Testosterone in Women

My thoughts: testosterone is a viable therapeutic option in some women with symptoms suggestive of low androgens, provided they have undergone a comprehensive evaluation looking at many other factors in their health and are already optimizing their diet/lifestyle. Also, testosterone should be evaluated in not just in the context of symptoms but also in looking at optimization of all sex hormones. Careful monitoring for androgenic side effects is advisable with appropriate intervention should they arise. Routine monitoring of serum testosterone levels is not warranted and can be misleading, baseline levels are reasonable to attain but after that symptoms and side effects should guide further management of therapy. Women should be advised of the ‘off-label’ nature of testosterone therapy as well as the risks/benefits. We should not ignore the impact of declining androgen levels in women as they age given their role in deteriorating mental/physical health. The stigma of hormone replacement in women is pervasive and needs to be reversed.