Practice Guideline: When Is Androgen Therapy Indicated for Women?

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Practice Guideline: When Is Androgen Therapy Indicated for Women?

An evidence-based guideline from the Endocrine Society urges restraint.

Numerous articles in the lay press, as well as in the scientific literature, have extolled the virtues of androgen therapy and its ability to increase libido in women. The Endocrine Society has now weighed in with an evidence-based practice guideline urging restraint in the use of androgens in women.

Key recommendations include:

A diagnosis of androgen deficiency should not be made in any women at this time, because there is neither a well-defined clinical syndrome nor normative data on testosterone or free testosterone levels across the lifespan of women.
Although evidence exists that short-term administration of testosterone increases libido in selected women, particularly those having undergone bilateral oophorectomy, the generalized use of testosterone by women should be discouraged, because indications are inadequate and no evidence of long-term safety is available.
Sensitive and specific assays for total and free testosterone in women are needed before this field can advance.
Considerable research is required to define the syndrome of androgen deficiency and to identify the benefits and risks of androgen therapy in women.

The guideline summarizes the literature for each of these areas and suggests that we have yet to define conditions that, if not treated with androgens, have adverse health consequences for women.

— Robert W. Rebar, MD

Published in Journal Watch General Medicine November 7, 2006