Androgen Therapy in Women.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing trial literature without a systematic review protocol or meta-analysis
PubMed 31687883 · doi:10.1089/jwh.2018.7494
What was done
The authors reviewed the biological role and therapeutic use of androgens in women. They conducted a search of PubMed using the terms "HSDD," "DHEA in women," "testosterone in women," and "androgens in women," synthesizing findings from randomized placebo-controlled trials and reference lists on low-dose testosterone for hypoactive sexual desire disorder (HSDD) and intravaginal dehydroepiandrosterone (DHEA) for genitourinary syndrome of menopause.
What was found
The abstract reports no numerical data, sample sizes, or effect sizes. Qualitatively, it states that most randomized placebo-controlled trials demonstrate improvement in sexual function with low-dose testosterone in select postmenopausal women with HSDD. Short-term therapy appeared safe without major emergent safety concerns, but long-term effects on cardiovascular risk and breast cancer incidence remain unknown.
Why it matters
This review outlines the clinical evidence for androgen replacement in female sexual dysfunction, reinforcing that while low-dose testosterone benefits postmenopausal HSDD, off-label use requires counseling on the absence of long-term safety data and strict monitoring to avoid supraphysiologic levels.
Limits
The abstract describes a narrative review without meta-analytic pooling, study quality appraisal, or quantitative results. Long-term cardiovascular and oncologic safety remains unmeasured, and results apply only to selected postmenopausal women with HSDD rather than broader populations.
Cited by
- supports There are no FDA-approved testosterone medications specifically for women in the United States.