A new testosterone therapy is transforming sexual health for menopausal women in South Africa by addressing low libido effectively and safely. Experts highlight its potential as a game-changer, backed by growing evidence and personal stories of renewed vitality. While not suitable for all, it offers hope for those with hypoactive sexual desire disorder.
Testosterone levels in women typically halve by menopause compared to their twenties, contributing to a significant drop in sexual desire. International studies indicate that 30-50% of post-menopausal women experience this decline, with one in three reporting infrequent or absent sexual activity. In South Africa, hormone therapy approval has sparked rapid interest, as noted by Cape Town gynaecologist Dr Marlena du Toit, who serves as Programme Director of Sexual Health at Stellenbosch University.
"Testosterone treatment for menopausal women is such an exciting topic right now," du Toit says. "For the first time, we have solid evidence to treat post-menopausal loss of libido safely and effectively." Diagnosis involves ruling out biological, psychological, and social factors, with blood tests used for safety rather than confirmation. Professor Tobie de Villiers, past president of the International Menopause Society, calls it a "genuine game-changer" for women with hypoactive sexual desire disorder (HSDD).
One beneficiary is Susan, a Western Cape mother who entered menopause at 52. Suffering from hot flushes, mood swings, fatigue, and vanished libido, she received oestrogen and a low-dose testosterone prescription. Within weeks, her symptoms eased, and she reports having the best sex of her life after nearly 40 years of marriage. "It works for me," she says, noting minor manageable side effects like slight hair growth.
Experts emphasize that women's arousal is circular and context-driven, starting from emotional connection rather than spontaneous physical response, as described by Professor Rosemary Basson. Testosterone amplifies dopamine pathways in the brain, priming desire without creating it outright. The South African Health Products Regulatory Authority approved TestaFeme, a transdermal cream, six months ago for post-menopausal women with HSDD.
Risks include acne, hair growth, or deeper voice if overdosed, and it's contraindicated for those with breast cancer history or certain disorders. Family therapist Marlene Wasserman warns it's no substitute for addressing relationship issues. Monitoring ensures safety, with many women experiencing boosted energy and confidence without major side effects.