Androgen Treatment in Women

The document from October 1, 2007, examines the use of testosterone therapy in women, highlighting its controversial nature due to the absence of clear indicators for androgen deficiency. Testosterone, produced in equal parts by the ovaries and adrenal glands in premenopausal women, affects bone, skin, hair follicles, and sebaceous glands, and is also a precursor to estrogen. Symptoms of androgen deficiency are nonspecific, such as reduced well-being, fatigue, and sexual dysfunction, and diagnosis should consider clinical symptoms and low free testosterone levels. Testosterone therapy has shown benefits in postmenopausal women, improving libido, mood, bone density, and muscle mass, with a notable study of 562 participants demonstrating enhanced sexual desire and activity. However, accurate testosterone measurement is challenging, and long-term safety data is lacking, with potential side effects like hirsutism, acne, and unknown risks of cardiovascular issues and cancer. The therapy is contraindicated in certain conditions and should be monitored to keep testosterone levels within the high-normal range for reproductive-age women. The document concludes that while testosterone therapy can be beneficial for women with androgen deficiency, especially postmenopausal with decreased sexual desire, it should not be used without estrogen therapy, and more long-term safety studies are required.