Testosterone Gel

Background

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: 

https://www.rcog.org.uk/for-the-public/menopause-and-later-life/