A panel of experts representing five medical societies recommends against prescribing androgen therapy to healthy women.
The task force included experts from the Endocrine Society, the American Congress of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, the European Society of Endocrinology, and the International Menopause Society.
The groups’ recommendations update previous clinical guidelines issued in 2006.
The panel conducted two systematic reviews of published data on androgen therapy for women. Other meta-analyses and trials were also examined.
“We continue to recommend against making a diagnosis of androgen deficiency syndrome in healthy women because there is a lack of a well-defined syndrome, and data correlating androgen levels with specific signs or symptoms are unavailable,” they wrote.
Hypoactive sexual desire disorder (HSDD) may be the exception, however. Past research has shown that some women with HSDD do benefit from androgen therapy. A three- to six-month course may be appropriate for some women. However, these patients should be monitored carefully, as adverse effects like acne and hirsutism can develop.
The long-term effects of androgen therapy on breast and cardiovascular health is still unclear, they said.
Some physicians do prescribe testosterone off label for conditions like infertility, non-HSDD sexual dysfunction, cognitive issues, and bone health. But the task force does not recommend this practice.
“Currently, there isn’t enough evidence that any benefits outweigh the risks to most women,” said task force chair Dr. Margaret E. Wierman in an Endocrine Society press release. Dr. Wierman is the society’s Vice President of Clinical Science.
“More research is needed to determine the long-term safety of testosterone therapy in postmenopausal women,” Dr. Wierman added.
The task force recommended against routine use of dehydroepiandrosterone (DHEA), as there has not been enough research on its safety or effectiveness.
Neither testosterone nor DHEA are recommended for women with low androgen levels associated with certain medical conditions, such as hypopituitarism or surgical menopause. Again, research has been limited and the risks of long-term use are unknown.
Details on the guidelines were first published online last month in The Journal of Clinical Endocrinology and Metabolism.
“Experts Recommend against Diagnosing Testosterone Deficiency in Women”
(Press release. October 3, 2014)
The Journal of Clinical Endocrinology and Metabolism
Wierman, Margaret E., et al.
“Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline”
(Abstract. Published online: October 3, 2014)
Medscape Medical News
“Practice Guideline Nixes Testosterone Therapy for Women”
(October 7, 2014)