5 August 2019

Testosterone can aid post-menopausal sexual health

Clinical Endocrinology Sex Women

Sexual function and wellbeing in postmenopausal women may be significantly improved by testosterone treatment, an Australian review and meta-analysis has concluded.

The research, which included 46 reports on 36 trials involving more than 8000 post-menopausal women, cited benefits such improved sexual desire, function and pleasure, together with reduced concerns and distress about sex.

Earlier research has suggested testosterone can improve sexual function in women, but available formulations have been designed for men and evidence for their safety or for adverse side-effects in women is scant.

“Our results suggest it is time to develop testosterone treatment tailored to postmenopausal women rather than treating them with higher concentrations formulated for men,” senior author Professor Susan Davis, from Monash University, said.

The authors said non-oral formulations were preferred for use in women because of the adverse lipoprotein effects of oral testosterone.

Adverse side-effects of non-oral formulations appeared to be restricted to small weight gain, mild acne and increased hair growth, but more research on long-term effects was needed, the authors said.

“Nearly a third of women experience low sexual desire at midlife, with associated distress, but no approved testosterone formulation or product exists for them in any country and there are no internationally-agreed guidelines for testosterone use by women,” Professor Davis said.

“Considering the benefits we found for women’s sex lives and personal wellbeing, new guidelines and new formulations are urgently needed.”

The review found there were no serious adverse effects for glucose or insulin in the blood, blood pressure, or breast health, although there was only limited data was available for breast cancer risk and further research was needed in this area.

And while testosterone could be given to women with or without hormone replacement therapy, the study recommended the hormone should not be prescribed for issues such as fatigue, low mood or muscle strength.

Lancet Diabetes & Endocr: online 26 July