Experts recommend against diagnosing testosterone deficiency in women

Recommended by Dr. Michael White, Updated on November 21st, 2020



Contact: Jenni Glenn Gingery 202-971-3655 The Endocrine Society @EndoMedia

Washington, DCThe Endocrine Society today issued a Clinical Practice Guideline (CPG) advising against the use of testosterone therapy in healthy women.

The CPG, entitled "Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline," was published online in the Journal of Clinical Endocrinology and Metabolism (JCEM), a publication of the Endocrine Society. The Society updated its 2006 recommendations to address new research concerning testosterone and dehydroepiandrosterone (DHEA) therapy in women as well as advances in testosterone testing and measurement techniques.

Androgens are a group of sex hormones that includes testosterone. DHEA is a prohormone that can be converted into testosterone or estradiol, a form of estrogen. While these are often thought of as male hormones, small amounts of androgens also are found in women.

"Although limited research suggests testosterone therapy in menopausal women may be linked to improved sexual function, there are too many unanswered questions to justify prescribing testosterone therapy to otherwise healthy women," said Margaret E. Wierman, MD, of the University of Colorado in Aurora, CO. She also is the Society's Vice President of Clinical Science and chair of the task force that authored the guideline.

"When we reviewed past studies, we found many women who had low testosterone levels measured by older or new techniques did not exhibit any signs or symptoms of concern," Wierman said. "As a result, physicians cannot make a diagnosis of androgen deficiency in women."

This is different from men, who often display specific symptoms of androgen deficiency. In cases where men have both symptoms and low levels of testosterone, they can be diagnosed with hypogonadism, according to the Society's Clinical Practice Guideline on Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes.

For women, the only situation where the Society suggests prescribing testosterone therapy is if a woman has been diagnosed with Hypoactive Sexual Desire Disorder (HSDD). This condition occurs when a woman has no interest in sex and that lack of interest causes personal distress. In these cases, the CPG suggests a three- to six-month trial of testosterone to see if the therapy improves sexual function.

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Experts recommend against diagnosing testosterone deficiency in women

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