Testosterone Therapy for Women with Low Sexual Desire: A Position Statement from the Brazilian Society of Endocrinology and Metabolism

    Rita Vasconcellos Weiss, Alexandre Hohl, Amanda Athayde, Dolores Pardini, Larissa Gomes, Mônica de Oliveira, Ricardo Martins da Rocha Meirelles, Ruth Clapauch, Poli Mara Spritzer
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    TLDR Testosterone therapy may slightly increase sexual desire in women with HSDD but lacks broad recommendation due to safety concerns and limited approval.
    In 2018, the Brazilian Society of Endocrinology and Metabolism conducted a review involving nine experts on the use of testosterone therapy for women with low sexual desire, particularly postmenopausal women. The review found that testosterone had a small positive effect on sexual desire in women with sexual dysfunction, but due to a lack of long-term safety data and insufficient evidence, a broad recommendation for testosterone therapy could not be made. The review also noted that no testosterone formulations were approved for women by regulatory agencies in the United States, Brazil, and most other countries. The society suggested that testosterone therapy could be considered for women diagnosed with Hypoactive Sexual Desire Disorder (HSDD), based on a systematic review of seven randomized trials involving over 3,000 women. However, the therapy was associated with increased acne and hair growth. The document also highlighted potential risks of breast cancer and cardiovascular disease, and noted that prolonged administration of anabolic-androgenic steroids (AAS) could potentially lead to hair loss (alopecia), menstrual irregularities, and infertility.
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