From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Testosterone supplementation is generally contraindicated in a 28-year-old female with a partial empty sella and elevated estrogen level of 513 pg/mL. A partial empty sella refers to a condition where the pituitary gland appears partially flattened within the sella turcica (the bony structure that houses the pituitary) on imaging studies. This finding is often incidental but can sometimes indicate previous pituitary inflammation, hemorrhage, or idiopathic intracranial hypertension. The elevated estrogen level suggests normal or even excessive ovarian function, which would make testosterone supplementation inappropriate and potentially harmful.
Key Considerations
- Testosterone therapy in women with normal estrogen levels can lead to virilization (development of male secondary sexual characteristics), menstrual irregularities, acne, and potential cardiovascular risks.
- Adding testosterone could further disrupt the already imbalanced hormonal environment.
- The partial empty sella should be evaluated by an endocrinologist to determine if there are any pituitary hormone deficiencies or excesses that require treatment, as suggested by 1.
- The high estrogen level itself may need investigation to rule out conditions like polycystic ovary syndrome, estrogen-producing tumors, or medication effects.
Management Approach
- Management should focus on identifying and addressing the underlying cause of the hormonal imbalance rather than adding testosterone.
- According to 1, hormonal pituitary evaluation should be assessed at the moment of the diagnosis, along with a careful imaging using MRI.
- If no alterations are detected, it is suggested to have a careful revaluation at 24-36 months, in relation to the low risk of progression to empty sella syndrome.
Conclusion Not Required
Instead, the focus is on the direct management and consideration of the patient's condition based on the most recent and highest quality evidence available, such as the study published in 2024 1.