There is more to female sexual function than circulating testosterone, and symptomatic women require a thorough clinical evaluation
The 2019 global consensus position statement on the use of testosterone therapy for women1 aims to provide guidance for clinicians managing women with female sexual dysfunction. The recommendations, graded according to levels of evidence, have been developed by an international taskforce with representatives from a range of organisations and societies, headed by Australian endocrinologist Professor Susan Davis, the current President of the International Menopause Society. The position statement bases many of its recommendations on a systematic review and meta‐analysis of randomised controlled trials.2
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1. Davis SR, Baber R, Panay N, et al. Global consensus position statement on the use of testosterone therapy for women. J Clin Endocrinol Metab 2019; 104: 4660–4666.
- 2. Islam RM, Bell RJ, Green S, et al. Safety and efficacy of testosterone for women: a systematic review and meta‐analysis of randomised controlled trial data. Lancet Diabetes Endocrinol 2019; 10: P754–P766.
- 3. Popat VB, Calis KA, Kalantaridou SN, et al. Bone mineral density in young women with primary ovarian insufficiency: results of a three‐year randomized controlled trial of physiological transdermal estradiol and testosterone replacement. J Clin Endocrinol Metab 2014; 99: 3418–3426.
- 4. Barton DL, Wender DB, Sloan JA, et al. Randomized controlled trial to evaluate transdermal testosterone in female cancer survivors with decreased libido; North Central Cancer Treatment Group protocol N02C3. J Natl Cancer Inst 2007; 99: 672–679.
- 5. Goldstein I, Kim NN, Clayton AH, et al. Hypoactive sexual desire disorder: International Society for the Study of Women's Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clin Proc 2017; 92: 114–128.
- 6. Simon JA, Davis SR, Althof SE, et al. Sexual well‐being after menopause: an International Menopause Society White Paper. Climacteric 2018; 21: 415–427.
- 7. Parish SJ, Meston CM, Althof SE, et al. Toward a more evidence‐based nosology and nomenclature for female sexual dysfunctions ‐ Part III. J Sex Med 2019; 16: 452–462.
- 8. Davison SL, Bell R, Donath S, et al. Androgen levels in adult females: changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab 2005; 90: 3847–3853.
- 9. Davis SR, Davison SL, Donath S, et al. Circulating androgen levels and self‐reported sexual function in women. JAMA 2005; 294: 91–96.
- 10. Kanakis GA, Tsametis CP, Goulis DG. Measuring testosterone in women and men. Maturitas 2019; 125: 41–44.
- 11. Cappelletti M, Wallen K. Increasing women's sexual desire: the comparative effectiveness of estrogens and androgens. Horm Behav 2016; 78: 178–193.
- 12. de Villiers TJ, Hall JE, Pinkerton JV, et al. Revised global consensus statement on menopausal hormone therapy. Climacteric 2016; 19: 313–315.
- 13. Santoro N, Worsley R, Miller KK, et al. Role of estrogens and estrogen‐like compounds in female sexual function and dysfunction. J Sex Med 2016; 13: 305–316.
- 14. Worsley R, Bell RJ, Gartoulla P, et al. Prevalence and predictors of low sexual desire, sexually related personal distress, and hypoactive sexual desire dysfunction in a community‐based sample of midlife women. J Sex Med 2017; 14: 675–686.
- 15. Zeleke BM, Bell RJ, Billah B, et al. Hypoactive sexual desire dysfunction in community‐dwelling older women. Menopause 2017; 24: 391–399.
- 16. Johansen N, Linden Hirschberg A, Haase Moen M. The role of testosterone in menopausal hormone treatment. What is the evidence? Acta Obstet Gynecol Scand 2020; 99: 966–969.
- 17. Fooladi E, Reuter SE, Bell RJ, et al. Pharmacokinetics of a transdermal testosterone cream in healthy postmenopausal women. Menopause 2015; 22: 44–49.
- 18. El‐Hage G, Eden JA, Manga RZ. A double‐blind, randomized, placebo‐controlled trial of the effect of testosterone cream on the sexual motivation of menopausal hysterectomized women with hypoactive sexual desire disorder. Climacteric 2007; 10: 335–343.
- 19. Goldstat R, Briganti E, Tran J, et al. Transdermal testosterone therapy improves well‐being, mood, and sexual function in premenopausal women. Menopause 2003; 10: 390–398.
- 20. Jane FM, Davis SR. A practitioner's toolkit for managing the menopause. Climacteric 2014; 17: 564–579.
This article has been reviewed and endorsed by the Endocrine Society of Australia, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and the Australasian Menopause Society.
No relevant disclosures.