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Global Guidance for Testosterone for HSDD

Global Guidance for Testosterone for HSDD

By Barb DePree, MD, NCMP,MMM

Created: 11/13/2019
Last Updated: 11/13/2019

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Many clinicians have used testosterone to treat hypoactive sexual desire disorder/dysfunction (HSDD) in women, but it has been "off-label," without formal guidance or approval from the U.S. Food and Drug Administration (FDA). Now a new global position statement on testosterone has been endorsed by multiple organizations worldwide, including the International Menopause Society, The International Society for the Study of Women's Sexual Health, and the North American Menopause Society.

The position is the result of "an expansive review" of available evidence and is intended to help clinicians and women determine when testosterone therapy is appropriate.

The panel that wrote the statement concluded that there is evidence-based indication for the use of testosterone for the treatment of HSDD, with the guidance that the resulting level of testosterone in the blood is in the normal range for premenopausal women.

HSDD, also known as hypoactive sexual interest and arousal disorder, is a loss of sexual desire and being unsatisfied with how often you consider or pursue sex (with no medical reason for the lack of sex). Read more about Coaxing Back Desire After Menopause.

The panel concluded that there isn't currently sufficient data to support the use of testosterone to treat any other symptom or condition, including hot flashes, anxiety, interrupted sleep, depression or breast cancer prevention.

We often rely on the FDA, and we should. But occasionally, FDA approval lags behind the data that supports the use of a treatment for a specific condition. This is one of those instances, and I hope this leads to more clinicians suggesting testosterone therapy to women with HSDD, and, as the panel suggests, to the formulation of some testosterone treatments specifically for women.

Barb DePree, MD, has been a gynecologist for 30 years, specializing in menopause care for the past 10. Dr. DePree was named the Certified Menopause Practitioner of the Year in 2013 by the North American Menopause Society. The award particularly recognized the outreach, communication and education she does through MiddlesexMD, a website she founded and where this blog first appeared. She also is director of the Women's Midlife Services at Holland Hospital, Holland, Michigan.

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