Safety and Efficacy of Transdermal Testosterone for Treatment of Hypoactive Sexual Desire Disorder

The document reviews the use of transdermal testosterone (T) therapy for treating hypoactive sexual desire disorder (HSDD) in women, with a focus on postmenopausal populations. Clinical trials, including the APHRODITE and ADORE trials, have shown that a 300 µg/day dose of T can significantly improve sexual satisfaction and desire with minimal side effects such as hair growth and mild clitoromegaly. However, long-term safety data, particularly regarding breast cancer and cardiovascular disease risks, is lacking. The Endocrine Society does not recommend generalized use of T due to insufficient treatment indications and safety data, while the North American Menopause Society considers it an option for postmenopausal women on estrogen therapy. Despite no FDA approval for T therapy in women in the USA, off-label use is common. The document emphasizes the need for considering psychological factors and comorbidities before off-label T treatment and recommends both pharmacological and psychosocial therapies. Monitoring for androgenic side effects and assessing sexual response are advised during therapy. Further research is needed to understand the long-term effects of T on breast and cardiovascular health.