Men suffering from a testosterone deficiency or hypogonadism — symptoms and low levels of testosterone — tend to be prescribed testosterone therapy; however, there is constant debate over whether or not the same therapy should be prescribed to otherwise healthy women with low sexual desire. A Clinical Practice Guideline (CPG) issued by the Endocrine Society on Friday titled "Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline" has suggested that doctors do not use testosterone therapy to treat healthy women.

"Although limited research suggests testosterone therapy in menopausal women may be linked to improved sexual function, there are too many unanswered questions to justify prescribing testosterone therapy to otherwise healthy women," Dr. Margaret E. Wierman, from the University of Colorado in Aurora, Colo., and the Endocrine Society's Vice President of Clinical Science, said in a statement.

Wierman and her colleagues from the Endocrine Society have upgraded their 2006 recommendation following new evidence on testosterone and dehydroepiandrosterone therapy in women in addition to techniques for testing and measuring testosterone levels. This CPG does not recommend prescribing testosterone to treat sexual dysfunction in women. Testosterone therapy used by women has been linked to a wide range of side effects, including changing levels of cholesterol, acne, and excessive hair growth on the face, back, or chest. However, breast cancer and cardiovascular disease risk are still unknown.

Although the CPG advises against prescribing testosterone therapy for otherwise healthy women, the Endocrine Society does state that prescribing it to women diagnosed with Hypoactive Sexual Desire Disorder (HSDD) is acceptable. HSDD is diagnosed in women who develop personal distress due to a lack of interest in sex. When prescribing testosterone therapy for women with HSDD, the Society suggests a three- to six-month trial to gauge how this treatment affects sexual desire.

"When we reviewed past studies, we found many women who had low testosterone levels measured by older or new techniques did not exhibit any signs or symptoms of concern," Wierman said. "As a result, physicians cannot make a diagnosis of androgen deficiency in women. Currently, there isn't enough evidence that any benefits outweigh the risks to most women. More research is needed to determine the long-term safety of testosterone therapy in postmenopausal women."

Androgens — a group of sex hormones that includes testosterone — are often attributed to men, but women also have a small amount of androgens. DHEA is a hormone produced in the body’s adrenal glands that can be converted into testosterone or estradiol, a form of the female sex hormone estrogen. According to the American Cancer Society, DHEA therapy is not a safe and effective way to treat different types of cancer, especially cancers that respond to hormones such as breast, prostate, and uterine cancer.

Source: Arlt W, Basson R, Wierman M, et al. Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology and Metabolism. 2014.