A Systematic Review of Randomized Controlled Trials Investigating the Efficacy and Safety of Testosterone Therapy for Female Sexual Dysfunction in Postmenopausal Women

Channa N. Jayasena; Fatima M. Alkaabi; Curtis S. Liebers; Thomas Handley; Stephen Franks; Waljit S. Dhillo


Clin Endocrinol. 2019;90(3):391-414. 

In This Article

Limitations of Data

Currently, there is limited long-term data evaluating whether testosterone replacement increases the risks of cardiovascular disease, or breast cancer. In view of the controversy regarding the safety of testosterone therapy in older men (albeit when administered at much higher doses),[108] a similarly cautious approach might be appropriate for postmenopausal women with risk factors for cardiovascular disease or breast cancer. It is also important to consider that many of the clinical trials performed to date have been industry funded. It is plausible that reporter bias might have skewed the published literature towards studies supporting the usage of testosterone in postmenopausal women; future, academic-sponsored studies are needed to address this concern. Finally, to fulfil the criteria for HSDD or Female sexual dysfunction, selected study participants were screened to exclude disease comorbidities. It is, therefore, not known whether postmenopausal women with disease comorbidities would also benefit from testosterone therapy. This limits the extent to which published data may reflect everyday clinical practice.