Testosterone-hormone-replacement therapy may reignite your sexual desire.

By Jill Case
Relationship Difficulties: Young couple having problems

Dr. Saima Jehangir says that three hormones are critical to a woman’s sexual desire: estrogen, progesterone and testosterone. Yes, testosterone! Testosterone is not exclusively a male hormone; women also require the proper amount of testosterone to have a healthy sex life.

“Testosterone is responsible not only for the desire to have sex, [but]for blood flow to the erogenous zones when you do have sex,” explains Dr. Saima Jehangir, a board-certified Austin OB-GYN who provides holistic women’s health and wellness care at Lotus Gynecology, Health & Wellness.

Women’s testosterone levels begin to drop when we’re in our late 30s and continue to drop as women age.

“As testosterone levels decrease, blood flow to the erogenous zones decreases,” adds Jehangir, who provides hormone-replacement therapy and other treatments that help women who suffer from sexual dysfunction. She is also one of the few OB-GYNs who provide and understand testosterone-hormone-replacement therapy.

When blood flow to the erogenous zones decreases, sex becomes less pleasurable since there isn’t enough blood flow to stimulate the nerves. Testosterone-hormone-replacement therapy can help.

“When you elevate testosterone levels, it increases blood flow to the erogenous zones so that the sex feels better,” Jehangir says. “Some women will say they didn’t develop the libido or the desire … but that when they did have sex, it was much better.”

Estrogen treatment can also help with this problem.

Currently, OB-GYNs do not learn about the benefits of testosterone therapy as a treatment for sexual dysfunction.

“Testosterone is very underutilized in females with sexual dysfunction,” Jehangir says.  “We’re not taught about this in medical school, and it’s not considered traditional medicine. It’s considered an alternative therapy. Nine out of 10 OB-GYNs won’t know how to use testosterone, how to dose it or what it does. Finding a physician and deciding for yourself whether testosterone is a good treatment for you is important.”

If you suspect you have sexual dysfunction, Jehangir offers a suggestion.

“Find a doctor that you trust and that you are comfortable talking with. Find someone who is interested in having this conversation with you because not every doctor is. From there, hopefully, you can make a multi-disciplinary action plan,” Jehangir says, adding that this may involve multiple therapies. “Most sexual dysfunction is not due to one thing. Sometimes it is, but if it isn’t, addressing it with someone who can help facilitate all the different aspects of healing that you require is important.”


Sexual dysfunction refers to mental or physical problems that can affect a person’s sex life. A variety of factors cause these problems, including:

• hormonal changes
• getting older
• anxiety or stress
• negative sexual experiences or trauma in the past
• physical illness
• mental-illness issues, such as depression
• certain medications, such as antidepressants
• problems in your relationship
• pelvic issues, including problems with the pelvic-floor muscles


The treatment needed is determined by the type of problem the patient is having.

• Medication: Your doctor may need to adjust your current medications if they are affecting your sexual desire.
• Hormone-replacement therapy: Hormones that can help with sexual dysfunction include estrogen, progesterone and testosterone. They can be systemic, such as patches, hormone pellets, etc., or local, such as vaginal creams or tablets.
• Psychological counseling: Counseling can help patients overcome past trauma or negative experiences.
• Couples therapy: Your sexual dysfunction may be due to problems in your relationship that you need to address as a couple.
• Pelvic-muscle rehabilitation: This is a new and promising subspecialty of physical therapy. Your therapist will customize a treatment plan to teach you to relax, control and strengthen your pelvic-floor muscles.
• Addyi (flibanserin), the “female Viagra”: This medication works on the brain to create sexual desire in women.


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