Androgens and female libido

Background: Hypoactive sexual desire disorder (HSDD) in women is a common complaint—and the demand for androgen substitution in affected women is frequent. Objectives: To clarify the correlation between peripheral androgen concentration and female sexuality. To review the knowledge about androgen substitution for the treatment of HSDD in women. Materials and methods: Narrative review of the literature selected after a nonsystematic, but comprehensive Medline literature search (keywords: androgens, pre-androgens, testosterone, hormone substitution AND female sexual desire, hypoactive sexual desire disorder, female sexuality) between 2006 and 2017, including the reference lists of selected articles. Results: Androgens show a clear, but weak correlation with female sexual desire, whereby measurement of peripheral androgen concentrations is often not very helpful for diagnosis and therapy of HSDD. Although transdermal testosterone therapy is efficient in some women, approved testosterone medication for women is generally unavailable—and data about long-term side effects is sparse. Conclusion: We recommend to respect the multifaceted nature of sexuality in order to consider biological, psychoemotional and sociocultural aspects in diagnosis and therapy of affected women. © 2017, Springer Medizin Verlag GmbH.