From the Research
Testosterone replacement therapy (TRT) in women is primarily indicated for hypoactive sexual desire disorder (HSDD) that causes personal distress, particularly in postmenopausal women or those who have undergone surgical menopause, as supported by the most recent study 1. The indication for TRT in women is based on the diagnosis of HSDD, which is characterized by a lack of sexual fantasies, thoughts, and/or desire for or receptivity to sexual activity.
- The diagnosis of HSDD should be made after ruling out other causes of symptoms, such as relationship or mental health problems, and laboratory testing should confirm low testosterone levels 2.
- Typical dosing for TRT in women is much lower than for men, with transdermal preparations preferred, such as creams or gels at 0.5-2 mg daily, or testosterone patches at 150-300 mcg/day 3.
- Treatment should start at the lowest dose and be titrated based on symptom response and serum levels, aiming to maintain testosterone within the upper range of normal female values 4.
- Regular monitoring is essential, including assessment of lipid profiles, liver function, and screening for adverse effects like hirsutism, acne, voice deepening, and clitoromegaly 5. The use of TRT in premenopausal women with HSDD is still being studied, and more research is needed to determine its effectiveness and safety in this population.
- However, some studies suggest that TRT may be beneficial for premenopausal women with low circulating testosterone levels and decreased satisfying sexual activity 1.
- The long-term safety of TRT in women is not yet established, and further studies are needed to determine its potential risks and benefits 2.
- In clinical practice, TRT should be used with caution and under close monitoring, with careful consideration of the potential benefits and risks for each individual patient.