Testosterone use in pre and post-menopausal women:
The FDA has not approved any testosterone products for use in women, but it is used off-label in the form of creams, implanted pellets, patches, troches, injections, and is sometimes compounded by pharmacies.
Testosterone use in menopausal women:
- Braunstein described the following views of the Endocrine Society and the North American Menopause Society regarding the use of testosterone in menopausal women (20):
- Both organizations concur that measuring free or total testosterone levels are inaccurate, and there is no correlation established between testosterone levels and sexual performance. Both societies recognize testosterone to be low in oophorectomy, adrenal insufficiency, hypoactive pituitary gland, therapy with glucocorticoids, oral estrogen, and in chronic disease. Sexual function is restored when testosterone is used with estrogen following oophorectomy.
- The North American Menopause Society expressed that whether testosterone is taken by pill or otherwise, the research available shows improvement in sexual desire when added to postmenopausal estrogen therapy.
- The Endocrine Society Clinical Practice Guidelines advise against routine use of testosterone by post-menopausal women because it is an insufficient indication and cited a lack of safety data with long term use.
Testosterone use in pre-menopausal women:
Currently there is no medical authority which recommends the routine use of testosterone in pre-menopausal women. Further research is needed to ensure safety and beneficial outcomes of testosterone used in this population. Testosterone therapy for 2 years without estrogen at an average dose of 121 mg in the form of an implanted pellet improved symptoms as measured by the Health Related Quality of Life Menopause Rating Scale in the majority of menopausal and pre-menopausal patients (22).