Sex Patches Versus Candlelight
No matter how many studies suggest that testosterone, the hormone of sexual desire for both men and women, can help overcome a decreased libido, I will still be a fan of romantic dinners.
Recent studies revealed that 25-50 percent of women have a low sex drive. I suspect that stress, dealing with diapers, lack of sleep and selfish mates have as much to do with this as an ebb in hormones. Nevertheless, in the wake of these findings, a new study, just published in the prestigious New England Journal of Medicine, has found an increased rate of “satisfying sexual episodes” in postmenopausal women who used a 300 mcg testosterone patch.
At a time when reproductive hormones are falling (post menopause), it is not surprising that a little testosterone goes a long way to rekindle the flame. But there is a clear cost. Testosterone can increase facial hair, muscular development, and even give you a lower voice. So, you may feel like having more sex, but you may look more like a man which could turn your partner off. Plus, there are the longer term risks to consider including potentially breast cancer, heart attack, or stroke.
Testosterone patches are not approved for this use by the FDA, though they have been prescribed as sexual enhancers for women “off-label” for many years. An FDA advisory panel has considered them as recently as 2004, but rejected them on the basis of safety issues. I’m sure that Proctor and Gamble, which manufactures the Intrinsa testosterone patch, and provided research grants for the current study, aptly named APHRODITE, will now expect the FDA to reconsider the issue, based on the study’s positive results. But safety is still an important issue. 4 of the study participants who received the patch as opposed to the placebo – were diagnosed with breast cancer. The long term risk of heart attack and stroke has still not been sufficiently studied, and remains a major concern.
I am not yet an advocate of these patches, though I know many other knowledgeable doctors who are, and have found them to be quite effective. For these doctors I would say that if romance isn’t the answer, that perhaps they are being reasonable to consider prescribing the patches on a case by case basis, even while I have my eye on the need for further research.
Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News Medical Contributor and writes a health column for LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: the Truth About the Epidemic of Fear” and “Bird Flu: Everything You Need to Know About the Next Pandemic”. Read more at www.doctorsiegel.com
Tags: hormone, libido, menopause, sexual desire, testosterone, testosterone patch
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Dr. Siegel, thank you for giving the rational counterpoint, in the popular press, to the renewed interest the NEJM article will engender in our patients. As a board-certified OBGYN, I am frequently asked for a “magic pill” to enhance the decreased libido of some of my patients. When I interview them further, I invariably find that, as you suggested, they are overworked, have minimal opportunity for quality “alone time” with their significant others, often have disinterested, boorish or frankly abusive husbands, and are frequently depressed and sleep-deprived.
Despite the fact that women’s magazines frequently feature helpful, accurate, and sometimes entertaining articles on improving one’s romantic and/or sex life, I find that my patients are often far more interested in a magic pill. Not that different from weight loss issues, I’m afraid. As a society, we have become far more interested in the quick fix than in putting in the effort for a satisfying and long-lasting solution free of unwanted and potentially dangerous side effects.
Loved your article. My wife and I recently launched a site with the purpose of assisting couples looking to add more romance, fun, sex, and intimacy to their relationship. Finding alone time is not easy. At http://www.intimatesurprises.com We deliver a monthly intimacy kit filled with items chosen to inspire couples to put a do not disturb on the bedroom door. The idea is that a sexy, sensual, intimate and yes, fun interlude can be delivered to your doorstep each month. Its take out for your sex life. Just add two lovers and enjoy.
As an ivory tower type, your take on the issue is predictable. Those of us who actually practice medicine are well aware of the value of testosterone in the post menopausal HSDD patient. And, no, it doesn’t take a patch that’ll probably wind up costing several dollars a pop that probably won’t even be approved by the FDA.
And, no, hypertrophic musculature and deepening voice are not expected side effects of therapeutic doses of testosterone.
By the way, breast cancers were detected in three women assigned to testosterone. One had symptoms before randomization and in one the diagnosis was made after only four months of therapy. The third was reported at the completion of the study. So that’s one case out of nearly 600 where causality might be an issue.
If you want to prescribe romantic dinners, good luck. Once the rest of us get the depression and stress treated that might be a viable solution. Unfortunately, the treatment will not improve the porcine traits of a significant percentage of the male population.