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Question:
I had an autologus bone marrow transplant for non-hodgkins lymphoma in 1991
I am taking an estradiol patch 0.1mg per day. iam also taking syntheroid at low doses
i cannot feel sexual excitement and i was wondering if I should try to use a low dose of testosterone in a gel form?
Please let me know your opinion because I am shy to ask my doctor.
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Answer:
by Megan P Fleming: (05/20/2004)
You asked a good and important question that many women might find difficult to ask. Sexual health is an important aspect of an individual's quality of life; however, health care professionals often neglect it from assessment. I encourage you to raise your concerns with your doctor.
The description provided raises questions that may be important to your case and can help your doctor determine the best treatment recommendations. The first part of your question states that you can't feel sexual excitement, and then you clarify your belief that the problem has been a lack of sexual desire for the past 10 years. It is not clear from the details of the information provided if you have difficulties with arousal, desire or both. When you were diagnosed and treated for Non-Hodgkin's lymphoma? Did you notice the change in your libido and arousal before or after your diagnosis and treatment? You mentioned that you had an autologous bone marrow transplant. Were you also treated with chemotherapy, and/or radiation? In the additional information you indicated that you had a total hysterectomy. What was the medical indication for this surgery? Surgical removal of a woman's ovaries induces menopause and sudden loss of the ovarian production of both estrogens and androgens. I assume that you were prescribed the estradiol patch so that you would not experience problems with hot flashes and vaginal atrophy both associated with loss of estrogen. You also indicated that you are taking Synthroid, which is most commonly prescribed for the treatment of Hypothyroidism.
Although loss of libido is sometimes associated with low levels of testosterone, there can be other causes or contributing factors. It is not uncommon for women to experience decreased sexual interest. Results from the recent National Health and Social Life Survey indicated that 30% of women in your age group (40-49) reported a lack of sexual interest. Your doctor can obtain a morning total and free testosterone level to determine if your loss of libido is associated with deficient testosterone. Currently in the United States, there are no testosterone drugs that are FDA-approved for use women with sexual problems and testosterone deficiency. There are however, a number of physicians who prescribe supplemental testosterone replacement for women who experience loss of libido and are not helped by traditional hormone replacement therapies (HRT). Estratest is a form of HRT available in the United States that contains both estrogen and testosterone. Controversy still exists among physicians who prescribe supplemental testosterone as to which method of administration is preferable to maximize efficacy and minimize possible side effects. The most significant concerns are related to the possible reduction in HDL (good) cholesterol, liver damage and virilization (i.e. hair growth, deepening of voice, irritability).
For more information on the indications and use of testosterone in women, review the article by Ellen Rap in the Women's Health section of the site. The book, The Hormone of Desire: The Truth About Sexuality, Menopause, and Testosterone, by Susan Rako, 1996 is another good resource.
Reviewed by Sexual Health Editorial Team
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