title: Clinical review: The benefits and harms of systemic testosterone therapy in postmenopausal women with normal adrenal function: a systematic review and meta-analysis.
abstract: BACKGROUND
  The use of T has been suggested to improve women's health during the postmenopausal period.
  
  
  OBJECTIVE
  We conducted a systematic review and meta-analysis of randomized trials to summarize the best available evidence regarding the benefits and harms of systemic T in postmenopausal women with normal adrenal function.
  
  
  METHODS
  A comprehensive search of MEDLINE, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, EBSCO CINAHL, and Scopus was conducted through January 2014. We conducted study selection, data extraction, and appraisal in duplicate. Random-effects meta-analysis was used to pool results.
  
  
  RESULTS
  We identified 35 randomized trials (n = 5053) at a moderate risk of bias. T use was associated with statistically significant improvement in various domains of sexual function and personal distress in postmenopausal women, although the majority of the trials did not have specific or contemporary diagnostic criteria for androgen deficiency in women. T use was also associated with a reduction in total cholesterol, triglyceride, and high-density lipoprotein and an increase in low-density lipoprotein and in the incidence of acne and hirsutism. No significant effect was noted on anthropometric measures and bone density. Long-term safety data were sparse, and the quality of such evidence was low.
  
  
  CONCLUSIONS
  Despite the improvement in sexual function associated with T use in postmenopausal women, long-term safety data are lacking.
authors.affiliation: Knowledge and Evaluation Research Unit (T.E., M.B.S., Z.W., T.K., N.A., C.U., M.N., B.F., O.A., V.M.M., M.H.M.), and Center for the Science of Healthcare Delivery (T.E., Z.W., N.A., M.H.M.), Mayo Clinic, Rochester, Minnesota 55905; Internal Medicine Department (M.B.S.), Georgia Regents University, Augusta, Georgia 30901; and Mayo Clinic Libraries (L.P.), Division of Endocrinology, Diabetes, Metabolism and Nutrition (V.M.M.), and Division of Preventive, Occupational, and Aerospace Medicine (M.H.M.), Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: Tarig
authors.initials: T
authors.lastname: Elraiyah
authors.forename: Mohamad Bassam
authors.initials: MB
authors.lastname: Sonbol
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Tagwa
authors.initials: T
authors.lastname: Khairalseed
authors.forename: Noor
authors.initials: N
authors.lastname: Asi
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Undavalli
authors.forename: Mohammad
authors.initials: M
authors.lastname: Nabhan
authors.forename: Belal
authors.initials: B
authors.lastname: Firwana
authors.forename: Osama
authors.initials: O
authors.lastname: Altayar
authors.forename: Larry
authors.initials: L
authors.lastname: Prokop
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Murad
mesh_terms: D000311:Adrenal Glands / Q000187:drug effects* / Q000502:physiology; D000375:Aging / Q000187:drug effects* / Q000502:physiology; D000728:Androgens / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects* / Q000502:physiology; D016032:Randomized Controlled Trials as Topic; D019529:Sexuality / Q000187:drug effects* / Q000502:physiology; D013739:Testosterone / Q000008:administration & dosage*
chemical_list: D000728:Androgens; D013739:Testosterone