Exclusive | Testosterone is restoring women’s libido

Shannon Gonzalez insists she would have gotten divorced without testosterone.

In 2021, her hair started falling out — and her libido was “in the toilet.” She had recently entered drug-induced menopause, which triggered a series of symptoms that affected her career, strained her marriage and shook her sense of self.

“Who is this person? I don’t know her,” Gonzalez, now 48, recalled. “I feel like a fish out of water and I don’t know how to rebuild everything I’ve lost.”

It took her years to find a solution: testosterone, a hormone therapy that could help a growing number of women reignite their sexual desire and bring other benefits, although it hasn’t yet been approved by the U.S. Food and Drug Administration.

hormonal disruption

Gonzalez is at increased risk for certain cancers due to a BRCA2 gene mutation. To reduce her risk, she underwent a hysterectomy and bilateral mastectomy just months after giving birth to the youngest of her three children.

The consequences are brutal.

“My hysterectomy doctor was terrible,” says Gonzalez, a certified nursing assistant from Oakley, California. “He didn’t prepare me at all for the hormonal challenges.”

The surgery put her into menopause, and she was juggling life with a new baby, two teenage children, a husband and a full-time job.

“I was at the bottom,” Gonzalez said.

The brain fog made it difficult for her to work, the pain slowed her down, sleep became difficult, and her motivation disappeared. Hot flashes, night sweats, and massive hair loss make it worse.

“I’m very vain. I love doing my hair and makeup every day,” Gonzalez said. “It was a huge blow to my self-esteem when I didn’t have that hair.”

She also struggled in the bedroom, battling low libido and vaginal dryness. Due to other health problems, she was taking two medications known to cause sexual dysfunction.

Sex had always been at the heart of her marriage, so the sudden turn was shocking.

“I really have to try to keep up with him in the bedroom,” Gonzalez said. “I was just going through the motions and thinking, ‘Well, maybe it’ll come back.'” “

But the relationship between the couple became increasingly tense. Her husband, Hector, feels like he’s constantly pursuing her, and she’s having a hard time meeting him halfway.

“Don’t give up on me, I told him. Don’t stop trying,” Gonzalez pleaded.

Low love, desire and libido

Kimberly Solo, a therapist in Massachusetts, said Gonzalez’s experience is common during menopause, a time when many women face relationship challenges and divorce rates rise.

“A lot of women just feel like part of their gender identity is gone,” she told The Washington Post. “Then I think it deteriorates their relationship because there’s no communication around it.”

Solo, 44, has personal experience with the struggle.

“Around 41, I started feeling really tired and my energy really changed,” she said. “Then I noticed my libido dropped and my ability to orgasm was really affected.”

In her practice, she sees how mismatched sexual desires can affect a relationship.

“If you don’t talk and just tell them ‘no’ when your partner initiates sex, they will sometimes feel hurt or rejected and stop trying,” she explains. “It’s a cycle that repeats itself, and the next thing you know, it’s a month, then six months, then a year.”

She credits open communication with keeping her marriage strong while she searches for solutions to reignite her desires in the bedroom.

Turn to testosterone

After extensive research, Solo asked her ob-gyn about taking testosterone. Although generally considered a “male” hormone, women also need it – albeit in smaller quantities.

“By midlife, many women have lost up to half of their natural testosterone,” said Joanna Strober, CEO and founder of Midi Health, a virtual clinic that serves women with perimenopausal and menopausal symptoms.

“This decline shows up in how women feel every day, such as low energy, fatigue, brain fog, mood changes, and even changes in muscle and bone strength,” she continued.

Then there’s the impact on intimate relationships.

“When testosterone drops, libido tends to drop along with it, which can put a real strain on relationships,” says Strober. “But it’s more important than sex. It’s about how connected and confident you are in your body.”

Research shows that restoring hormones to premenopausal levels can enhance libido, mood, energy and strength. However, federal regulators have not approved any testosterone products specifically for women, although more than 30 testosterone products are approved for use in men.

As a result, Solow’s doctors refused to prescribe him testosterone, citing potential side effects, limited long-term safety data, and a lack of FDA approval.

“I don’t believe she had malicious intent,” she said, “but I’m very frustrated.”

Cases like Solo’s are not uncommon. Without FDA-approved testosterone treatments for women, many patients are forced to rely on off-label or compounded male formulas, Strobel said.

“This is not ideal care,” Strober said. “This means women are getting products that were never designed for their physiology or dosage needs.”

This in turn increases the risk of side effects. At low doses, this is rare, but at higher doses, women taking testosterone may experience acne, hair loss, unwanted hair growth on the face, chest, and back, deepening of the voice, mood changes, and other problems.

Find a solution

Not one to take “no” for an answer, Solo turned to Midi Health, which began offering testosterone to women through a pilot program more than a year ago and officially launched the service in October.

“We want to demystify testosterone,” Strober said. “If you’ve been struggling, there is a way forward, and you don’t have to do it alone.”

Midi’s clinician-led, precision-dose topical cream for women is available through its provider network and covered by major insurance companies. It’s available in 12 states, with plans to roll out nationwide as regulations allow.

After a thorough evaluation and lab work, the company created a custom testosterone plan for Solo. Within six weeks, she started noticing results.

“My energy and sexual function are definitely not where they were when I was in my 20s, but it’s definitely an improvement,” said Solo, now an unpaid Midi patient ambassador.

A year and a half later, she still experiences some menopausal symptoms, but says the biggest benefit is the sex.

“It was hard to even have an orgasm before, so now that I can, I enjoy sex more and want to have sex more,” said Solo, who has had no adverse reactions to the medication. “It brings back that desire.”

Gonzalez’s comeback

Gonzales saw similar results. She says her sex life has been revitalized through testosterone injections, estrogen, progesterone supplements and Addyi, a drug for women with low libido.

“Now, instead of always having him climb my tree, it’s me climbing his tree,” she said. “Sex a few times a month turned into sex every other day and it became a normal, healthy, loving relationship for us.”

Gonzalez gets his testosterone through three telemedicine companies, including Midi, and now uses Morph Health & Wellness.

The drug increased her motivation, improved her sleep, reduced pain, and even reduced hot flashes and night sweats, all without any side effects.

“It changed my life,” Gonzalez said. “I feel stronger than ever. I feel healthier than ever.”

Looking back on her journey, she urges other women not to give up on themselves or their sex lives.

“This is just a temporary moment and this will pass,” Gonzalez said. “There is light at the end of the tunnel.”