As supplementation for menopausal women with low sexual desire if HRT alone is not effective.
CCG (HRG included)
As supplementation for postmenopausal women with low sexual desire if HRT alone is not effective.
• The diagnosis of HSDD must involve a full clinical assessment and other factors contributing to female sexual arousal disorder (FSD) must be identified and addressed before testosterone therapy is initiated.
• Women must be counselled on the absence of long term safety data for the use of testosterone in women.
• Women must be counselled on the unlicensed nature of the testosterone products available and the implications of this.
• Tostran should be considered before other preparations as the dose is measurable. We recommend a dose not exceeding one full depression of the canister piston (10 mg testosterone) on alternate days.
• Patients should be monitored for their clinical response to treatment and assessed for signs of androgen excess with a serum total testosterone level every 6 months, to screen for overuse. If no benefit is experienced by 6 months, treatment should be ceased.
• In the absence of long-term safety data, women with a history of breast cancer or with a known high risk of breast cancer should not be prescribed testosterone.
• In the absence of long-term safety data, women with cardiovascular disease and/or uncontrolled hypertension should not be prescribed testosterone.
• In patients receiving long-term androgen therapy, the following laboratory parameters should also be monitored regularly: haemoglobin, and haematocrit (to detect polycythaemia), liver function tests, and lipid profile.
• Improved insulin sensitivity may be observed in patients treated with androgens and may require a decrease in the dose of antidiabetic medications.
Further patient information is available via the RCOG menopause hub:
Amber level 1
Reason for decision:
Shared care required