Ten per cent. That is the share of premenopausal women in their later reproductive years who experience clinically distressing low sexual desire, according to researchers at Monash University. By perimenopause, that figure climbs to nearly 20 per cent. Yet for the vast majority of those women, there is no approved treatment available anywhere in Australia. A world-first clinical trial now aims to change that.
The study, led by Professor Susan Davis at Monash's Women's Health Research Program, is enrolling 260 women in Victoria aged between 35 and 50 who are not yet menopausal. Each participant applies a small amount of testosterone cream to the thigh, where the hormone dissolves into the skin at low concentrations. It is a straightforward delivery method, but the science behind it has taken years to establish.
"In Australia, right now, there is no specific treatment for low libido that has been approved for premenopausal and perimenopausal women," Davis said. The gap is not trivial. Untreated sexual dysfunction can erode relationships, compound mental health pressures, and diminish self-esteem. Researchers say the condition is chronically underreported precisely because of the stigma that surrounds it.
This is not, however, uncharted territory for the Monash team. Their earlier research on testosterone therapy was central to a 2022 decision by the Therapeutic Goods Administration to approve a testosterone cream formulation for women after menopause. Davis described that approval as "a game changer for a lot of women." The current trial applies the same formulation to a younger cohort, building the evidence base needed to extend that approval to women who have not yet reached menopause.
For Sarah Eglinton, 52, who took part in a comparable earlier trial, the research resonates at a deeply personal level. She said that in her mid-30s she had assumed low energy and reduced desire were simply the inevitable consequences of raising young children. The hormonal dimension was something she stumbled upon, rather than being told about by a clinician.
"Not really knowing that during that phase, my testosterone starts to drop and continues to drop," she said. "It's a taboo subject, so you sort of suffer in silence a little bit."
Eglinton's account reflects a broader pattern that women's health advocates have raised for years. Organisations like Jean Hailes for Women's Health have argued that conditions affecting women's sexual wellbeing receive less clinical attention and research funding than equivalent conditions affecting men. Testosterone therapies have been prescribed to men for decades; the evidence base for women has taken considerably longer to build, and regulatory approvals have lagged accordingly.
There is a legitimate debate about how research priorities are set. With public health budgets under sustained pressure, trade-offs exist between funding conditions with direct mortality impact and those that primarily affect quality of life. Some health economists argue the burden of proof should be consistent regardless of which sex a condition predominantly affects. Others contend that funding decisions should weight disease burden and mortality risk more heavily. Both positions are defensible, and neither is the exclusive domain of any particular political tradition.
What is harder to dispute is the immediate clinical need. If the Monash trial returns positive results, it would create a regulatory pathway for a treatment targeting a cohort that currently has no approved options. The National Health and Medical Research Council has progressively increased investment in women's health research in recent years, and this trial is a product of that longer-term commitment. Whether the results ultimately justify a new TGA approval will depend entirely on the data the study produces.
The research, reported by 9News, is recruiting now through Monash University. Victorian women aged 35 to 50 who are not yet menopausal and who experience distressing low libido may be eligible to participate.