Safety of testosterone therapy indicated for hypoactive sexual desire disorder in postmenopausal women

SummaryHypoactive sexual desire disorder (HSDD) is a common sexual disorder in postmenopausal women. Testosterone therapy is a possible option for treatment of HSDD in postmenopausal women, although there are concerns over the safety of testosterone use. Clinical trial data have been limited so far, although more trial results are awaited. Additionally, there is a lack of larger long-term observational studies which have addressed this issue, identifying research gaps in this topic. Androgenic disorders, such as hirsutism, are established adverse effects of testosterone use in women. However, the relationship between breast cancer, endometrial cancer, ovarian cancer and cardiovascular events with testosterone therapy is unclear in postmenopausal women, given the available evidence. As such, any preexisting risk factors for these events may be considered in patients treated with testosterone, along with the acceptability of potential androgenic adverse effects that the patient may experience. Overall, there is still a lack of clarity on the safety of using testosterone therapy for HSDD in postmenopausal women and data from further studies are needed to draw a firm conclusion.