Testosterone therapy for female sexual dysfunction: a systematic review of the literature demonstrating outcomes in premenopausal and postmenopausal women
Abstract
INTRODUCTION: Testosterone therapy is increasingly used for the treatment of female sexual dysfunction (FSD), particularly hypoactive sexual desire disorder (HSDD). While evidence and guidelines support its use in postmenopausal women, its role in premenopausal populations remains less clear. Clarifying how menopausal status influences treatment response is essential for optimizing individualized care.
OBJECTIVES: To systematically assess the effectiveness of testosterone therapy (TT) for FSD in premenopausal and postmenopausal women, with specific attention to improvements in libido, sexual satisfaction, and related outcomes.
METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched included Scopus (n = 586), PubMed (n = 193), and CINAHL (n = 31), yielding 810 records. After removal of duplicates (n = 243) and screening (n = 567), a total of 33 studies were included. Studies were eligible if they evaluated TT in pre- or postmenopausal cisgender women with FSD and reported relevant sexual function outcomes. Study quality and design were considered in the synthesis, and subgroup analysis by menopausal status was performed.
RESULTS: Among the 33 included studies, two randomized controlled trials (RCTs) involving premenopausal women and 7 RCTs involving postmenopausal women looked at testosterone supplementation. In premenopausal populations, transdermal and vaginal…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 800 participants or records.
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