Testosterone Modestly Improves Sexual Desire in Postmenopausal Women With HSDD

Low sexual desire that causes personal distress — clinically termed hypoactive sexual desire disorder (HSDD) — is one of the most common sexual health complaints among postmenopausal women, yet treatment options remain limited and often misunderstood. This narrative review from Mayo Clinic addresses a critical gap in clinical practice by synthesizing current evidence on testosterone therapy for HSDD in peri- and postmenopausal women.

The review examines research on testosterone's role in female sexual function, noting that while there is no formally recognized androgen deficiency syndrome in women, declining testosterone levels across the menopause transition correlate with reduced sexual desire in some individuals. Studies included in the review demonstrate that testosterone treatment can produce modest but meaningful improvements in sexual desire and satisfaction among appropriately selected postmenopausal women.

Importantly, the evidence does not support broader claims sometimes made for testosterone in women. The review found no convincing data that testosterone improves bone density, cognitive function, energy levels, or brain health in this population. Evidence for benefit in women of late reproductive age also remains sparse, suggesting the therapy's applicability is currently narrower than sometimes promoted.

A key practical challenge is that no FDA-approved testosterone product for women exists in the United States, largely due to the absence of long-term safety data. Despite this, two clinical guidelines now offer structured guidance on dosing, patient selection, and monitoring for off-label use. The author summarizes these guidelines to make the information actionable for frontline clinicians.

The review underscores both the promise and the boundaries of testosterone therapy for women's sexual health, providing a clinically grounded framework for shared decision-making with patients seeking this treatment.