Testosterone plays modest role in menopausal women's sexual function

Levels of testosterone and other naturally-occurring reproductive hormones play a limited role in driving menopausal women's interest in sex and sexual function, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

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

"While levels of testosterone and other reproductive hormones were linked to women's feelings of desire and frequency of masturbation, our large-scale study suggests psychosocial factors influence many aspects of sexual function," said one of the study's authors, John F. Randolph, Jr., MD, of the University of Michigan Medical School in Ann Arbor, MI. "A woman's emotional well-being and quality of her intimate relationship are tremendously important contributors to sexual health."

The longitudinal cohort study examined data from 3,302 women who participated in the decade-long Study of Women's Health around the Nation (SWAN) to analyze the relationship between reproductive hormones and sexual function during the menopausal transition. Participants were asked about their interest in 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 study also found that women with higher levels of testosterone masturbated more frequently than women with lower levels of testosterone. Higher levels of DHEAS also were associated with more frequent masturbation. The researchers found women who had high levels of FSH masturbated less frequently 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. The findings suggest a women's relationship status and other psychosocial factors may be stronger than any hormonal effects.

"Women's relationships and day-to-day reality are intricately linked to sexual function," Randolph said. "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.