Dr. Sarrel discusses if women commonly take testosterone for sexual problems.
Yes, that would be the most common reason because that’s been the PR for testosterone, but in fact, you know, it did turn out in our study and in quite a number of studies across the world—I mean, they go on and on and on—all showing the same thing. The most common symptom of women who are sex hormone-deficient, we think , one of the most common must be hot flushes. But in fact, the most common is fatigue; that’s the single most common symptom that women experience.
And we found that in fact that was one of the symptoms that responded first. It could respond to estradiol replacement, but in women who weren’t responding adequately, it was only when we added the androgen–testosterone or a derivative of testosterone—that the fatigue problem dropped down to a level where it was insignificant.
So remember, it acts in muscle. It has many effects on the body, so no surprise that fatigue would be initial, but women don’t come in complaining of that. They are experiencing it, but it’s the sex issue that drives them for help.
Just as sort of a side remark, women will put up with a great deal of suffering. Women will say typically, “Well, I have had a loss of desire. After all, I am getting older; what’s the big deal?” But in fact, if they are in a relationship, and we know, let’s take women in their mid to late 40s–over 90 percent are in an ongoing relationship, whether it’s a marital relationship or any kind of relationship.
This decrease in desire has an impact on the unit that’s made up of the two people, whether it’s a male-female couple or a female-female couple. If one is experiencing the effects of a testosterone deficiency, the other feels it.
So it’s not surprising that women would come in finally saying, “I need some help about the sexual issue.” Well, what led to this appointment? ”Well, my partner doesn’t want to have sex with me anymore.” Why not? ”Well, we find he doesn’t want to initiate. If we start, he is having problems having an erection.” Oh well, what we have learned is most often, that’s no one’s fault.
He is sensitive to how you are feeling, and if you are in pain or if you are not responsive, whether the male happens to be a human male or it could be a monkey male, they are going to have the same problem. They all withdraw. They stop initiating, and they stop responding sexually themselves.
He is simply showing his sensitivity to you and his caring about you. And in a way that you should understand this is it is a reflection that he is caring about you for yourself and concerned about you. It’s not as selfish that he is caring to meet his needs; he’s really caring about you. So let’s clear the air about that.
About Dr. Sarrel, M.D.:
Philip M. Sarrel, M.D., completed his medical education at New York University School of Medicine, his internship at the Mount Sinai Hospital, and his residency at Yale New Haven Hospital. In addition to his many years on the faculty of the Departments of Obstetrics and Gynecology and Psychiatry at Yale University School of Medicine, Dr. Sarrel has also been a Faculty Scholar in the department of psychiatry at Oxford University, Visiting Senior Lecturer at King’s College Hospital Medical School at the University of London, Visiting Professor in Cardiac Medicine at the National Heart and Lung Institute in London, and Visiting Professor in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York. He is currently Emeritus Professor of obstetrics, gynecology, and psychiatry at Yale University.