Experts Recommended Against Testosterone Therapy for Healthy Women

Testosterone deficiency is difficult to diagnosis in women and therapy may be risky, says Endocrine Society

(RxWiki News) When a woman hits menopause, her hormone levels may change substantially. In some cases, menopausal women may need hormone therapy. Today, the Endocrine Society issued its clinical guidelines for androgen therapy in women.

The organization recommended against diagnosing women with testosterone deficiency and against treating healthy women with testosterone therapy.

Androgens are a group of hormones, including testosterone. They are typically considered male hormones, although women have small amounts of androgens as well.

Some doctors recommend androgen therapy to women going through menopause.

To write the recent guidelines, the Endocrine Society created a task force of researchers and medical professionals from several health organizations. The task force was chaired by Margaret Wierman, MD, of the University of Colorado.

The task force conducted two reviews of previous studies, trials and analyses on testosterone and androgen therapy for women.

The task force members assigned scores to each study or review based on their confidence in the evidence.

The task force noted that women with low testosterone levels often did not exhibit symptoms, which makes diagnosis of androgen deficiency difficult. As a result, they recommended against diagnosing androgen deficiency in women.

They found that there was not enough evidence to recommend testosterone therapy to address infertility, any cognitive, metabolic or bone health issue, or general well-being.

Additionally, they recommended not using DHEA, a type of androgen hormone, because there was not enough evidence to ensure its effectiveness or safety.

The task force also recommended against androgen therapy as a treatment for women with low androgen levels.

"There are too many unanswered questions to justify prescribing testosterone therapy to otherwise healthy women," said Dr. Wierman in a statement.

The task force said that this type of therapy was not proven to be effective and there were no long-term studies of its risk.

Not everyone agrees with these recommendations. According to Dr. Angela DeRosa, "Blanket recommendations have the potential to undermine the clinical judgment of health care professionals and the rights of patients to receive the best available care. Over the span of human history, the practice of medicine has evolved through trial and error and careful observation, and it continues to evolve as we discover new insights into how our bodies work and where things go wrong."

Dr. DeRosa told dailyRx News about the use of hormone therapy in her own experience.

"Over the last 18 years, both as a physician and as a patient, I have personally witnessed countless positive health outcomes resulting from optimizing patient’s hormone levels, including my own," Dr. DeRosa said. "I began experiencing perimenopausal symptoms in my mid-20s, while still in medical school, and reached menopause at 35."

The Endocrine Society suggested that testosterone therapy may be appropriate for women who experience no interest in sex and are distressed about it. In those cases, a three- to six-month therapy course may be helpful, the task force said.

The clinical guidelines were published in the Journal of Clinical Endocrinology and Metabolism on October 3.

Funding was provided by the Endocrine Society. Some of the task force members disclosed financial ties to health organizations and pharmaceutical companies.

Review Date: 
October 3, 2014