Testosterone in Women: Measurement and Therapeutic Use

The document from 2017 examines the challenges in measuring testosterone in women and its therapeutic applications, particularly for sexual interest/arousal disorders, hirsutism, and polycystic ovary syndrome (PCOS). It points out the inaccuracy of androgen assays designed for men when used for women and suggests that clinical assessment is often more reliable than hormone assays for hirsutism and PCOS. The relationship between testosterone levels and libido in women is less clear than in men, with studies showing inconsistent results. Testosterone therapy has shown modest benefits for sexual function in menopausal women, with a Cochrane review of 35 studies involving 4,768 participants indicating improved sexual function. A 300 µg/24-hour transdermal patch post-oophorectomy increased satisfying sexual episodes by one per month. However, evidence for premenopausal and perimenopausal women is lacking, and testosterone treatment should be considered off-label and used cautiously. The document concludes that routine androgen measurements are not informative for sexual dysfunction in women and should not be standard for hirsutism, while testosterone therapy may be beneficial in select cases of female sexual interest/arousal disorder with an individualized approach.