madman
Super Moderator
In The Lancet Diabetes & Endocrinology, Rakibul Islam and colleagues report findings of a systematic review and meta-analysis of testosterone therapy for women, with the aim to assess the benefits and risks of this treatment at doses close to those achieved with a 300 µg transdermal patch—a dose that was effective in improving sexual function and psychosexual wellbeing against placebo in oophorectomised women with hypoactive sexual desire disorder. In postmenopausal women, testosterone supplementation for at least 12 weeks improved several domains of sexual response, including satisfactory sexual event frequency, sexual desire, pleasure, arousal, orgasm, responsiveness, and self-image. Moreover, testosterone significantly reduced sexual distress in both postmenopausal and premenopausal women, although data were sparse in premenopausal women. These findings confirm those of a previous systematic review and meta-analysis, which showed short-term efficacy—in terms of improvement of sexual function and the safety of transdermal testosterone—in naturally and surgically menopausal women affected by hypoactive sexual desire disorder and taking or not taking oestrogen–progestin hormone therapy.
Islam and colleagues’ findings also add relevant information about cardiometabolic safety of testosterone. A significant increase in LDL-cholesterol, and a reduction in total cholesterol, HDL-cholesterol, and triglycerides, was noted with testosterone administered orally, but not for non-oral testosterone.4 No effect of testosterone was recorded on blood pressure, blood glucose, and insulin, but testosterone treatment was associated with a significant increase in weight, irrespective of the route of administration. Mild adverse cosmetic effects (acne and hair growth) were also reported, but these side effects did not lead to withdrawal from treatment. No other adverse effects of testosterone therapy were noted, including effects related to breast and endometrial safety. Finally, testosterone did not show an effect on cognitive performance, bone mineral density, body composition, muscle strength, depressed mood, and measures of psychological general wellbeing, although data are limited.
Notwithstanding these findings, we must gain insight into the therapeutic role of testosterone for women by designing adequate long-term studies to address benefits and risk in specific clinical conditions relevant to healthy female longevity. In particular, there is an urgent need in the area of sexual medicine to ensure gender equality in treating effectively those women with female sexual dysfunction clearly related to hypoandrogenic states. However, products specifically approved in women should become available to achieve this goal; at present, only male formulations are available, with clinicians adjusting the dose to the female circulating testosterone range.
Islam and colleagues’ findings also add relevant information about cardiometabolic safety of testosterone. A significant increase in LDL-cholesterol, and a reduction in total cholesterol, HDL-cholesterol, and triglycerides, was noted with testosterone administered orally, but not for non-oral testosterone.4 No effect of testosterone was recorded on blood pressure, blood glucose, and insulin, but testosterone treatment was associated with a significant increase in weight, irrespective of the route of administration. Mild adverse cosmetic effects (acne and hair growth) were also reported, but these side effects did not lead to withdrawal from treatment. No other adverse effects of testosterone therapy were noted, including effects related to breast and endometrial safety. Finally, testosterone did not show an effect on cognitive performance, bone mineral density, body composition, muscle strength, depressed mood, and measures of psychological general wellbeing, although data are limited.
Notwithstanding these findings, we must gain insight into the therapeutic role of testosterone for women by designing adequate long-term studies to address benefits and risk in specific clinical conditions relevant to healthy female longevity. In particular, there is an urgent need in the area of sexual medicine to ensure gender equality in treating effectively those women with female sexual dysfunction clearly related to hypoandrogenic states. However, products specifically approved in women should become available to achieve this goal; at present, only male formulations are available, with clinicians adjusting the dose to the female circulating testosterone range.
