International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women

Abstract

Background:The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD.

The Roles of Androgens in Humans: Biology, Metabolic Regulation and Health

“…There is a constant evolution, reflected in the short-time between actualizations of these statements [ 481 , 646 , 647 , 648 , 649 ]; but the use of TRT for aging (and/or MS-derived hypogonadism) keeps growing [ 650 ]. The focus is now shifting to the discussed and controversial use of TRT in women [ 651 , 652 , 653 ], which may be related to the deeply ingrained (and scientifically unjustifiable) notion that sex hormones fully imply an “absolute” link to gender: androgen for males and estrogen for females, with no space in between. This unproved belief has been a pillar of “sex hormone medical knowledge”, and remains true up to the present for generations of physicians, scientists and social leaders and activists.…”

Clinical management of hypoactive sexual desire disorder in postmenopausal women

“…ISSWSH has published a clinical practice guideline, informed by a Global Consensus Position Statement 9 developed by 11 international medical societies, including The North American Menopause Society, on the use of testosterone therapy in women that supports the use of systemic transdermal testosterone therapy for postmenopausal and late-reproductive-aged women with HSDD 10 . Recommended formulations are approved transdermal products for men using approximately one-tenth of the dose for men, with the targeted goal of the physiologic premenopause range.…”

Dehydroepiandrosterone exacerbates nigericin-induced abnormal autophagy and pyroptosis via GPER activation in LPS-primed macrophages

“…Dehydroepiandrosterone (DHEA, 3β-hydroxy-5-androstene-17-one) is an important cholesterol-derived intermediate that function both as the major steroid hormone with systemic endocrine function in humans, and as a food supplement or drug approved by FDA [ 15 – 18 ]. Our and other researchers found that DHEA has anti-inflammation and anti-oxidant activities in several mouse inflammatory model [ 19 – 21 ], which implied that it can be used as a potential anti-inflammatory supplemental agent.…”