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Dr. Sarrel shares what a woman can expect when she starts taking testosterone.
Dr. Sarrel:
Well, remember the reason why the woman has started taking testosterone, most common reason wouldn’t be fatigue, but she should keep track of her level of fatigue because she is going to see that respond. It should. Mainly, she should keep track of her level of sexual desire.
Remember we talked about seven being the highest and zero being none and one being down at the bottom? So she knows where she started, and she could over a period of four weeks, six weeks, eight, ten, twelve weeks, she could keep a daily record.
We have found women have no problem doing that. They know they can track, “Well, in the first week not much happened; the second and the third week I started to get some feelings.” By the end of the fourth week what we saw was about a third of the women on an androgen that was controlled by the FDA and that did work and we could rely on.
And about a third of the women said, “Hmm, I am starting to have sexual feelings again. I am starting to have some fantasies. I am starting to feel more relaxed about sex. My partner is starting to respond sexually. Things are moving in the right direction.”
We did find that for all of the women in our study, and I think they are fairly representative because I know the testosterone patch data, that it can take as long as six months. Most of the women by the end of three months could say, “This is helping me. This is making a difference so I am finding myself more interested in sex. I am having some sex dreams.” Some of the women started having orgasm in sleep and started being able to be more sexually responsive, just natural things happening because the missing hormone was now there and having its effects.
But to take 10 or 12 weeks is the norm. If a woman responds early, you can’t argue with that. On the other hand, you always worry about an early response being a placebo response. What you want to know is well, six months after starting, if it was working is it still working? So we followed the women for three years, and what we did find is that the women who responded initially continued to respond, and the big changes were a lowering of the SHBG, an elevation of the bioavailable testosterone is what correlated with increased desire and a better sex life.
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.