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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45932
Experience:  Board Certified Physician
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I am a 65 year old woman, 3 years into a sexually active 2nd

Resolved Question:

I am a 65 year old woman, 3 years into a sexually active 2nd marriage, and my libido has
completely disappeared. I can achieve orgasm regularly but I'm just not interested in or bothered to initiate in sex activity, which is upsetting to my very loving husband. About 15 years ago I was told that I had zero DHEA (whatever that does) by an endocrinologist which appeared to be familial (my female cousins had the same problem). I have tried HRT in the past years but ended up having bleeds and also putting on 3kg almost immediately. I think maybe I have very low testosterone too as I very rarely have to shave my legs or underarms. I currently take Vagifem (10mgs pessaries) twice a week together with Replens twice a week to combat dryness. Is there anything which will help me to regain my former libido? I love my husband very much and have no emotional problems do believe the problem is physical/endrocinological.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.
This is Dr. David

the most common agent used for women to improve libido is testosterone.

several studies showed that 300 mcg/day testosterone patch increased sexual desire and frequency of sexual activity and was well tolerated and presented few side effects

North American Menopause Society's position statement about testosterone therapy in postmenopausal women states that transdermal patches and topical gels or creams are preferred over oral products because of first-pass effects which make the testostserone more effective at lower doses

oral testosterone is generally not well absorbed and does not result in measurable blood levels of the hormone

1% testosterone gel Androgel for the treatment of low libido in women is being studied in the US but has not gained FDA approval yet.

it can be difficult to obtain androgel for women in the UK.

you can talk to your doctor about this option and see if they will be willing to prescribe this for you for you to pay out of pocket for topical testosterone to help improve libido. you might have to find a private endocrinologist or gyn doctor to prescribe this for you

let me know if you have other questions.
Customer: replied 3 years ago.

Does taking topical testosterone require oestrogen to be taken at the same time? Does it cause problems like body hair and a deep voice?

Expert:  Dr. David replied 3 years ago.
with low doses of topical testosterone, there are risks

there are small risks for blood clots and hair growth and acne.

it doesn't require you to take estrogen.

it shouldn't affect your voice.
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