Low testosterone is not a valid diagnosis in healthy women, and most women with low amounts of the hormone should not use testosterone-replacement drugs, the Endocrine Society said in a new guideline.
“Although limited research suggests testosterone therapy in menopausal women may be linked to improved sexual function, there are too many unanswered questions to justify prescribing testosterone therapy to otherwise healthy women,” guideline task force chair Dr. Margaret Wierman, of the University of Colorado, said in news release.
Dr. Wierman said that in a review of past studies, women who had low testosterone levels did not exhibit any signs of the deficiency or symptoms of concern. “As a result, physicians cannot make a diagnosis of androgen deficiency in women.”
Androgens are a group of sex hormones that includes testosterone. Although these hormones are usually thought of as being male, they are also present in women in small amounts.
Dr. Wierman acknowledged that some limited research in the past indicated testosterone therapy in menopausal women restored some sexual function. But “there are too many unanswered questions to justify prescribing testosterone therapy to otherwise healthy women,” Dr. Wierman said.
One exception in which the Endocrine Society approves of prescribing testosterone therapy for women is when they are diagnosed with Hypoactive Sexual Desire Disorder (HSDD), a condition marked by an absence of interest in sex that causes personal distress. In such cases, the Endocrine advises in its Clinical Practice Guideline trying a trial of testosterone therapy of three to six months to see if sexual function improves.
The Endocrine Society emphasizes that physicians refrain from prescribing testosterone for off-label purposes such as boosting sexual function in women unless the female patient is diagnosed with HSDD.
Use of testosterone in women has been linked to changes in cholesterol and other conditions including acne and excessive growth of hair on the face, back, or chest. Long-term risks to the breasts and cardiovascular system in women could be possible but haven’t been studied.
“Currently, there isn’t enough evidence that any benefits outweigh the risks to most women,” Wierman said. “More research is needed to determine the long-term safety of testosterone therapy in postmenopausal women.”