Purpose of review
Testosterone therapy for women, particularly those with natural or surgically induced menopause, albeit controversial, is becoming more widespread. This review presents current data regarding the effects of endogenous androgen and examines recent findings using testosterone therapy in women.
Current evidence indicates that androgens have important biological effects in women, acting directly via androgen receptors in tissues, such as bone, skin fibroblasts, hair follicles and sebaceous glands. They also act indirectly via the aromatization of testosterone to estrogen on various sites, such as the ovaries, bone, brain, heart and adipose tissue. Data from randomized controlled trials suggest that exogenous testosterone therapy improves sexual function, mood, and bone mineral density in women with androgen insufficiency.
Androgen therapy may be necessary for the management of carefully selected women with androgen insufficiency. Women with natural or surgically induced menopause may be candidates for testosterone therapy if they have decreased sexual desire and no other identifiable cause for decreased libido. Data from studies investigating the effects of testosterone therapy in young women with androgen insufficiency are needed. Common adverse effects of testosterone therapy include hirsutism and acne, which reverse with discontinuation of treatment. Long-term trials evaluating safety and effectiveness of testosterone therapy in women are lacking.