Testosterone for Low Sexual Desire in Premenopausal Women: A randomized, double-blind, placebo-controlled trial: The SYBIL study

Low sexual desire with associated distress is the most common sexual dysfunction in women, with a prevalence in Australian premenopausal women in the order of 8%. Testosterone has been shown to be an effective treatment of low sexual desire with associated personal distress in postmenopausal women. However, while small studies suggest a potential benefit of testosterone for premenopausal women aged 35 to 45 years with low desire, the available data is insufficient to support its use in premenopausal women. Specifically, improvement in sexual desire, arousal and satisfaction with AndroFeme1® 10mg/day, was seen in a double-blind, placebo controlled pilot study of 34 women aged 35 to 45 years. Sexually-related personal distress was not evaluated in this study. In a separate study, another transdermal skin spray preparation improved the frequency of satisfying sexual events in premenopausal women compared with placebo, sexual desire did not improve and associated distress was not evaluated. However, testosterone blood levels in premenopausal women decline by about 25% between the ages of 18 to 39 years and continue to decline with age, but with little, or no change over the menopause transition. Therefore whether testosterone therapy is effective for the treatment of low sexual desire and associated personal distress in premenopausal women aged 35 to 50 years warrants investigation.