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International consensus on testosterone treatment for women

2 September 2019

The first Global Position Statement on the use of testosterone in the treatment of women, led by the International Menopause Society (IMS), was published in four leading international medical journals today. The statement has been authored by a diverse team of leading experts based around the world and has been endorsed by internationally-esteemed medical societies. Read the press release here.

pdfGlobal Consensus Position Statement on the Use of Testosterone Therapy for Women549.15 KB

The Global Position Statement was developed to inform health care professionals of the known benefits and potential risks of testosterone therapy for women. The aims were to provide clear guidance as to which women might benefit from testosterone therapy; identify symptoms, signs, and conditions for which evidence does not support the prescribing of testosterone; explore areas of uncertainty; and to identify any prescribing practices that have the potential to cause harm.

The panel concluded that:

  1. a testosterone blood level should not be used to diagnose HSDD. HSDD should be diagnosed following a careful medical assessment that elicits lowered sexual desire with associated personal distress and no other treatable cause. Read more here.
  2.  there is only evidence for beneficial effects of testosterone therapy in postmenopausal women, and specifically those suffering with HSDD
  3.  there is insufficient data to support the use of testosterone for the treatment of any other symptom or clinical condition or for disease prevention
  4. testosterone treatment should only be with formulations that achieve blood concentrations of testosterone that approximate what is normal for premenopausal women
  5. although treatment of postmenopausal women with doses that result in blood levels seen in premenopausal women was associated with mild increases in acne and body/facial hair in some women, it was not associated with scalp hair loss or voice change
  6. as no approved testosterone for women is presently approved by any national regulatory body, male formulations can be used judiciously in small doses with blood testosterone concentrations monitored regularly
  7. compounded testosterone should not be used if a regulatory approved product is available
  8. larger studies are needed to inform clinical recommendations regarding the use of testosterone for HSDD in premenopausal women
  9. studies must be undertaken to establish the longer-term cardiometabolic and breast safety of testosterone therapy for women.

The advice was developed by nine leading medical organisations including The International Menopause Society, The International Society for Sexual Medicine, The Federacion Latinoamericana de Sociedades de Climaterio y Menopausia, The American College of Obstetricians and Gynecologists, The North American Menopause Society, The European Menopause and Andropause Society, The International Society for the Study of Women’s Sexual Health, The Royal College of Obstetricians and Gynaecologists, and The Endocrine Society, and endorsed by several additional Societies.

It was published on 2 September 2019 in four leading international medical journals: Climacteric, Maturitas, The Journal of Sexual Medicine, and The Journal of Clinical Endocrinology and Metabolism.

The Global Position Statement is based on the world wide published literature in this field, including a recent systematic review and meta-analysis of clinical trials of testosterone therapy in women published in the Lancet Diabetes and Endocrinology on 25th July 2019, and where data were not available, on expert opinion of international leaders in this field.

There are no clearly established indications for testosterone therapy for women prior to the publication of the consensus statement.

There was no external funding for this process which was entirely supported by grants from the participating societies.

Translated versions of the Global Position Statement are available on the International Menopause Society website: you can also view the statement here.

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