39February 2011

As women age, their level of testosteronenaturally decreases. The ovaries and theadrenal glands produce testosterone.However, a woman in her forties has onaverage only half of the testosterone circu-lating in her blood stream as does a woman

in her twenties. Studies have shown that oral contra-ceptive use can permanently lower the free level oftestosterone in women long after birth control has beendiscontinued. Levels of testosterone can greatly impactsexual libido and sexual function in women.

Symptoms of decreased levels of testosterone include:absent or greatly diminished sexual motivation and/ordesire; persistent, unexplainable fatigue; or lack ofenergy. Treatment, in the form of testosteronereplacement therapy, is available.

Testosterone is available commercially in a patch andgel, both of which are not FDA approved for womenand come in much higher strengths than women cansafely use. As a compound, it’s available in topical andvaginal creams, troches, gels, as well as other formula-tions, depending on patient-specific factors and choice.Compounded Testosterone cream is becoming increas-ingly popular because it does not irritate the skin asmuch as commercially made patches or gel.

A 2007 study found that testosterone cream significantly improved sexual scores in menopausalwomen with low sexual desire. It was effective, easy to use and had no side effects over the three-monthperiod of active treatment. The North AmericanMenopause Society stated in a mission statement:“Postmenopausal women with decreased sexualdesire associated with personal distress and withno other identifiable cause may be candidatesfor testosterone therapy.”

Side effects may occur with high doses of testos-terone, including oily skin, acne, aggressivebehavior, increased hair growth, deepening of thevoice, weight gain, and changes in cholesterol. The dose can be adjusted if any of these adverse effectsoccur. Testosterone therapy is contraindicated inwomen with a history of breast or uterine cancer or inthose with cardiovascular or liver disease.

Mary PreFontaine, R.Ph. FAAFM is a consultingpharmacist specializing in dosages for hormonetherapy. PreFontaine works with physicians to find the

best possible dosage and dosage forms for patients experiencing a variety of symptoms caused from hormonal imbalances.

Testosterone: Prescription for PassionBy Mary PreFontaine, R.Ph, FAAFM