Testosterone therapy for menopausal women

It has been suggested that there is a link between low circulating concentrations of testosterone and reduced sexual functioning in postmenopausal women,¹ and it has been more than 60 years since the effects of testosterone therapy for the management of menopausal symptoms were first reported.² Since then, testosterone supplementation has received growing attention for its potential role in maintaining sexual function in menopausal women. The National Institute for Health and Care Excellence guideline on the diagnosis and management of menopause recommends considering testosterone supplementation for women with low sexual desire if hormone replacement therapy (HRT) alone has been ineffective.³ However, in the UK no testosterone products are licensed for such use. A testosterone patch authorised by the European Medicines Agency in 2006 for use in women with surgical menopause was withdrawn from the market in 2012 for commercial reasons.⁴ Here, we provide an update on the evidence of the effectiveness and safety of testosterone supplementation in menopausal women.