Dr. Sarrel explains when a doctor would recommend a woman take testosterone.
The usual complaint that a woman would make would be the problem of loss of sexual desire. It’s an extremely common problem. In our studies at Yale, we studied a group of 130 women who’d come to our menopause research clinic, and we were studying the effects of hormone deficiency at the menopause and the impact on many different aspects of body function, but we did of course ask about sexual function.
Seventy-seven percent of the women complained of a loss of desire. Now what do we mean by a loss of desire? We asked the women to do the following when we were collecting our data: We said, “Well, you have told us that you have experienced a loss of sexual desire. Let’s use a simple scale, and our scale is going to go from 1 to 7. If your level of sexual desire is a 1 or a 2 or a zero, it’s very low. If your level of desire is 3, 4, or 5 it’s moderate. If your level of desire is 6 or 7, you regard yourself as a high sex-desire person. How would you rate your level of desire now?”
By “now,” we mean over the last four weeks. The women in our study typically said, “Well, now I am either a zero or a one or a two.” And then we said, “How would you rate your level of desire when you feel you are your normal healthy self and the kind of level of sexual desire you have been accustomed to over your adult life?” And the women would often say, “5, 6. Oh, I am a 7; I have always been right at the top.”
“And now you’re a 2?”
In order to come up with that statistic, that 77 percent of the women had an experience of loss of desire, they had to demonstrate in our simple question a two-level change. Someone who had been a 5 is now a 3 or lower. Someone who had been a 4 is now a 2 or lower. Someone who had been a 7 is now a 5, 4 or lower. So you see a significant change.
What I am getting at is there’s a way you can go about this systematically, and a woman can tell for herself what is the difference for herself. So the most common problem could be for a woman if she was really sophisticated and she was able to go to the health care provider and say, “My problem is loss of desire; all my life I had been a level 6 or 7, now I am a level 2,” he or she will look at her like she is a nut, but in fact what she is presenting, because none of the health care providers have been taught this, but the woman herself can say, “Look, I know I am experiencing a significant change.”
Why should a woman be so precise? Well, precision is the name of the game here with hormones because if you can say to someone, “Here is where I was; here is where I am now; help me.” Then she can really open a dialogue with the health care provider. Whether it’s the nurse or the doctor in the office, she could say, “Look at this change, and I am really upset about this. This is a source of distress.” And that’s the most common of the problems.
Now there were other problems, for example, inhibited sex response, or the problem of vaginal dryness, or the problem of pain with intercourse, or women who all their lives had experienced orgasm now no longer were experiencing an orgasm, or what was the most typical description, “Oh, I can experience an orgasm, but it takes me so long to come.” That was a persistent complaint, but nothing was more common, or nearly as common as the problem of a significant loss of sexual desire.
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.