A Woman's Sex Drive, Restored by Testosterone

For Bette, 72, who asked that her last name be withheld, testosterone therapy has restored a sex drive that virtually vanished after she underwent a hormonal treatment for breast cancer. She was terribly distressed, she says, when the "terrific sex life" she and her husband had enjoyed for 52 years crashed. So she traveled from her Kansas City home to see whether Irwin Goldstein, director of sexual medicine at San Diego's Alvarado Hospital, could help. He could, it turned out. He treated her with a low dose of a testosterone gel that has been approved for men with certain medical conditions. The medicine isn't FDA approved for use in women, but doctors like Goldstein can legally prescribe it "off label" if they think it might help.

While Bette may be happy with her treatment, experts advise that breast cancer survivors must be especially cautious about taking hormone-based treatments for low libido. The body converts some testosterone into estrogen, which could raise a woman's risk of recurrence, says Eric Winer, director of the Breast Oncology Center at the Dana-Farber Cancer Institute. Aromatase inhibitors, which Bette and many other breast cancer survivors take, can prevent this conversion from happening, Goldstein says.

Some doctors don't recommend off-label treatments at all. "Whenever you're using a drug [to treat] an indication for which it has not been tested, you're playing russian roulette," says Steven Nissen, who oversees cardiovascular medicine at the Cleveland Clinic. "It's risky business."

His message won't sway everyone, though. Says Bette: "I'd rather have something worth living for right now, rather than living in the old folks' home. I'm not going to miss any fun."