Safety of testosterone treatment in postmenopausal women.
OBJECTIVE
To critically examine the safety of T therapy given to postmenopausal women.


METHODS
MEDLINE literature review, cross-reference of published data, and review of Food and Drug Administration transcripts.


RESULTS
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.


CONCLUSIONS
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.
Braunstein
Glenn D
GD
Department of Medicine, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California 90048, USA. braunstein@cshs.org
D005260:Female; D006801:Humans; D008297:Male; D017698:Postmenopause / Q000187:drug effects* / Q000502:physiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D013739:Testosterone / Q000009:adverse effects* / Q000627:therapeutic use*
D013739:Testosterone