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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Common dermatologic treatments like spironolactone and finasteride may quietly undermine sexual desire in menopausal women — a risk that's rarely discussed. Experts are calling on dermatologists to screen for hypoactive sexual desire disorder (HSDD) before and during antiandrogen therapy. Shared decision-making and cross-specialty communication are key to helping patients navigate these overlapping concerns.
Menopausal women frequently deal with two overlapping challenges: androgen-sensitive skin and hair conditions (like acne, hirsutism, and hair loss) and low sexual desire. But a growing concern is that the medications used to treat one may worsen the other. Dermatologists Shoshana Marmon, MD, PhD, and Melissa Mauskar, MD, are raising the alarm that antiandrogens like spironolactone and finasteride — both of which list decreased libido as a side effect — are rarely discussed in the context of hypoactive sexual desire disorder (HSDD) when prescribed to menopausal women.
The issue is compounded by the fact that testosterone therapy, increasingly sought by postmenopausal women for HSDD, directly conflicts with antiandrogen medications. Guidelines from the International Society for the Study of Women's Sexual Health specifically flag finasteride and dutasteride as incompatible with testosterone therapy. Yet no FDA-approved testosterone product exists for women, making treatment inherently off-label and complex.
Key Takeaways:
Why it matters: Dermatologists are often the first — and sometimes only — clinician a menopausal woman sees for these concerns. Recognizing the HSDD-dermatology overlap and facilitating cross-specialty communication can meaningfully improve quality of life for midlife women.
