Key messages from scientific research that's ready to be acted on
Got It, Hide thisIslam RM, Bell RJ, Green S, et al. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol. 2019;7:754-66.
Does treatment with testosterone improve sexual function In women? Does it affect body weight or cholesterol levels?
Women sometimes have problems with sexual functioning. Problems can include low levels of desire or arousal, pain when having sex, or difficulty having orgasm. These may be more likely to happen after menopause but can happen for many reasons at any time of life. When these problems don’t go away, keep coming back, or cause distress, they may be considered sexual dysfunction. Women who are worried or upset about changes in their sexual functioning should talk to their doctor. This review looks at whether one treatment, testosterone, can improve symptoms of sexual dysfunction in women.
The researchers did a systematic review of studies available up to December 2018. They found 36 randomized controlled trials that included 8,480 adult women. Most women had gone through menopause, either naturally or because of surgery.
The key features of the studies were:
Compared with placebo or other hormone therapies, testosterone:
In postmenopausal women, testosterone may improve sexual function and desire by a small amount compared with placebo or other hormone therapies. Testosterone can worsen some cholesterol levels when given orally, and it also increases body weight. We need more studies using low doses of testosterone to be confident about its effects. (Testosterone doses currently available in most countries are intended for men and are too high for women.)
Outcomes | Effects of testosterone |
Increased number of satisfying sexual events by about 1 per month (8 trials with 3,238 women) | |
| Small improvement in sexual desire (15 trials with 3,762 women), arousal (11 trials with 3,271 women), orgasm (11 trials with 3,289 women), responsiveness (8 trials with 3,212 women), and sexual distress (7 trials with 2,886 women) |
| Improved scores for pleasure (7 trials with 3,006 women), sexual self-image (7 trials with 2,997 women), and sexual concerns (7 trials with 3,009 women) |
Cholesterol | Increased LDL-C levels (the type of cholesterol that increases risk for heart disease) when given orally (9 trials with 637 women) |
| No effect on LDL-C levels when not given orally (mainly using a patch or cream) (10 trials with 1,768 women) |
Body weight | Increased weight by about 0.5 kg (5 trials with 2,032 women) |
Adverse events | Increased risk for acne (10 trials with 3,264 women) and extra hair growth (11 trials with 4,178 women) but did not increase risk for alopecia (hair loss) (5 trials with 2,459 women), voice changes (5 trials with 2,587 women), enlarged clitoris (3 trials with 1,643 women), or serious adverse events (9 trials with 4,063 women) |