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Testosterone in Women: Clinical Evidence and Practice Guidelines

Lanoff J, Simon JA

Obstetrics and gynecology clinics of North America, 2026

Abstract

Testosterone therapy may benefit postmenopausal women beyond treating low sexual desire and shows cardiovascular safety with potential protective effects. While improvement in sexual desire remains the only guideline-supported indication, expanding research has prompted investigation into testosterone's broader physiologic effects. Evidence supports cardiovascular safety with potential protective vascular effects as well as improvements in sexual function, genitourinary health, lubrication, and tissue integrity. Long-term safety data remain limited, though serious adverse events appear uncommon when testosterone levels are maintained within normal female ranges. These emerging applications should be viewed as hypothesis-generating and do not yet support guideline-level changes to clinical practice.

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