Androgen replacement supported for postmenopausal low libido

Evidence supports the efficacy of testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD) but clinicians still have questions about whether the disorder warrants treatment and how therapy should be delivered, according to Melbourne endocrinologist Susan Davis. Professor Davis, who is Professor of Women’s Health at Monash Medical School, argued in a review in Clinical Endocrinology that HSDD had negative effects on mental health, vitality, social function and bodily pain. “Loss of sexual desire for many women is a significant cause of loss of personal well-being, personal distress and relationship disharmony,” she said. Existing clinical guidelines on testosterone therapy for women did not reflect the consistent findings from a number of recent large studies. They showed that the administration of testosterone after natural or surgical menopause in women with HSDD improved many markers of sexual function and reduced the distress associated with the condition. Because many physical, physiological, cultural and relationship factors could influence sexual well-being, women presenting with diminished sexual interest required a general psychological, physical and social health assessment. Measuring testosterone levels was unhelpful in making the diagnosis, as there was no lower level that defined androgen deficiency, Professor Davis said. However, a single measurement before starting treatment was recommended to exclude younger women with normal to high levels who would be at greater risk of side effects. Clinical Endocrinology 2010; 72: 149-154. http://www3.interscience.wiley.com/journal/122522254/abstract...