madman
Super Moderator
Abstract
INTRODUCTION AND OBJECTIVES:
Testosterone replacement therapy (TRT) is an established treatment for hyposexual desire in postmenopausal women, yet the broader effects of TRT on menopausal symptoms remain uncertain. Our research aims to define optimal testosterone levels for symptomatic improvement in postmenopausal women.METHODS:
We retrospectively analyzed symptomatic postmenopausal patients treated at a single menopause clinic in the United Kingdom. Patients who completed a standardized 23-item Menopause Symptom Questionnaire (MSQ) before and after TRT with an available post-TRT serum testosterone level were included. Each MSQ item was rated from 0 (not bothered) to 3 (extremely) bothered, yielding a score of 0-69. A desirable outcome was defined as a post-TRT score < 15, consistent with thresholds used for estrogen benefit. Logistic regression models tested sequential testosterone cutoffs from 30-100 ng/dL in 10 ng/dL increments, adjusting for age, MBI, alcohol use, and smoking. Odds ratios indicated likelihood of achieving desirable MSQ score above vs. below each cutoff. The cutoff with the lowest Akaike Information Criterion value was selected as optimal.RESULTS:
A total of 279 patients with a mean age of 56.4 ± 6.4 were included in the analysis. All patients were on standard estrogen therapy before and during TRT. Serial logistic regression analysis revealed patients who reach a threshold testosterone of 78 ng/dL were significantly more likely to achieve a desirable MSQ outcome (p=0.006) with an odds ratio of 4.0 (95% CI: 1.4-11.7).CONCLUSIONS:
Our findings suggest a target serum testosterone of 78 ng/dL, a level at the upper end of the normal premenopausal range, as an optimal target for women undergoing TRT in conjunction with traditional estrogen therapy. Further research investigating potential safety, adverse effects, and efficacy is needed to support the results of this preliminary study.
