Fertil Steril. 2007 Jul;88(1):1-17. Epub 2007 May 10.
Safety of testosterone treatment in postmenopausal women.
Braunstein GD.
Department of Medicine, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles,
California 90048, USA. braunstein@cshs.org
OBJECTIVE: To critically examine the safety of T (testosterone) therapy given to postmenopausal women.
DESIGN: MEDLINE literature review, cross-reference of published data, and review of Food and Drug Administration transcripts.
RESULT(S): Although some retrospective and observational studies provide some long-term safety data, most prospective studies
have had a duration of 2 years or less. In addition, with the exception of the female-to-male transsexuals, T was administered in
conjunction with estrogens or estrogens and progestins, which confound the interpretation of some of the studies. The major adverse
reactions are the androgenic side effects of hirsutism and acne. There does not appear to be an increase in cardiovascular risk
factors, with the exception of a lowering of high-density lipoprotein with oral T. There are little data on endometrial safety, and
most of the experimental data support a neutral or beneficial effect in regards to breast cancer. There does not appear to be an
increased risk of hepatotoxicity, neurobehavioral abnormalities, sleep apnea, or fetal virilization (in premenopausal women) with
the physiologic treatment doses of T.
CONCLUSION(S): Except for hirsutism and acne, the therapeutic administration of T in physiologic doses is safe for up to several
years. However, prospectively collected long-term safety studies are needed to provide a greater degree of assurance.
PMID: 17493618 [PubMed - in process]
Dr. Gordon:
The study speaks for itself. After over a half century of testosterone availability (and many thousands of studies)
there is no known (or even speculated) downside to treating postmenopausal women with testosterone.
With current medical policy we'll likely all be long dead and buried before any "long term" studies are done. As a
general rule, if acne or facial hair growth is a problem then the dose of testosterone is too high.
