Across the world, testosterone therapy for women is still prescribed in the absence of a well-established indication.
In recent decades, in order to reduce the severity of various symptoms, clinicians have suggested to patients the use of testosterone, despite the uncertainty of the benefits and risks of this treatment.
In fact, testosterone is prescribed off label and women are either on dose-adjusted male medications or receiving combination treatment.
Find out in the article on estet-portal.com about the features of prescribing testosterone for women before - and postmenopausal period.
- Features of prescribing testosterone for women
- Mechanisms of action of testosterone hormone therapy
- Side effects of testosterone therapy in womenn
Peculiarities of prescribing testosterone for women
There is a compelling argument − create a global consensus statement based on evidence-based and educate healthcare professionals about the known benefits and possible risks of testosterone hormone therapy for women.
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It is also necessary to identify the symptoms, signs and conditions under which prescribing testosterone for women is warranted, explore the margins of uncertainty, and identify any potentially harmful practices.
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Testosterone options:
- directly through the androgen receptor − non-genomic androgenic mechanism;
- by reduction to active dihydrotestosterone and/or aromatization to estradiol and its metabolitec.
Mechanisms of action of testosterone hormone therapy
Testosterone therapy in doses close to physiological (during the intermenopausal period) has a beneficial effect on sexual function in women and increases sexual desire.
The data obtained in the studies confirm that there is no effect on bone mineral density of the spine, hip in general and the femoral neck in particular over a 12-month observation period (level IIA) testosterone has no effect.
The only evidence-based reason for prescribing testosterone therapy in postmenopausal women is the diagnosis of HSDD − hypoactive sexual desire disorder / dysfunction − decreased/dysfunction of sexual desire in women.
The level of total testosterone in serum can be determined with a high degree of accuracy and reproducibility (level B) using:
- liquid/gas chromatography;
- tandem mass spectrometric analysis.
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In order to exclude the possibility of high initial or above physiological serum testosterone concentrations during treatment, in clinical practice direct immunological tests may be appropriate if both liquid / gas chromatography and tandem methods are not available mass spectrometric analysis.
Current studies on the clinical effects of testosterone in women should focus on measuring total testosterone as a primary biomarker rather than "free" testosterone. serum testosteronei.
No anabolic effect of testosterone was observed in women, in particular, no statistically significant effect of testosterone at physiological doses on total fat, muscle strength and muscle mass.
Side effects of testosterone therapy in women
Recommendations regarding possible androgenic side effects of testosterone therapy in women:
- Systemic testosterone therapy at physiological doses in selected postmenopausal women is associated with acne, slight increase in body and facial hair, but is not associated with alopecia or changes votes (level IIA).
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- Oral testosterone therapy is associated with an unfavorable lipid profile and negative effects on cholesterol, LDL and HDL levels and cannot be recommended in cardiovascular disease (level IIA).
Importantly, non-oral (transdermal, injectable) testosterone therapy at physiological doses in premenopausal women has no statistically significant side effects on the lipid profile in the short term.
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Regular monitoringof patients' response to treatment for signs of androgen excess, measurement of total serum testosterone every 6 months to prevent prescribing excessive hormonal therapy.
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