Physician HRT Training: Testosterone Therapy for Female Sexual Dysfunction
Here’s a startling statistic for women’s health care providers: It is estimated that approximately 43% of women in the U.S. between the ages of 18 and 59 years old experience some degree of sexual dysfunction. But while male sexual dysfunction has been extensively researched, there has been far less study addressing the treatment of sexual dysfunction in women.
In 2011, the FDA Reproductive and Urologic Drug Products Advisory Committee released a statement saying that Hypoactive Sexual Desire Disorder (HSDD) – characterized by the absence of sexual fantasies and desire for sexual activity – is a significant medical condition for women. Yet, in spite of this recognition, the lack of awareness of female HSDD has slowed the development of both physician training and treatments designed for women with sexual dysfunction.
Women’s Testosterone Therapy: Hypoactive Sexual Desire Disorder (HSDD)
Testosterone is understood to be the primary hormone underlying sexual desire in both men and women. In healthy women, studies have found that higher free testosterone levels have been linked to increased sexual desire – while anti-androgen therapies have been associated with a loss of sexual desire.
The reason testosterone is important for women’s sexual health, is because it is a major precursor of estradiol production. In premenopausal women, the normal range for testosterone in women is 15 to 70 ng/dL – and circulating testosterone levels are approximately 10 times greater than their estradiol levels. But by the time a female patient reaches her 40s, her blood testosterone levels will be approximately one-half of what it was in her 20s. This testosterone drop is why loss of libido is one of the most commonly reported symptoms of perimenopause and menopause.
Causes of Decreased Testosterone in Women
While menopause is the most common factor influencing testosterone decline in women, a number of other things can cause reduced testosterone levels in women.
Obviously, as every physician knows, a bilateral oophorectomy dramatically reduces female testosterone levels, since the ovaries are responsible for producing 50% of a woman’s testosterone. (Conversely, certain diseases such as polycystic ovarian syndrome (PCOS) can raise testosterone levels.)
Certain diseases and chronic illnesses can also interfere with a woman’s hormone production. Hypopituitarism, adrenal insufficiency, anorexia, cancer, burn trauma, and in some cases depression, can all result in lowered female testosterone levels. Glucocorticoid medications (used to reduce inflammation) can also lower a woman’s testosterone levels.
Treating Low Testosterone in Women with HRT
Several randomized, controlled trials of postmenopausal women suggest that testosterone therapy improves sexual desire, sexual responsiveness, and frequency of sexual activity. In these trials, testosterone was delivered in combination with HRT of either estrogen therapy – or estrogen-progestin therapy for women with an intact uterus.
However, the HRT delivery system chosen for testosterone therapy in females is crucial. When testosterone is taken orally by women it is not effective because there is extensive first-pass metabolism in the liver. Testosterone injections are invasive, painful, and inconvenient. And topical gels are messy and unpleasant – and bring the danger of ‘transference’ to family members in close proximity. With testosterone patches, studies have shown that there are often application-site reactions, and most women also do not like that the patch is visible on the skin.
And with all of these testosterone delivery methods – pills, patches, shots, and gels – there are peaks and troughs of hormone levels leading to a roller coaster of symptom ups and downs. However, subdermal pellet application has several advantages over other forms of testosterone administration.
SottoPelle Method HRT utilizes time-released subdermal pellets that consistently deliver hormones to the body – 24/7 – as they are needed. This avoids the ups-and-downs of pills and shots. Subdermal delivery also obviates any liver issues. And because a single pellet insertion lasts from three to six months, patients are free from having to remember to take or apply daily pills, patches, or gels.
Note: Although many clinical studies have shown benefits from testosterone us intreating sexual dysfunction in females, it should be avoided in certain patients, including: women who could become pregnant, women who have or have had breast or uterine cancer, women with high cholesterol, heart disease, or liver disease.
Physician HRT Training for the Lowest Effective Dose
Perhaps the biggest advantage of the SottoPelle® Method HRT training is that it enables physicians to offer their patients the most individualized and conservative dosages possible. SottoPelle Method physician HRT training teaches the provider to identify and treat individual patient hormone levels and deficiencies through very thorough blood testing, extensive lab work, and the use of our convenient online dosing calculator.
While hormone pills and patches are a standard one-size-fits all dosage, hormone pellets are individually dosed and compounded for each patient’s unique hormone replacement needs. This ensures the most effective results with the smallest hormone dose and the fewest side effects.
Physician HRT Training – Testosterone Replacement
While androgen insufficiency is a clinical symptom of multiple disease states in men, low testosterone levels are considered to be the primary hormonal issue underlying lack of sexual desire in both men and women.
And an abundance of clinical research shows that balancing female testosterone levels, along with estrogen and progesterone, is elemental in increasing libido in females. Understanding androgen therapy in women is therefore important for physicians undergoing HRT training and starting a hormone therapy practice, if they wish to effectively treat women with Hypoactive Sexual Desire Disorder (HSDD).
The SottoPelle Method not only utilizes the safest, most convenient, and effective HRT delivery method, it also offers physicians the best opportunity to individualize patient hormone replacement – so the lowest effective dose may be administered.
At SottoPelle® we are passionate about training physicians on the problems linked to sex hormone deficiency. Hormonal well-being affects more than just a patient’s libido, energy levels, and weight. Hormones support the body’s primary cardiovascular and metabolic function. Restoring the balance and improving sex hormone deficiency helps get a patient back on track to a longer, healthier life.
The SottoPelle Method Physician Hormone Therapy Training program helps physicians nationwide treat their patients. With hormone replacement therapy on a physician’s list of clinical offerings, patients can experience optimal wellness. Call us today to sign up!
Physician HRT Training: 323.986.5100 (press 1)
Julie M. Wickman, PharmD, Ashley Groves, Lauren Wiggins, Nishma Patel, Androgen Therapy in Women
Philadelphia College of Osteopathic Medicine; US Pharm. 2014;39(8):42-46.
IMPORTANT DISCLAIMER: This article is provided as general information only and is not intended to be used as medical advice. While the benefits of hormone replacement are well documented through clinical research, we are not representing that hormone therapy is a “cure” for any disease. Only your treating physician can determine if hormone replacement may be a beneficial part of your healthcare regimen, based on your age, overall health, risk factors, and lifestyle.