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Testosterone Treatment : Psychological and Physical Effects in Postmenopausal Women

INTRODUCTION There is no agreed upon definition of androgen deficiency in women, nor is there a clear-cut parameter, such as free testosterone level, with an accepted limit below which biochemical testosterone deficiency can be diagnosed. However a cluster of symptoms appear to characterize androgen deficiency in women: loss of sexual desire, diminished well-being, lowered mood, loss of energy (or feeling of vitality), decreased assertiveness (often associated with decreased confidence) and, over time, lowered bone mass and reduced muscle strength.1 There is substantial evidence that judicious androgen replacement, usually in the form of testosterone, is effective in improving wellbeing and libido in postmenopausal women, in addition to increasing bone mineral density (BMD). Currently, the availability of products for the treatment of androgen replacement in women is limited, although prescription of androgens to women is widespread and likely to increase; hence the necessity to review the rationale for therapy, suggest guidelines that will help physicians identify the women most likely to benefit, and consider the available options and the risks of therapy.