Testosterone, the Female Hormone

As women get older, menopause becomes inevitable. Estrogen, widely considered THE female hormone, falls and is eventually absent. Progesterone, the OTHER female hormone, likewise falls victim to menopause. What most people don't realize is that yet another female hormone, testosterone, will fall as well.

Both men and women have testosterone. But since men have so much more of it, it is mistakenly called the male hormone. We know what testosterone does for a woman by what happens when it's gone...sex drive, or libido suffers.

Here are some interesting observations about menopause, testosterone, libido, and quality of life:

Testosterone either declines 50% or is absent altogether in women after the menopause. The adrenal glands can provide some, but this source is very unreliable after menopause.
With a fall in testosterone, libido falls and with it, frequency of sexual intimacy.
With a fall in sexual frequency, more arguments occur in a marriage and partners grow more distant, increasing estrangement, either through separation psychologically or separation of actual addresses.
With life spans lasting longer than ever, and with the baby boomers in the menopausal years, we can expect an "epidemic" of loss of sexual function and happiness.

The Importance Of Sex

Is this putting too much importance on sex?The answer is no in the strongest possible terms.

You don't have to be Masters and Johnson to know that sex pervades our lives. All of the media is absolutely obsessed with it. But this is a charade:

Actually, all of the media is obsessed with money, and since sex sells...there you are.

But sex sells because we are the ones obsessed.

Is this nasty or vile or debauchery?

No, again.

We are deeply sexual beings, and to deny it is as ridiculous as denying hunger or thirst or the need for comradery, friendship, or love. And the statistics on sexual dysfunction and marital discord after the menopause prove this.

Sexual dysfunction is real pathology that needs to be treated. In menopausal women, the first need that should be addressed is the estrogen. Estrogen provides structural nourishment for the vaginal tissue, lubricating glands, and the clitoris. Decreased sensitivity of the clitoris occurs with decreased estrogen. More importantly, with its absence the thinning vaginal walls may lead to painful intercourse, which then adds a severe psychological obstacle to overcome in regaining a normal intimacy between the married couple.

A trial of estrogen replacement, besides addressing a possible cause of sexual dysfunction, will also provide the benefits of reducing the risk of heart disease and osteoporosis. (Progesterone should be added, too, in the presence of the uterus, so that a balanced effect on this tissue will prevent any pre-cancerous changes in the uterus.) Once estrogen deficit has been corrected, if there is inadequate improvement in libido, testosterone should be added, which is the whole point of this article.

A Woman's Libido

One of the problems that women have is the prejudice against their gender when it comes to vague complaints like decreased libido. Male and female doctors alike have been traditionally prone to ignore these complaints as being "all in the head." This attitude has been unfairly strengthened by the fact that women outnumber men in depression by 2:1, and in anxiety by 4:1. But I've always found that it's the ethically correct thing to give a woman the benefit of the doubt before writing off a complaint as irrationally neurotic. To do so is a tragic misdiagnosis that is disgraceful to the medical profession. But along with the care of not labeling complaints as hysterical, a physician must also be aware that there may in fact be some psychological factors that are part (not the only cause) of the problem. In this vein, a psychologist, psychologist, or social worker can be helpful in rounding out the treatment.

But if the only problem is hormonal, then this can be diagnosed...and corrected. Quality of life depends on it, and so too may the marriage.