Indication

NICE says: consider testosterone supplementation for menopausal women with low sexual desire if HRT alone is not effective.

The BMS says: if HRT with adequate oestrogen intake has not been effective, testosterone supplementation can be considered in menopausal women with low sexual desire.

• A holistic biopsychosocial approach should be undertaken to exclude other causes for low sexual desire.
• Common medication culprits for low sexual desire include use of SSRIs, SNRIs, pyschiatric medications and oral oestrogen.
• Oral oestrogen can reduce libido by increasing SHBG levels. Switching women from an oral to a transdermal oestrogen can improve libido alone.

• RCTs to date have neither been large enough nor long enough to definitively determine the effects of testosterone on cognitive health, mood, energy and musculoskeletal health.
• Further, better designed studies are required to determine this.