Androgens exert important effects on numerous biological events in women, being the obligatory precursors for oestrogen synthesis. Androgens have been used for decades, but when should testosterone therapy be prescribed for women and how should these patients be monitored?
- The main circulating androgenic steroids are dehydroepiandrosterone (DHEA), androstenedione and testosterone.
- DHEA and androstenedione are considered androgen precursors with little androgenic activity.
- Testosterone is a bioactive androgen converted within the peripheral target tissues and cells into dihydrotestosterone.
- The only indication for testosterone therapy supported by evidence is the management of hypoactive sexual desire dysfunction in postmenopausal women.
- During short-term testosterone use in postmenopausal women, no severe adverse events have been demonstrated when testosterone levels achieved are similar to physiological testosterone concentrations for premenopausal women.
- Regulatory approved women’s formulations of testosterone are essential and urgently needed to ensure safety and enable research into long-term use.