Lifting the Lagging Libido
Delivering hormone replacement therapy through the skin via a patch helps improve sexual dysfunction in postmenopausal women.
Menopause is more than hormones gone haywire. As estrogen and progestin levels dwindle down to virtually nothing, and the normal levels of androgens like testosterone are cut in half, women experience a wide variety of symptoms that affect everything from their appearance to their mental and physical health.
More frequently than one might think, those changes involve one of a woman’s most intimate attributes—her interest in and response to sex. “Female sexual dysfunction—low libido, slow arousal, difficulty reaching orgasms and painful intercourse—is a problem that many menopausal women view as a normal part of aging and have simply decided to accept,” says Subir Roy, M.D., professor of obstetrics and gynecology at the Keck School of Medicine of USC. “Where men have the choice of Viagra, there is a lack of treatment options for women.”
But results of a study led by Roy and his USC colleagues suggest a possible way to help. According to the Keck School researchers, data from 23 women indicate that delivering traditional hormone replacement therapy (HRT) transdermally—through the skin via a patch—might actually improve libido in women.
“The results might be the first step in providing a new solution for post-menopausal women, since preliminary results show that HRT from a patch had positive effects on mood and libido, leading to more orgasms,” says Roy, who was the study’s principal investigator.
Addressing the lagging libido experienced by millions of postmenopausal women is particularly important because there is no real treatment currently approved by the U.S. Food and Drug Administration, says Roy. Some preliminary studies indicate that testosterone and/or androgen supplements can be helpful, he adds, but then notes that “administering such therapies in women is risky. And since we don’t have data on long-term effects and correct dosing, we often see unwanted side effects such as excessive hair growth and acne.”
On the other hand, says Roy, the results of the study of transdermal HRT shows that, when administered through the skin, the hormones “allow a woman’s body to better utilize the androgens—including testosterone—she already has, resulting in improved libido.”
Why does a skin patch make all the difference? Roy says it has to do with where the hormones first make an appearance. Oral HRT, for instance, goes through the stomach and intestines to the liver, where it stimulates a protein called sex-hormone binding globulin (SHBG), which binds with and decreases the already-low levels of testosterone in the body. But when HRT is administered via the skin, the hormones go directly into the bloodstream and are distributed throughout the body before making their way to the liver; this results in a lower level of SHBG and higher levels of available androgens. And that, says Roy, resulted in “a greater degree of sexual satisfaction” in 30 to 35 percent of the women in the study.
“The stereotype of older people not being interested in having good sex just isn’t true,” says Terry Linehan, a study participant from Los Angeles. “A satisfying sex life is very important to most marriages, no matter what your age. I wasn’t looking for a ‘miracle pill’ or a quick fix; I just hoped that if the reason behind my low libido was due to my hormone levels that I could help find a way to regulate the problem.”
Future trials to further investigate these findings will be supported in part by Novogyne Pharmaceuticals, marketer of the CombiPatch, the only FDA-approved combination estrogen/progestin patch.
“Since our study group, which consisted of 23 postmenopausal women with no mood or affective disorder, was small, these results are only preliminary,” Roy says. “Larger and longer investigations, which are underway, will be able to verify what our results suggest.”
Postmenopausal women living in the Los Angeles area who are interested in participating in these trials should call (323) 221-2402.
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