Menopause and sexual desire: The role of testosterone

Rossella E. Nappi, Francesca Albani, Valentina Santamaria, Silvia Tonani, Ellis Martini, Erica Terreno, Emanuela Brambilla, Franco Polatti

Research output: Contribution to journalArticlepeer-review


The present short review underlines the role of testosterone (T) in the motivational and satisfaction components of women's sexuality and critically discusses the strategies to treat hypoactive sexual desire disorder (HSDD), a condition of low desire associated with personal and/or interpersonal difficulties, which is more common in surgical menopausal women. There are multiple ways androgens target the brain regions (hypothalamic, limbic and cortical) involved in sexual function and behaviour. Even though circulating available androgens have been implicated in several domains of sexual response, they seem to be related weakly to symptoms, such as low sexual desire, poor sexual arousal, orgasm and diminished well-being in postmenopausal women. The possibilities of treating low sexual desire/HSDD are multifaceted and should include the combination of pharmacological treatments able to maximize biological signals driving the sexual response, and individualized psychosocial therapies in order to overcome personal and relational difficulties. Transdermal T has been shown to be effective at a dose of 300 mg/day both in surgically and naturally menopausal women replaced with estrogen or not, without any relevant side-effects. However, the decision to treat postmenopausal women with HSDD with T is mainly based on clinical judgement, after informed consent regarding the unknown long-term risks.

Original languageEnglish
Pages (from-to)162-168
Number of pages7
JournalJournal of the British Menopause Society
Issue number4
Publication statusPublished - Dec 2010


  • Androgens
  • Climacteric
  • Hypoactive sexual desire disorder
  • Sexual function

ASJC Scopus subject areas

  • Obstetrics and Gynaecology


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