Androgen Therapy in Women

Area of Science:

• Endocrinology
• Women's Health
• Sexual Medicine

Background:

• Androgens play a role in female libido and sexual arousal, but their broader functions are not fully understood.
• Testosterone, an ovarian androgen, is used off-label for hypoactive sexual desire disorder (HSDD) in postmenopausal women.
• The United States Food and Drug Administration (FDA) has not approved testosterone for women due to efficacy and safety uncertainties.

Purpose of the Study:

• To review current knowledge on the role and clinical applications of androgens in women.
• To evaluate the effectiveness and safety of testosterone therapy for HSDD.

Main Methods:

• Systematic literature search of PubMed using keywords: "HSDD," "DHEA in women," "testosterone in women," and "androgens in women."
• Review of relevant articles and randomized placebo-controlled trials.

Main Results:

• Most randomized trials indicate improved sexual function with low-dose testosterone in select postmenopausal women with HSDD.
• Short-term safety appears favorable, with no major concerns identified.
• Long-term effects on cardiovascular risk and breast cancer incidence remain unknown.

Conclusions:

• Low-dose testosterone therapy can be considered for carefully selected postmenopausal women with HSDD after addressing other causes of sexual dysfunction.
• Informed patient counseling regarding unknown long-term safety data is crucial.
• Close clinical and laboratory monitoring is recommended to prevent supraphysiologic dosing.