What should you know about high testosterone low sex drive?

Sexual desire is influenced by sleep, mood, stress, pain, vaginal dryness, relationship factors and medical conditions, as well as hormones. A high testosterone result can reflect treatment, polycystic ovary syndrome, a laboratory variation or another cause. The result needs interpretation with symptoms, menstrual history and the test method.

Perimenopause and menopause can change desire and vaginal comfort even when testosterone is not low. Genitourinary syndrome of menopause may cause dryness or pain that makes sex difficult, which can reduce desire over time.

Ask for a medication and health review, including testosterone, supplements, contraception, antidepressants and other prescribed medicines. Mention pain, dryness, irregular periods, acne, increased facial hair, sleep problems and mood changes. A clinician may repeat the hormone test or check related hormones when appropriate.

Treatment should target the cause. Lubricants, vaginal treatment, counselling, relationship support or changes to a contributing medicine may help. Testosterone therapy for women is not a general solution for every change in desire and should only be considered after an individual assessment.

Arrange a clinical review for rapidly increasing facial or body hair, voice deepening, scalp hair loss, severe acne, new menstrual disruption, pelvic pain, bleeding after sex, or distress that persists. Seek urgent help for sudden severe pelvic pain, fainting or heavy bleeding.

Could the result be related to a medicine or test timing? What other causes of reduced desire should we assess? Is pain or vaginal dryness contributing, and what treatment is appropriate? How would any testosterone treatment be monitored?