IMR Press / CEOG / Volume 50 / Issue 8 / DOI: 10.31083/j.ceog5008159
Open Access Review
What is the Role of Testosterone Therapy in Postmenopausal Women? A SWOT Analysis
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1 Women’s Health Center, American Hospital, 34365 Istanbul, Turkey
2 Turkish Menopause and Osteoporosis Society, 34098 Istanbul, Turkey
3 Department of Obstetrics and Gynecology, Mamak State Hospital, 06270 Ankara, Turkey
4 Department of Obstetrics and Gynecology, Istanbul University Cerrahpasa School of Medicine, 34098 Istanbul, Turkey
*Correspondence: fatihaktoz@gmail.com (Fatih Aktoz)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2023, 50(8), 159; https://doi.org/10.31083/j.ceog5008159
Submitted: 17 March 2023 | Revised: 13 April 2023 | Accepted: 17 April 2023 | Published: 2 August 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objective: The objective of this review is to examine the current state of evidence on postmenopausal testosterone use in women and explore its potential benefits and risks using the SWOT analysis method which is an evaluation system that allows reviewing any issue under the headings of strengths, weaknesses, opportunities and threats. Mechanism: Testosterone plays a role in female sexual physiology through its effects on the brain and peripheral tissues. At the central level, it stimulates regions of sexual function and interacts with specific receptors in the brain to regulate sexual desire, arousal, and satisfaction. At the peripheral level, testosterone affects various tissues and organs that are involved in sexual function, including the vagina, clitoris, and labia. Testosterone interacts with the androgen receptor in cells and triggers various physiological responses depending on the tissue. It stimulates sperm production in the testes, promotes bone growth and maintenance, and increases muscle mass and strength through protein synthesis. Testosterone also has a beneficial effect on bone density and the cardiovascular system, reducing the risk of heart disease and stroke. It influences cognitive functions such as memory, processing speed, and executive function through androgen receptor-regulated regions of the brain. Findings in Brief: Postmenopausal testosterone therapy may improve sexual function, muscle mass, and reduce the risk of osteoporosis. However, its long-term safety and effectiveness are still under debate. Testosterone therapy can be effective in treating certain symptoms in postmenopausal women, but it may also increase the risk of cardiovascular events and endometrial cancer, and can lead to adverse symptoms such as acne and hirsutism. Careful monitoring and regular hormone level checks are necessary to ensure safe and effective use. It’s important to consider the potential risks and benefits when deciding whether testosterone therapy is appropriate for a postmenopausal woman. Conclusions: Testosterone therapy in postmenopausal women may be a valuable treatment option for selected women. However, more research is needed to better understand the long-term effects of its use. Further research may also help to determine optimal dosing and route of administration, as well as specific testosterone preparations for women.

Keywords
postmenopausal women
testosterone therapy
SWOT analysis
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