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Androgen therapy in women, beyond libido

Abstract Objective The aim of this review was to summarize the literature regarding the potential role of testosterone therapy for women. Methods The author conducted a search of the literature using Medline (Ovid, 1946–present) and PubMed (1966–2013) for English-language studies that included the following search terms: ‘testosterone’ or ‘androgen’ combined with ‘women’, ‘therapy’ or ‘treatment’. Results Randomized, placebo-controlled trials have consistently shown that transdermal testosterone therapy improves sexual desire, arousal, orgasm frequency and satisfaction in premenopausal and postmenopausal women presenting with sexual desire/arousal problems. No adverse metabolic effects have been observed in these studies. In postmenopausal women, testosterone therapy has also been associated with favorable effects on body composition, bone, cardiovascular function and cognitive performance. Conclusions Although androgens have many varied roles, the focus of testosterone therapy for women has been on improving sexual desire. Not only do testosterone effects on sexuality extend beyond libido, but testosterone has other key physiological actions. Issues that urgently need to be addressed include approval of a testosterone formulation that delivers a female dose such that physicians refrain from prescribing compounded testosterone or modifying doses of testosterone formulated for men and regulation of prescription of compounded androgens for women.