July 25, 2019

expert reaction to study looking at testosterone and sexual function and sexual wellbeing in postmenopausal women

A study, published in The Lancet Diabetes & Endocrinology, reports that testosterone may significantly improve sexual function and sexual wellbeing in postmenopausal women.

Prof Richard Anderson, Elsie Inglis Professor of Clinical Reproductive Sciences and Head of Section of Obstetrics and Gynaecology, MRC Centre for Reproductive Health, University of Edinburgh, said:

“The role of testosterone treatment for sexuality problems in postmenopausal women has been controversial for years.  The analysis by Prof Davis and colleagues provides good quality evidence that the real problems some postmenopausal women have in this regard can be improved by testosterone treatment.  There is now a real need to have a suitable preparation that can be prescribed to help this group of women, rather than trying to use a product that is designed for the much higher doses that are needed by men.”

Dr Channa Jayasena, member of the Society for Endocrinology, and Clinical Senior Lecturer at Imperial College London, said:

“‘Traditional’ hormone replacement therapy (HRT) containing oestrogen has well-known benefits for improving sexual function in menopausal women.  However, women also make small amounts of testosterone, which has a less clear role in female sexual function.  There is a lot of debate among doctors whether adding testosterone to HRT helps patients feel better and is safe.

“This is an important piece of work comprehensively reviewing all the clinical trials to date,  which agrees with a similar review we recently published.  The results suggest that in women with problems with sexual function, adding testosterone to traditional HRT may have benefit.  Testosterone was not without side effects: acne and slightly increased facial hair were common complaints.  The message is that oestrogen-containing HRT should still be the treatment of choice for almost all menopausal women.  However, testosterone could be added to HRT when menopausal women have sexual symptoms which are persistent.”

‘Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data’ by Rakibul M Islam et al. was published in The Lancet Diabetes & Endocrinology at 23:30 UK time on Thursday 25 July 2019. 

DOI: http://dx.doi.org/10.1016/S2213-8587(19)30189-5

Declared interests

Prof Richard Anderson: “I don’t have any conflicts.”

Dr Channa Jayasena: “Has published a systematic review on the same topic.”