From the Guidelines
Testosterone cypionate is not recommended for females as a first-line treatment for female sexual dysfunction due to the potential for masculinizing side effects and the lack of strong evidence supporting its use in this population. The evidence base for interventions to treat female sexual dysfunction in survivors is weak, and high-quality studies are needed 1. According to the NCCN clinical practice guidelines, treatment for female sexual dysfunction should be guided by the specific type of problem, and may include over-the-counter and prescription options, pelvic physical therapy, and integrative therapies 1.
Some of the recommended treatments for female sexual dysfunction include:
- Integrative therapies such as yoga and meditation, which may be helpful for female survivors with sexual dysfunction 1
- Cognitive behavioral therapy (CBT), which has been shown to be effective at improving sexual functioning in breast cancer survivors 1
- Vaginal moisturizers and gels, oils, and topical vitamin D or E, which can help alleviate symptoms such as vaginal dryness and sexual pain 1
- Pelvic physical therapy, which may improve sexual pain, arousal, lubrication, orgasm, and satisfaction 1
- Vaginal dilators, which are an option for survivors with pain during sexual activity 1
- Topical prescription medications such as vaginal estrogen, which has been shown to be effective in treating vaginal dryness, itching, discomfort, and painful intercourse in postmenopausal women 1
When considering prescription medications, the risks and benefits should be discussed, and the survivor should be referred to an appropriate healthcare provider for prescription and/or treatment 1. In general, any treatment for female sexual dysfunction requires careful consideration of risks versus benefits and regular monitoring by a healthcare provider.
From the Research
Testosterone Cypionate for Females
- Testosterone cypionate is sometimes used off-label for the treatment of hypoactive sexual desire disorder (HSDD) in females, as mentioned in studies 2, 3, 4.
- However, it is not FDA-approved for this indication, and its use is not without controversy, with some studies highlighting the need for caution and further research 5, 6.
- Flibanserin and bremelanotide are the only FDA-approved medications for the treatment of HSDD in premenopausal women, with testosterone being considered an off-label option 3, 5, 4.
- The use of testosterone in women is a complex issue, with a need for safe and regulated prescribing practices, as well as further research into its effects and potential benefits 6.
- Studies have shown that testosterone, along with other medications such as buspirone, bupropion, and sildenafil, may have some clinical benefit in women with sexual dysfunction disorders, but trials have significant design, dosing, or generalizability limitations 3, 4.