Testosterone could significantly improve sexual health problems in postmenopausal women, suggests a review of the existing research.
A comprehensive review of data from 8,480 women, published in The Lancet Diabetes & Endocrinology, found testosterone can improve sexual desire and pleasure in women who have gone through menopause.
The trials compared testosterone treatment to a placebo or an alternative hormone treatment (HRT) such as oestrogen, with or without progestogen.
You may think of testosterone as a hormone only men have, but it's also important for female sexual health, contributing to libido and orgasm. Testosterone levels decline naturally over a woman’s life.
"Our results suggest it is time to develop testosterone treatment tailored to postmenopausal women rather than treating them with higher concentrations formulated for men," said author Professor Susan Davis from Monash University.
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. Considering the benefits we found for women’s sex lives and personal well-being, new guidelines and new formulations are urgently needed.
No serious side effects were found. However, oral formulations of testosterone were associated with increased levels of 'bad cholesterol' - although the authors believe this side effect is only relevant to testosterone pills, not other formulations. An increase in acne, body hair and weight was also shown in some of the data. The authors recommend patients are advised of these effects so they can make an individual choice about whether to go ahead with testosterone treatment.
Dr Channa Jayasena, member of the Society for Endocrinology, and clinical senior lecturer at Imperial College London, who was not involved with the research, said: "The results suggest that in women with problems with sexual function, adding testosterone to traditional HRT may have benefit. Testosterone was not without side effects: acne and slightly increased facial hair were common complaints. The message is that oestrogen-containing HRT should still be the treatment of choice for almost all menopausal women. However, testosterone could be added to HRT when menopausal women have sexual symptoms which are persistent."