A Personal Prospective on Testosterone Therapy in Women—What We Know in 2022

Abstract

Hormone replacement therapy continues to be a controversial topic in medicine, with certain narratives regarding safety concerns that are not scientifically established in peer-reviewed literature. These negative narratives, specifically undermining the use of testosterone in women, have caused women to remain without any Food and Drug Administration (FDA)-approved testosterone therapies, while more than 30 FDA-approved testosterone therapies are available for men in the United States. This has resulted in millions of women suffering in silence with very common symptoms of perimenopause and menopause that could easily be addressed with the use of testosterone. There is growing evidence to support the use of physiologic doses of testosterone for sexual function, osteoporosis prevention, brain protection, and breast protection. The safety of testosterone use in women has been evaluated for the past 80 years. A recent publication on the complications of subcutaneous hormone-pellet therapy, looking at a large cohort of patients over 7 years, demonstrated long-term safety. In addition, there have been two large long-term peer-reviewed studies showing a significant reduction in the incidence of invasive breast cancer in women on testosterone therapy. Perhaps it is time for the FDA to consider approving products that would benefit testosterone-deficient women.

Uma avaliação sistemática do uso de implantes hormonais: suas indicações e efeitos

“…Ademais, o início do climatério pode cursar juntamente com a disfunção de Desejo Sexual Hipoativo (DSH), que afeta por volta de uma a cada dez mulheres na atualidade, caracterizado também pelo sofrimento referente à perda ou redução do interesse sexual feminino. Em contrapartida, pesquisas retratam melhora da sintomatologia a partir da suplementação hormonal, a qual mostrou que a administração subcutânea é ainda mais eficaz na manutenção de perfis lipídicos dentro da normalidade (Donovitz, 2022).…”

Association Between Sex Hormones Levels and Cancer Prevalence in Women, Especially Breast Cancer

“…Studies have shown that free testosterone levels in women are closely associated with ovarian function and metabolic disorders in women [51] . The current clinical use of testosterone in the treatment of invasive breast cancer in women has also achieved good e cacy [52] . Testosterone levels in women have also shown signi cant correlations with depression, cognitive function, and cardiovascular system diseases in women [53][54][55] .…”

The Role of Testosterone in Hypoactive Sexual Desire in Postmenopausal Women – An Intergrative Review

“…Hormone pellet implants function by forming a capillary network around them, allowing hormone absorption to be dependent on cardiac output (36). There are only two studies, reviewed by Parish et al in 2021, that investigate the use of testosterone implants in treating sexual dysfunction (9).…”

“…Given the absence of standardized methods for measuring testosterone levels in the bloodstream, involves adopting an individualized dosing algorithm. This strategy focuses on tailoring the dosage to reduce clinical symptoms specific to the patient while ensuring that serum levels are maintained at a threshold low enough to minimize any potential androgenic side effects (36).…”

“…Testosterone preparations designed for men are generally not recommended for women due to the high risk of adverse effects (16,36). When administering testosterone therapy to women, it's essential to monitor serum testosterone levels closely to avoid overdosing.…”