TLDR Testosterone therapy can modestly improve sexual function in menopausal women but should be used cautiously and is not recommended for routine measurement in sexual dysfunction or hirsutism.
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.
251 citations,
October 2014 in “The Journal of Clinical Endocrinology & Metabolism” The guidelines advise against using testosterone and DHEA in women for most conditions due to safety and effectiveness concerns, but suggest considering testosterone for postmenopausal women with low sexual desire.
26 citations,
July 2012 in “Journal of family planning and reproductive health care” The document says that hirsutism in women usually needs hair removal and hormone treatment to manage symptoms and improve well-being.
28 citations,
February 2011 in “Clinical Endocrinology” Women with PCOS have unhealthy changes in their cholesterol particles that are not related to their body weight.
855 citations,
June 2009 in “The Journal of Clinical Endocrinology & Metabolism” The guideline recommends mental health involvement in diagnosing gender identity disorder and outlines hormone and surgical treatment protocols, emphasizing safety, informed consent, and long-term monitoring.
77 citations,
June 2006 in “Best Practice & Research Clinical Endocrinology & Metabolism” The document concludes that accurate measurement of serum androgens is crucial for diagnosing hyperandrogenism.
59 citations,
August 2004 in “Human Reproduction Update” Testosterone replacement can help women with low libido and mood, but they need to have enough estrogen first to avoid side effects.
66 citations,
November 2001 in “European journal of endocrinology” Low SHBG and high FAI, FT, and DHEAS levels are effective in identifying PCOS.
12 citations,
March 2017 in “Journal of obstetrics and gynaecology Canada” Testosterone therapy can modestly improve sexual function in menopausal women but should be used cautiously and is not recommended for routine measurement in sexual dysfunction or hirsutism.
