Bioidentical Hormones for Menopausal Therapy

Cynthia K Sites

Disclosures

Women's Health. 2008;4(2):163-171. 

In This Article

Role of Testosterone in Menopausal Therapy

With reduced sexual desire occurring commonly in menopausal women, there has been increasing interest in testosterone as part of hormone therapy for "female androgen insufficiency".[37] Oral testosterone is delivered as methyltestosterone in the USA and as testosterone undecenoate in Europe. Some but not all studies suggest a potential negative effect on serum lipids and triglycerides with oral methyltestosterone in women.[38,39,40] Thus, transdermal routes of delivery of natural testosterone at 150-300 µg/day have been utilized in clinical trials.[41] This dosage appears to have minimal metabolic effects while increasing the number of satisfying sexual experiences per month in menopausal women.[41] There are currently no FDA-approved transdermal testosterone products available for women in the USA, so patients now rely on FDA-approved products for men or on compounded testosterone as part of hormonal therapy. In Europe, a new testosterone patch for women has been licensed for hypoactive sexual desire. The effect of testosterone on menopause symptoms may in part be related to the conversion of testosterone to estradiol or through effects on sex hormone-binding globulin and estrogen bioavailability. Further long-term studies are needed to examine the safety of transdermal testosterone alone or in combination with estradiol.

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