"A dizzying number of factors can conspire against sexual desire as midlife approaches depression medications illness career worries financial pressures marriage troubles young children in the home or an empty nest the sense that life is half over  and then theres testosterone. Usually we think of testosterone as a hormone that men have  in abundance. But testosterone plays a big role in setting the pace for a womans sex drive as well. And both men and women experience a natural drop in testosterone that can cause libido to ebb in midlife. Testosterone levels peak in the mids for both men and women. For women who have about  to  the amount of testosterone that men have testosterone levels taper off slowly until they plateau around the age of . For men testosterone levels continue to wane into their s. By the time women reach menopause their testosterone levels are about half of what they were in their s. Mens testosterone levels decrease by about  per year and then drop faster as they approach older age.   Testosterone treatment for men and women can help restore the hormone to a level that will push the sexual accelerator. But how often you feel like jumping in the sack is tied to so many complex biological and lifestyle factors experts say that its important to make sure youre treating the appropriate issues. If you have a serious illness or depression those should be addressed separately. And a number of things can go wrong with testosterone treatment. Testosterone use is very widespread but its misused a lot says Dr. Glenn Braunstein an endocrinologist and chairman of the department of medicine at CedarsSinai Medical Center in Los Angeles. Inaccurate diagnoses can result simply because blood draws were done at the wrong time of day. In men testosterone levels peak in the morning and dip in the afternoon so if doctors rely on a single blood test done in the afternoon they may misdiagnose the source of the problem Braunstein says. Men have a number of options for treating low testosterone including the topical gels Testim and AndroGel. These prescription drugs deliver the hormone from the skin into the bloodstream. Testosterone patches and injections are also available. The wellknown Viagra and its counterparts on the other hand dont have any effect on libido rather they improve erectile function. Getting and maintaining an erection requires generation of nitric oxide which aids in engorgement of blood vessels. But when nitric oxide levels drop too quickly the erection is lost. Viagra which is made only for men inhibits the breakdown of nitric oxide to keep an erection from waning prematurely. Patients whose testosterone levels are low may not benefit fully from taking Viagra until levels of the key hormone are increased Braunstein says. Yet in some cases testosterone can help both libido and erectile function though its not entirely clear why that is so. The observation has been that you may not get an adequate response to Viagra unless you add testosterone back Braunstein says. But he notes we do not want men who are otherwise normal in regards to testosterone to run out and get it because they want a better effect from Viagra. The Food and Drug Administration has not approved any testosterone treatments for women though a topical gel called LibiGel is in advanced clinical trials. To fill the void doctors sometimes resort to prescribing offlabel treatments for women such as low doses of the gels approved for men says Sheryl Kingsberg a clinical psychologist and chief of obstetricsgynecology behavioral medicine at University Hospitals Case Medical Center in Cleveland. But Kingsberg emphasizes that other factors  such as exercise fatigue sleep deprivation stress cardiovascular disease and obesity  cannot be overlooked when trying to restore or maintain sex drive. All of those things absolutely affect overall health and sexual health she says.   The converse is true as well. Studies show that having a healthy sex life can improve health and wellbeing. And for women who reach menopause and assume their best days are behind them Kingsberg has two words No way. Its important for postmenopausal women to know that the quality of a relationship has been shown to be a much better predictor of sexual health and sexual satisfaction than age and menopausal status she says. And another reason to keep ones libido in good working order Without it a relationship can really suffer she says. Bad sex does way more to subvert an otherwise good relationship than good sex does to promote an average one. READ MORE Midlife and What to Do About It http"