Dr. Sarrel explains how a woman's sex drive can be affected by testosterone.
Well, what I was talking about was how testosterone circulates in the bloodstream and enters cells all over the body, and I focused on brain cells, and there are specific parts of the brain where testosterone has what’s called receptors for the hormone. A hormone receptor is a protein in a cell, and when the hormone comes along, it goes into the cell and connects to that receptor, and then it induces, stimulates all those cell functions like sexual desire.
But we also know there are receptors for testosterone in muscle. Remember we talked about muscle strength and promoting muscle growth, and one of the important aspects of sexual function is the development—to develop muscle tension. If you can’t develop muscle tension, you can’t have an orgasm. What’s an orgasm? It’s a series of muscular contractions.
People who have muscular diseases lose their ability to be able to contract and have an orgasm, has nothing to do with their brain, has to do with the muscle. So we know that muscle throughout the body, including the muscles of around the vagina, are loaded with testosterone receptors, but it gets even more interesting than that because specific structures like the clitoris in a woman has testosterone receptors, and when that hormone gets to the clitoris, it stimulates its function, its growth, its sensitivity.
So in fact, it’s not just from a sexual point of view, the effect on desire, but also on an organ, sensitivity and response–the ability for the vagina muscles to develop a level of contraction during sex response, the ability of the clitoris to feel something. And one of the most common complaints of women who have a low testosterone, when you ask them, when I ask routinely, is there any difference in clitoral sensitivity?
Women will say, “It’s dead down there. It’s dead down there.” That’s a classic word to use for loss of cell growth. In medicine that’s called atrophy–shrinkage of tissue, loss of cells, loss of sensitivity. So you see, the whole story comes full circle as to understanding how hormones work and how it translates into what women feel or don’t feel.
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.