and cardiovascular complications. Not fun. Additionally, some researchers have noted an association between testosterone use and breast cancer. While the link is loose, it is another reason to opt for the short-term rather than long-term use of testosterone.
When it comes to hormones, testosterone is not the only game in town. While testosterone has gotten a lot of attention, it seems to work best on hypoactive sexual disorder (a.k.a. I am just not that interested).
When the desire is there but vaginal dryness is holding you back, cue estrogen. Low estrogen (think menopause and breastfeeding) leads to a loss of vaginal lubrication. Vaginal dryness equals vaginal discomfort, and collectively, these symptoms are a common culprit in sexual dysfunction. Vaginal estrogen (tablets, gels, creams, and rings) can be particularly helpful in alleviating vaginal dryness (picture a hose in a desert).
Oral estrogen can also add some water to the well but is generally not as effective as vaginal estrogen for the treatment of vaginal dryness. Going straight to the source is way more effective! Last, adding vaginal lubricants or moisturizers (Astroglide, Replens, etc.) will help to turn up the power on that hose and further reduce the dryness.
Hormones are certainly helpful in hampering sexual dysfunction. However, they are only the half of it. Treatment will generally take on many other forms, such as the addition or subtraction of other medications, counseling, and physical therapy. So, while our Fountain of Youth remains dry (no pun intended), the combination of treatments may just do the trick. It may not fill up that well, but it’s worth a shot!