NAMS takes stand on testosterone for postmenopausal women

While some research has shown testosterone therapy can improve sexual desire, arousal, and orgasmic response in postmenopausal women, The North American Menopause Society (NAMS), in a recent position statement, advises practitioners to proceed with caution.

They advocate first evaluating other causes of sexual dysfunction, including stress, fatigue, relationship conflict, depression, anxiety, vaginal atrophy, hypothyroidism, and drug use. They also stress that the association between low testosterone and sexual dysfunction is still somewhat tenuous. Hence, the lowest possible dose of testosterone for the shortest period of time should be used to achieve treatment goals. Products designed for men generally should not be used for women unless doses are reduced considerably and blood levels are monitored.

NAMS also reminds clinicians that while patches or topical agents may be preferred to oral preparations, only oral and intramuscular versions are currently government-approved for use in women. Finally, lab testing of testosterone levels should be used only to monitor testosterone levels during therapy and not to diagnose testosterone insufficiency; currently available tests cannot accurately detect the low values typically found in postmenopausal women.