Anonymous on September 8, 2011

I had a bone marrow transplant and hysterectomy and now I’m not interested in sex. Should I try testosterone gel?

I’m a 45 year-old-woman and recently had an autologous bone marrow transplant for Non-Hodgkin’s lymphoma…in addition to a hysterectomy. Now I’m taking some artificial estrogen. However, I don’t feel sexual excitement and I was wondering if I should take a low dose testosterone gel?

answered by Mitchell Tepper, PhD, MPH on September 8, 2011

Thanks for bringing your great question to us. I’m happy to offer you my best thoughts for your consideration…

First, you’re not alone. After a bone marrow transplant, many people experience a temporary decrease in sexual function.According to one study at the Stanford University Medical Center, about 14% of recent bone marrow transplant recipients reported sexual problems three months after treatment. Luckily, in most cases, these issues were resolved within a year for most participants in the study.  

Also keep in mind that, according to researchers at Massachusetts General Hospital,almost 40% of all women – not just those who’ve had cancer or a hysterectomy ⎼ experience some issue(s) with sexual function in their lifetime. In other words, your lack of sexual excitement may be unrelated to your other health issues.

That said, with the help of a doctor, most people can overcome sexual problems. So I would encourage you to see your regular doctor for a thorough evaluation of anypotential physical causes of your lack of sexual excitement. For example, women who are depressed or taking certain medications – particularly as treatment for depression – can sometimes experience trouble with sexual excitement.

Other times, sexual problems are linked to emotions about sex and the quality of your relationships...if this is the case for you, your doctor might refer you to a counselor or sex therapist. Be aware that finding the right amount and type of treatment(s) can be a work-in-progress. So be sure to keep in touch with your doctor while you get back on track.

What about testosterone for decreased libido? You mentioned that you had a hysterectomy. If your hysterectomy also included the removal of your ovaries (anoophorectomy), the testosterone production in your body could decrease by up to 50%. But researchers are still studying the effects of testosterone on women’s sexual function, and the results are unclear.

While somerecent studies at the Massachusetts General Hospital indicate testosterone treatment may be beneficial to women who are naturally or surgically menopausal and there are doctors who will prescribe testosterone for women “off label,” the body of research on testosterone treatment for women is inconclusive. In fact, the Endocrine Society’s Clinical Practice Guidelines advise against supplemental testosterone for women. And theU.S. Food and Drug Administration (FDA) has not approved testosterone gels for use in women either.  

Bottom line? See your doctor to discuss your concerns and questions about your lack of sexual excitement and – depending on your specific circumstances – to identify the best treatments for you.

Thanks again for sharing your concern in this forum, and I wish you good luck in regaining your sexual function and enjoyment.

Related info:

Mitchell Tepper, PhD, MPH

Dr. Tepper directs sexual health education at An AASECT-certified sexuality educator and counselor, his areas of expertise include sexual dysfunctions, sexuality following disability or illness, pleasure and orgasm, relationships, and military and veteran couples' counseling. Dr. Tepper was educated at the University of Pennsylvania and Yale University.

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