Meeting Women's Desire for Desire

Last year, the journal published an article showing the patch prompted substantial improvement in low-libido women who had gone through natural menopause. Most recently, Intrinsa was found to slightly improve sexual function in pre-menopausal women, as published in the journal Menopause.

Hormones play a critical role in all aspects of reproductive health, according to Judith Reichman, "Today" show medical correspondent and author of "I'm Not in the Mood" (William Morrow & Co., 1998). Women need estrogen for lubrication and comfort during sex. But they need testosterone to feel desire in the first place. With diminished testosterone, Reichman said, women don't just lose desire for their partners, they lose desire for any partner.

Some women's health advocates oppose the use of pharmaceuticals to stimulate sex drive. According to Leonore Tiefer, associate professor at New York University Medical School, "There are no norms in terms of sexual desire, nor could there ever be any." Treating lack of libido with a drug "causes a lack of attention to real sexual problems and their sources. Just because a chemical produces a response is no reason to think the situation prior was a medical condition," she says.

What's the Problem?

For some women, lack of desire is not a problem. Like the late writer Hunter S. Thompson, they are glad to finally dismount the "wild stallion" they've been riding most of their adult lives and settle down to other pursuits. But many who no longer enjoy sexual satisfaction miss it -- a lot.

Jean Atkins, 53, of suburban Maryland, said she lost interest in sex completely after a hysterectomy and removal of her ovaries three years ago. Until that time, sexual desire was a normal part of her life. After the surgery, she said, "it was the furthest thing from my mind."

Atkins mourned the loss of what had been an important part of her relationship with her husband. "He was very understanding," she said. "But we were both just kind of disappointed." When a friend told her that P&G's testosterone patch was being tested in a clinical trial, Atkins jumped at the chance to enroll in it.

Now she is welcoming sex back into her life.

"I notice a difference. I think about sex more than I have in years," Atkins said. After completing her part in the study, she learned that she had received Intrinsa, not the placebo against which it was being compared. Although she experienced some of the common side effects of testosterone, such as an extra facial hair or two, she plans to continue taking testosterone.

How Much Is Enough?

Blood testosterone levels in women have not been shown to correspond with libido. According to Simon, "In men there is a correspondence -- the more testosterone, the more erections and sexual thoughts." But while men may be more creatures of their hormones, said Simon, "women are very complex" in their sexual responses.

Further confounding the issue is that measurements of testosterone are not reliable in women. Because women produce so little of the hormone, testosterone tests, which were developed for men, are not sensitive enough to provide an accurate measurement.

In a study published in the July 6 issue of the Journal of the American Medical Association, researchers in Australia (one of whom receives funding from P&G) found no association between low libido and low blood testosterone levels. They wrote, "The measurement of serum testosterone . . . in individuals with low sexual function is not informative and levels of these hormones should not be used for the purpose of diagnosing (testosterone) insufficiency in women."

In other words, said Simon, with female sexual function, "Treat the symptom, not the blood test."