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The recent upsurge of interest in the biology of human sexuality and numerous articles about the use of hormones may lead many to consider the use of testosterone/androgens in women with FHSD. Androgen levels in women decline after menopause, and women with decreased androgen levels frequently report low sexual desire. Several authors have suggested that low dosages of testosterone might improve sexual functioning, increasing libido and sense of well-being (e.g., Basson 2005; Davis 1998; Davis et al. 2005; Shifren et al. 2000). In a study by Shifren et al. (2000) of women who had undergone oophorectomy, testosterone patches with either 150 or 300 micrograms of testosterone were used, with positive results in regard to increased serum free testosterone and heightened sexual functioning and sense of well-being. Some (Bartlik et al. 1999) suggest applying a topical preparation of methyltestosterone (0.25–1.0 mg/day in a cream base) to the vulva after bathing. The theory behind the application to the vulva is that the tissue may not initially be responsive to oral testosterone due to atrophy or a paucity of testosterone receptors. The authors (Bartlik et al. 1999) suggest using direct application to the vulva only about twice a week, so as to minimize the possibility of clitoral hypertrophy, and switching to oral testosterone (again 0.25–1.0 mg/day) after about a month in those who would prefer it (some patients may continue topical administration).

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