Dear Patrick: About five years ago, I saw my gynecologist because I had never had an orgasm and I had no desire to have sex. It was not easy to discuss these things with her, but she put me at ease and told me she would help me. She gave me a prescription for a low-dose testosterone cream that I used vaginally. Within a month, I felt more loving toward my boyfriend and really wanted to be physically close to him. I also had my first orgasm.
Unfortunately, I am seeing a new doctor now that I am in graduate school. The gynecologist here says that I have symptoms of “masculinization.” My family is from Italy, and I have a bit of a mustache, but so do my mother and sisters. I wax it and cosmetically you can’t tell it’s there. I need to shave my legs so if I am going to dress up for a formal occasion, I shave my legs. Is that abnormal? After giving me a pelvic exam this doctor also told me that my clitoris is too large. I am not sure what that means, but it has looked the same ever since I reached puberty at age 12. My periods are normal so I don’t understand what is masculine about me. The doctor told me there was no time for all of my questions, but I needed to understand that I was at risk for cancer and it would be malpractice to give me “male hormones.”
I ran out of my cream in January, and since then I have not had an orgasm. The man I am dating here does not seem to notice that I no longer get wet or come when we have sex. He just wants to use more lubricant. Do you think I should just learn how to do without sex? I am really confused about what is happening here. I don’t want to injure myself. I don’t want to get cancer. But I really miss feeling desire. It seems like life is pretty depressing, but maybe that is just the pressure of being in school?
Your doctor is your employee. You have a right to find a new one. You also have a right to—if not exactly tell the doctor what to do, at least to strongly advocate for yourself. Most people passively accept whatever a doctor tells them. This is not, in my opinion, helpful for most of us. Medical science is complex, but nowadays there are many sources available to explain important issues in lay terms. The more you educate yourself about the issues you are having, the better you will be able to evaluate the doctor’s suggestions and the results that you are getting (or not getting) from any given treatment modality.
Make an appointment with a new doctor. Take the medication that your gynecologist originally prescribed. If this new doctor refuses to give you the cream, tell him or her, “I trust my doctor. This treatment was safe and effective. It worked for me for years. I don’t want to jeopardize my relationship by giving up the ability to respond to my partner.” If you are told that “male hormones” should not be prescribed for women, you can counter that with the statement, “There is no such thing as a hormone that is present in men’s bodies and not in women’s bodies as well, and vice versa.” All the so-called female hormones are necessary for healthy male functioning. It is becoming more and more apparent that testosterone is necessary for healthy female bodies. Without it, most women would lack the ability to experience arousal or orgasm. Unfortunately, the ability to measure hormones and determine what is an optimum level is still fairly crude. But a low level prescription will not harm you. If a doctor claims that you are having side effects, you can calmly and politely say, “Those are normal for my body. They were present long before I asked my doctor to help me with my sexual problems.”
You may have to buckle down and look for doctors for a while. You may even have to return home so you can book an appointment with the original prescribing doctor. But I strongly urge you to do whatever is necessary to get help for yourself. All the sex education and therapy in the world is not going to help you if you lack the physical ingredients that are necessary to have a decent sex life. You deserve to have one. And if your partner doesn’t think so, too, and help you with this project, he doesn’t deserve to be with you.