Testosterone for women on the NHS

Well! They've been hammering on about 'Testosterone Deficiency Syndrome' in relation to men, but it's now being recognised more widely that women too can suffer from a lack of testosterone, a lack that bites particularly hard once they enter the menopause. And presumably, if they have had their lives dragged down while that is going on, then afterwards the problem will persist into old age. Which would affect people like myself and many, many other women.

The headline effect of a low testosterone level in women is of course a loss of libido - sexual desire - but it also affects mood, energy, muscle strength and stamina, according to a BBC News article currently viewable online. A certain Dr Panay has addressed the Royal College of General Practitioners in a conference at Harrogate with an urging that GPs draw women's attention to the benefits of testosterone hormone therapy (in the form of patches) if they come to them worried about their sex drive and other related menopausal problems. 'It's not the female Viagara,' he says, but should be offered as part of the counselling process, and it would be fairly cheap to prescribe.

I'm delighted that the whole subject can be talked about freely as a genuine problem that affects older women, and indeed any woman who finds that sex is an activity she would like to indulge in, but she has no energy for, or just can't get in the mood, or has to fight a positive mental or physical block where sex is concerned. Which in turn has the clear potential to stress a relationship - another worry. Perhaps all this has been talked about quietly in private between women for a very long time, but any new initiative to get it all out in the open has to be a good thing. In my lifetime I have seen a host of sexual topics become ordinary and unsensational. When I was young, so much was regarded as at least grossly embarrassing, and much was secret or utterly taboo. The 'Good Old Days' were so often the 'Ignorant Old Days', when it was usual for people to suffer in silence.

So, it may well come about quite soon that a visit to one's GP will include a particular question or two, to get one's sex life on the table. On these lines, perhaps:

DOCTOR: How are you getting on with your HRT, Lucy?
LUCY: Oh, fine. It's hard to lose weight, but that's a trade-off I accept.
DOCTOR: No difficulties with other things?
LUCY: Such as?
DOCTOR: I'm thinking about relationships, and whether the sexual aspect of the one you may have is completely without issues. You see, we are now offering treatment on the NHS to help the 15% of women who do have problems with enjoying sex. Do you think you may be one of them?
LUCY: I see where you are heading! Well, I don't have a relationship, and I'm not looking for one. And so I don't have any sex. There is is always the possibility of meeting somebody in the future, of course.
DOCTOR: Would you feel confident about the sexual aspect of a future relationship, if one developed?
LUCY: I admit I wouldn't.
DOCTOR: What would be the difficulty?
LUCY: A lack of desire. I don't feel any. I like chatting with men, but I have no urge to jump into bed with one.
DOCTOR: A lack of desire may indicate a low testosterone level. That can be improved - with hormone patches. And you'd notice a marked upward change to other things, such as your energy level, strength, and general zest for living.
LUCY: Well, I see the benefits. But quite honestly I'm happy as I am. I'm comfortable. If my libido were ramped up, I'd feel urges that might be hard to satisfy. Let's face it, I'm a bit old, and not an attractive proposition!
DOCTOR: On the other hand, you'd be likelier to respond if there ever were that chance. The testosterone would sharpen your appetite for sex, and nowadays nobody thinks it's ridiculous for older people to openly enjoy an active and satisfying sex life.
LUCY: Maybe. But there would surely be other effects. I don't want big muscles, and I don't want to become argumentative, aggressive and over-competitive. And of course I don't want to compromise the good effect of my oestragen patches. So on balance, no thanks!
DOCTOR: That's fine, Lucy. But if you ever change your mind, the treatment is there for the asking.

As you can see, I would turn down the offer of testosterone treatment. It would doubtless be wickedly pleasant to be randy all the time, but I have no illusions about the chances of slaking my greatly heightened desire! None at all. It would seem like a constant piquant torture. And testosterone has masculinising effects that I certainly don't want, quite apart from altering aspects of my personality. I don't want to turn into a frustrated and bitchy cougar. I want to stay the sexless but amiable person I am right now.

Nevertheless, am I being selfish? Am I denying some man in my locality a relationship (and a sex life) he might be yearning for? Well, at the present time I'm blissfully unconscious of any admirers - local or otherwise - who might be trying to catch my eye. But I'm sure that if my libido were jacked up to a stratospheric level I would become vividly aware of any hungry male interest within six hundred yards. And that should we meet, I would discover the searing passion and desperate emotion that has hitherto eluded me. Is it worth giving up my easy-going, settled life for a roller-coaster existence in which only multiple orgasms matter?

Hmm. I don't think so.