Testosterone for women

COLUMBIA, S.C. — Testosterone makes the man, but what does it do for the woman?

Gets her sex life simmering faster than the best paperback romance novel, advocates say.

Or poses unnecessary health risks to address sex-drive problems that probably aren’t even hormonal to start with, critics say.

The Food and Drug Administration recently came down on the side of caution. An FDA panel decided more study was needed before Intrinsa, the first testosterone patch for women, could be approved for the U.S. market.

But some women are not waiting for a federal seal of approval. With their doctors’ blessing, they are experimenting to see whether testosterone might be good for what ails them — usually, lackluster libidos.

“I think the FDA is wrong,” said Shailesh Patel, an endocrinologist with the Medical University of South Carolina in Charleston.

“In Europe and elsewhere, it has been available (to women) for a long time,” he said. “It’s used commonly in Australia. Many studies have shown that it really does improve libido.”

To some women, the notion that their bodies make testosterone at all comes as a surprise.

But along with female hormones, women produce testosterone in their ovaries and adrenal glands, said Gail Whitman-Elia, a reproductive endocrinologist with the Advanced Fertility and Reproductive Endocrinology Institute in West Columbia, S.C.

Whitman-Elia said she got some entreaties for testosterone from female bodybuilders and from lesbians seeking to boost their masculine characteristics. But most of the requests come from women in or approaching menopause who think testosterone will help their sex lives.

Unless their ovaries have been removed, they won’t find this doctor receptive.

“A lot of people are under the misconception that when a woman goes through menopause, her ovaries are dead,” Whitman-Elia said.

Yet for many years the ovaries continue to produce estrone, a weak estrogen, as well as testosterone, she said. With adrenal glands also producing androgens (male hormones), most women have an ample supply, especially if they exercise as well, she said.

Whitman-Elia said a permanently deepened voice, balding and liver damage were among side effects she had observed. Acne and abnormal hair growth also may occur.

“I don’t think it’s a quick fix by any means,” said Whitman-Elia, who said situations such as depression or a difficult marriage were more often the cause of women’s sex-drive problems.

She usually advises counseling.

“I believe that libido is 90 percent non-hormonal,” she said.

But those who favored approval for the Intrinsa patch said it represented long-overdue attention to women’s sexual health. Intrinsa manufacturer Procter & Gamble said early studies had not shown any serious problems with the patch, which delivers testosterone through the skin.

“I think it’s only fair that women should have something for libido,” said a Charleston woman who cited the erectile-dysfunction drugs that help men function sexually.

She went through menopause early and, at 51, is using estrogen-testosterone therapy to cope with lagging energy and libido.

“The quality of life makes a difference,” said the woman, who asked that her name not be used.

Patel favors testosterone therapy for women whose ovary function has been impaired through menopause, premature ovarian failure or surgery.

He said careful monitoring could head off any side effects before they became serious.

For patients who need it, he usually prescribes a lotion applied to the skin, similar to the testosterone gels that male patients use. To get the right combination of male and female hormones for female patients, he writes a prescription that can be formulated by a compounding pharmacist.