Testosterone cream for low sex drive?

Dear Alice,

Is it true that women can apply testosterone cream to their vaginal area to increase sex drive?

Dear Reader,

While some studies suggest that testosterone cream might increase sex drive in women, it is not FDA-approved and it may not work for all women. The risks and side effects can be significant and unpleasant, so women experiencing low sex drive may want to consider alternative, less-risky treatments instead of topical hormone therapies.

For many women, their low sex drive is a tough nut to crack. It is important to note that a low sex drive is a complex issue —affected by physical, psychological, social, and/or hormonal causes. Women may experience challenges during any of the stages of sexual response, including sexual desire and arousal. These issues can occur in all women at any stage in life, although they occur more frequently around hormonal events (such as after having a child or during menopause) or after an illness. Common experiences include:

  • Little or no desire to have sex
  • Inability to maintain arousal
  • Pain during sex
  • Inability to orgasm

There are medical and non-medical treatments that may increase sex drive:

Non-Medical Treatment Options:

  • Improving communication with your partner. Do you talk about sex with your partner? Do you feel comfortable addressing this issue? Can you express your feelings and desires in an open and honest way? 
  • Strengthening your pelvic muscles. These muscles are used during sexual intercourse and, just like you do crunches if you want to tone your abs, they need to be targeted with specific exercises as well. Pelvic muscle exercises are called Kegel exercises.
  • Thinking about your lifestyle and possibly considering some changes. Are you drinking a lot of alcohol? Do you smoke? Are you getting enough exercise? Making changes to lead a healthier lifestyle will not only benefit your overall health, but can also (bonus!) improve your sex life.
  • Talking with a counselor or therapist. There may be other issues in your life that are affecting your sexual desire. A trained professional can help you figure out if there are steps you may take to address these issues.

Medical Treatment Options:

If you are considering medical treatment, you should think about discussing your symptoms with a health care provider. Female sexual dysfunction may be the result of other medical conditions, so your doctor may develop a treatment plan to address those issues. Other treatments include:

  • Estrogen therapy. Estrogen is a hormone that plays a part in vaginal health. Low levels of estrogen can affect female sex drive. Estrogen therapy may involve creams, gels, or tablets. It is usually given to women to cope with menopause symptoms.
  • Progestin therapy. Progestin is another hormone that works in conjunction with estrogen. Research on progestin as a treatment for sexual dysfunction is mixed and it is not usually prescribed to treat sexual dysfunction.
  • Androgen therapy. Androgens are male hormones, including testosterone. Although both men and women have testosterone, the normal level in women is much lower than that in men. Studies using androgen therapy to treat sexual dysfunction in women have not been conclusive, and androgen therapy is not FDA-approved for treating female sexual dysfunction.

Testosterone therapy for low sex drive in women, though not FDA-approved, may still be available through a health care provider and can be given as a cream, patch, gel or injection. Because testosterone is a male hormone found in small levels in women, when extra testosterone is administered to women, some of the side effects can be unpleasant. These include:

  • Excess body hair
  • Acne
  • Enlargement of the clitoris
  • Mood changes, including aggressiveness and hostility

The risks of using testosterone cream can be high and there is no guarantee that it will increase sex drive in women. Female sexual dysfunction is an issue that is complicated and can involve many different aspects other than hormone levels. For women who are struggling with low sex drive, it may help to think about possible underlying causes and how these can be addressed before resorting to hormonal therapies.

Last updated Jul 20, 2015
Originally published Sep 28, 2007