Testosterone Replacement Therapy in Perimenopausal Women

Evidence on TRT in Perimenopausal Women

• The U.S. Preventive Services Task Force recommends against routine use of hormone therapy, including testosterone combinations, for the primary prevention of chronic conditions in perimenopausal women 1, 2, 3

Current Recommendations and Guidelines

• Hormone therapy of any kind is not recommended for the prevention of chronic conditions such as cardiovascular disease, osteoporosis, or dementia 4, 5
• For management of menopausal symptoms, guidelines recommend FDA-approved formulations with evidence-based approaches rather than testosterone therapy 6

Algorithm for Managing Perimenopausal Symptoms

• Assess menopausal status and symptom severity, and consider FDA-approved hormone therapy options rather than testosterone for vasomotor symptoms or genitourinary symptoms 6
• For women with an intact uterus requiring hormone therapy, use estrogen plus progestin rather than estrogen plus androgen combinations 5
• Use the lowest effective dose for the shortest possible time if hormone therapy is necessary 6

Common Pitfalls to Avoid

• Initiating testosterone therapy solely for prevention of chronic conditions like osteoporosis or cardiovascular disease 5
• Failing to discuss both potential benefits and risks of testosterone therapy with patients 6