Global Guidance for Testosterone for HSDD

Many clinicians have used testosterone to treat hypoactive sexual desire disorder/dysfunction (HSDD) in women, but it has been “off-label,” without formal guidance or FDA approval. Now a new global position statement on testosterone has been endorsed by multiple organizations worldwide, including the International Menopause Society, The International Society for the Study of Women's Sexual Health, and the North American Menopause Society. The position is the result of “an expansive review” of available evidence and is intended to help clinicians and women determine when testosterone therapy is appropriate.

The panel that wrote the statement concluded that there is evidence-based indication for the use of testosterone for the treatment of HSDD, with the guidance that the resulting level of testosterone in the blood is in the normal range for premenopausal women. The panel concluded that there isn’t currently sufficient data to support its use to treat any other symptom or condition, including hot flashes, anxiety, interrupted sleep, depression, or breast cancer prevention.

We often rely on the FDA, and we should. But occasionally, FDA approval lags behind the data that supports the use of a treatment for a specific condition. This is one of those instances, and I hope this leads to more clinicians suggesting testosterone therapy to women with HSDD, and, as the panel suggests, to the formulation of some testosterone treatments specifically for women.