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Testosterone may play modest role in menopausal women’s sex drive

Study suggests women's interest in sex is complicated: relationships, emotional health may have greater influence than hormones

ANN ARBOR, Mich. — Levels of testosterone and other naturally-occurring reproductive hormones play a limited role in driving menopausal women’s sexual function, according to a new study conducted in Michigan and six other clinical sites across the country.  
The findings, which appear in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, suggest that a woman’s relationship satisfaction and other psychosocial factors may outweigh any hormonal effects.

While testosterone is the main sex hormone in men, women also have small amounts of it, as ovaries naturally produce testosterone. Researchers set out to examine the role it and other hormones play in sexual function as women go through menopause.

“While levels of testosterone and other reproductive hormones were linked to women’s feelings of sexual desire, our large-scale study suggests psychosocial factors influence many aspects of sexual function,” says lead author John F. Randolph, Jr., M.D., professor in the Department of Obstetrics and Gynecology at the University of Michigan Medical School and researcher with the U-M School of Public Health. 

“A woman’s emotional well-being and quality of her intimate relationship are tremendously important contributors to sexual health.” 

John F Randolph Jr MD
Dr. John F. Randolph Jr.

Researchers examined data from 3,302 women who participated in the ongoing Study of Women’s Health across the Nation (SWAN) to analyze the relationship between reproductive hormones and sexual function during the menopausal transition. Participants were asked about their desire for sex and sexual activity. The women also had their blood drawn to measure levels of testosterone and other reproductive hormones including dehydroepiandrosterone sulfate (DHEAS), which the body can convert into testosterone or a form of estrogen called estradiol, and follicle-stimulating hormone (FSH). The body’s levels of FSH naturally rise when a women experiences menopause.

Researchers found women who naturally had higher levels of testosterone reported feeling sexual desire more frequently than women with low levels. Women who had high levels of DHEAS – a precursor to testosterone – also tended to feel desire more often than women with low levels.

The associations between hormone levels and sexual function remained fairly subtle, Randolph said. He noted that women who reported having fewer sad moods and higher levels of satisfaction in their relationships also reported better sexual function.

“Women’s relationships and day-to-day reality are intricately linked to sexual function,” Randolph says. “Our findings suggest menopausal women who are dissatisfied with their sexual function should consider whether these non-hormonal factors are playing a role when discussing treatment with a qualified health care provider.”

Although some studies have suggested that testosterone therapy may be able to improve sexual function in women who have had their ovaries removed, experts say there are many unknowns regarding its long-term health effects. In its updated Clinical Practice Guideline on Androgens in Women, the Endocrine Society advised against prescribing testosterone to healthy women and called for more research into the long-term safety of testosterone therapy.

Additional Authors: Huiyong Zheng and Siobán D. Harlow of the University of Michigan School of Public Health in Ann Arbor, MI; Nancy E. Avis of Wake Forest School of Medicine in Winston-Salem, NC; and Gail A. Greendale of Geffen School of Medicine at the University of California Los Angeles.

Disclosures: None
Funding: This study was supported in part by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (UCSF-CTSI Grant UL1 RR024131). The Study of Women’s Health Across the Nation (SWAN) has grant support from NIH, Department
of Health and Human Services, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) (Grants U01NR004061, U01AG012505,
U01AG012535, U01AG012531, U01AG012539, U01AG012546,
U01AG012553, U01AG012554, and U01AG012495).

Reference: “Masturbation Frequency and Sexual Function Domains are Associated with Serum Reproductive Hormone Levels across the Menopausal Transition,”  Journal of Clinical Endocrinology & Metabolism, Nov/20, 2014, doi: 10.1210/jc.2014-1725.

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