My thoughts on The Times article
I was disappointed to read the recent article in The Times (15 July) titled "Testosterone prescriptions for women soar."
While it raises important points about increased prescriptions, it unfortunately conflates distinct medical issues and presents a potentially misleading picture of testosterone use in women.
The article blurs the lines between testosterone treatment for gender dysphoria and its use for hypoactive sexual desire disorder (HSDD) in menopausal women. These are separate indications with different medical rationales and evidence bases.
There is a substantial body of evidence supporting the use of testosterone for the management of HSDD in menopausal women. A significant number of women enter menopause early due to premature ovarian insufficiency, or iatrogenic damage from chemotherapeutics, radiation, or surgery. The suggestion that the increase in prescriptions in younger age groups is primarily for management of gender dysphoria is misleading and overlooks the legitimate medical needs of many women.
The article raises some valid points about testosterone prescribing for women but fails to address two critical issues.
1. The UK lacks a licensed testosterone product specifically for women, forcing all prescriptions to be off-label.
2. Women are typically prescribed male testosterone formulations at reduced doses, which is fundamentally flawed.
Women are not simply scaled-down versions of men; our hormonal needs and physiology are distinct. The global consensus statement on testosterone therapy for women advocates for formulations that approximate premenopausal physiological concentrations for the management of HSDD. At these doses, serious adverse events are not associated with treatment.
As healthcare professionals, it's our responsibility to advocate for balanced reporting on menopausal health treatments. We must call for nuanced coverage that:
Acknowledges the challenges in prescribing testosterone therapy
Highlights the potential benefits when properly administered
Emphasises the importance of individualised care
Let's encourage media and health organisations to present a comprehensive view, empowering menopausal women with accurate information to make informed decisions about their health.
What are your thoughts on improving public understanding of this important topic?