Many women report a decrease in libido at some point in their lives. No one really knows what drives libido. Many gynecologists think that estrogen plays a role, and if a woman who is post-menopausal complains of a low libido, I usually ask her to think about estrogen replacement therapy. However, even women with normal estrogens can have a low libido, and many endocrinologists believe that testosterone plays a role. Our ovaries normally make testosterone, which everyone thinks of as a male hormone; we just make less than guys do. Replacing testosterone certainly makes sense, and topical 2% testosterone cream is a standard treatment. Unfortunately, no commercial pharmaceutical company makes it, so you have to obtain it from a pharmacist who can compound things herself. You can apply it to the labia daily, and if it works, you should see an effect in a few weeks.
Of course, any time you use testosterone, you have to be prepared for masculinizing side effects, such as acne or facial hair. Don’t worry too much, though — you will not wake up overnight with a beard. These things appear slowly, so that if you start noticing masculinization, you have plenty of time to cut down use of testosterone.
Some medications can inhibit libido, such as certain blood pressure medications. There are also some medical conditions, such as a pituitary tumor, that can present with decreased libido. So be sure to discuss this with your medical caregiver.
No one is quite sure what Viagra will do for women. Basically, we would expect it to increase pelvic blood flow, so for a few women I think it would enhance orgasmic response. However, its direct effect on libido in women is unknown. I will try to keep you apprised of new developments.