Re: Androgens in postmenopausal women

Dear Editor, In a valuable review on androgens and postmenopausal women, I was concerned that in the section defining female sexual dysfunction, the authors chose to rely upon the USbased Diagnostic and Statistical Manual of Mental Disorders (DSM–5), and within that manual it includes a controversial diagnosis combining sexual interest and arousal. Within a review article, where in general the reader will be unfamiliar with classifications of the various sexual dysfunctions, an authoritative source of information is paramount. In my opinion, this review should have included prominent reference to the more contemporary World Health Organization (WHO) International Classification of Diseases (ICD)-11 classification. This classification system has removed most sexual (and gender-based) problems and dysfunction out of the mental health classification chapters and into a new chapter (17) – Conditions related to sexual health. The ICD is also the more widely used system within the NHS for clinical coding (albeit still ICD-10). It is unfortunate that such a significant omission is within this otherwise valuable and informative review.