Testosterone As An Aid To Libido

Dr N,

I read with interest your comments on the importance of testosterone in HRT therapy if one is experiencing low libido. I am 54 yrs old and had a complete hysterectomy at 48 due to a very large fibroid attached to my uterus. I started estrogen treatment right away and have felt fine physically but have experienced a big loss of desire and pleasure in the libido department. My ob-gyn suggested Estratest, a combo of testosterone & estrogen but I did not find any significant improvement. You suggested a different delivery system for the testosterone. Could that make a difference in the effect for me? I currently am on .625 Premarin daily…I previously enjoyed a healthy sexual relationship with my husband so this is a real bummer for both of us…..Please advise…Thank you.



Although Estratest is effective for some women who have a decreased libido following a hysterectomy I don’t prescribe it. There are more effective and safer options. The most effective would be hormone pellet implants of estradiol and testosterone. Other alternatives¬† would be injections of depo testosterone every 2 to 4 weeks depending on the dose used. Another option would be a compounded estradiol/testosterone gel. Ultimately, when all else fails, subcutaneous hormone pellet implants rarely fail to restore libido and sexual response.

Dr N