Primary care use of testosterone therapy to benefit women experiencing distress related to decreased sexual desire after surgical menopause

Testosterone is a biologically significant hormone hypothesized to play a role in supporting women’s sexual desire. Women that undergo bilateral oophorectomy experience a marked change in hormonal status including a precipitous decline in testosterone levels. A number of these women experience a corresponding loss of sexual desire which can provoke distress and motivate them to seek sexual health care. Clinical research and guidelines suggest that testosterone therapy may be beneficial in improving sexual desire in these women. However, in Canada there are no licensed testosterone products for women. Consequently, clinicians are required to individually determine how to provide exogenous testosterone therapy. The purpose of this integrative literature review is to provide evidence-informed recommendations, derived from current literature, to inform nurse practitioners practicing in primary care settings how to safely prescribe, monitor and evaluate testosterone therapy. Research and education recommendations are also presented.