An Australian review published online this week in the The Lancet Diabetes & Endocrinology has suggested that, for postmenopausal women with low sexual desire causing distress, testosterone is an effective treatment – with a preference for non-oral administration.

Rakibul M. Islam, Ph.D., from Monash University in Melbourne, Australia, and colleagues conducted a systematic review of the literature to assess potential benefits and risks of testosterone for women. Data were included from 46 reports of 36 randomized controlled trials with 8,480 participants.

The researchers found that compared with placebo or a comparator, testosterone significantly increased sexual function, including satisfactory sexual event frequency (mean difference, 0.85; 95 percent confidence interval [CI], 0.52 to 1.18), sexual desire (standardized mean difference, 0.36; 95 percent CI, 0.22 to 0.50), pleasure (mean difference, 6.86; 95 percent CI, 5.19 to 8.52), arousal (standardized mean difference, 0.28; 95 percent CI, 0.21 to 0.35), orgasm (standardized mean difference, 0.25; 95 percent CI, 0.18 to 0.32), responsiveness (standardized mean difference, 0.28; 95 percent CI, 0.21 to 0.35), and self-image (mean difference, 5.64; 95 percent CI, 4.03 to 7.26); reductions were seen in sexual concerns (mean difference, 8.99; 95 percent CI, 6.90 to 11.08) and distress (standardized mean difference, −0.27; 95 percent CI, −0.36 to −0.17) in postmenopausal women.

When testosterone was administered orally, but not when administered non-orally, there was a significant increase in low-density lipoprotein cholesterol, and reductions in total cholesterol, high-density lipoprotein cholesterol, and triglycerides. There was an overall increase in weight with testosterone treatment; no effect was reported on body composition, musculoskeletal variables, or cognitive measures.

“Our comprehensive systematic review,” the authors wrote, “provides robust support for a trial of testosterone treatment, using a dose appropriate for women, when clinically indicated in postmenopausal women.”


REFERENCE: Islam et al: Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data;