Short term safety data is excellent.

Recent research indicates testosterone therapy improves sexual wellbeing in postmenopausal women. But without any long-term safety data or guidelines, should GPs be offering treatment to patients?

In an upcoming Healthed panel discussion, Professor Sue Davis, the director of the Monash University Women’s Health Research Program and the Specialist Women’s Health Clinic at Alfred Health, will cover the irrefutable evidence to date.

“Across all the studies that have been done, about 60% of women have a good response to treatment, with around a four-to-six-week lag from initiating treatment to getting a response,” she says.

“The short-term safety data for two years, including for breast health, is excellent with no evidence of serious adverse events. There was a slight increase in women reporting acne and hair growth.”

Davis cautioned that long-term safety data is still required, particularly for breast cancer.

Low libido causes distress in one in three middle-aged women and 15% of women aged 60 to 80 years.

They are the patients Davis and leading societies in the US and UK had in mind in their recent global consensus statement, which said the evidence supports the use of testosterone therapy for women with hypoactive sexual desire disorder (HSDD).

“I warn patients they are not going to be jumping from the rafters and that the response is subtle,” says Davis. “They become more responsive and positive, and they may get sexual thoughts, but it’s not dramatic,” she says.

“And the point is we don’t want it to be dramatic because we don’t want it to be life changing.”

There is no magic test to diagnose a woman with low libido. Davis advises GPs to first rule out iron deficiency, thyroid disease, kidney disease and abnormal blood glucose levels.

“We always recommend doing a baseline testosterone blood level test and a sex hormone binding globulin test,” she says. “We have shown in one study that women with an extremely high SHBG levels are unlikely to respond to testosterone treatment.”

When screening for HSDD, Davis says a diagnosis can now be made even if the patient is on SSRI or SNRI medication, and that treatment was just as effective for those patients.

Dr John Eden and Dr Rosie King will join Professor Sue Davis for a panel discussion on testosterone for women at Healthed’s 13 September webcast – Register for free here

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