Are the Endocrine Society's Clinical Practice Guidelines on Androgen Therapy in Women Misguided? A Commentary-Response

Abstract

The authors of The Journal of Sexual Medicine article, “Are the Endocrine Society's Clinical Practice Guidelines on Androgen Therapy in Women Misguided? A Commentary” criticize the Endocrine Society Guidelines on Androgen Therapy in Women Taskforce. They misquote the Guideline which recommended “against making the diagnosis of androgen deficiency at present because of the lack of a well defined clinical syndrome and normative data on total or free testosterone levels across the lifespan that can be used to define the disorder:”[1] In the Guideline it is acknowledged that “although there is evidence for short-term efficacy of testosterone in selected populations such as surgically menopausal women, we recommend against the generalized use of testosterone by women because the indications are inadequate and evidence of safety in long-term studies is lacking.” The Guideline further stated that to make future clinical recommendations, the following data would be needed: “(i) defining conditions that, when not treated with androgens, have adverse health consequences to women; (ii) defining clinical and laboratory parameters that distinguish those with these conditions; and (iii) assessing the efficacy and long-term safety of androgen administration on outcomes that are important to women diagnosed with these conditions”[1].