Effect of transdermal testosterone therapy on mood and cognitive symptoms in peri- and postmenopausal women: a pilot study

PurposeThe purpose of this study was to assess the impact of testosterone therapy on mood and cognitive symptoms in perimenopausal and postmenopausal women.MethodsA retrospective cohort study undertaken in a UK specialist menopause clinic. 510 women using hormone replacement therapy (HRT) with persistent low libido, cognitive and negative mood symptoms were treated with testosterone cream or gel for 4 months. A modified version of the Greene Climacteric Scale was used to measure self-reported symptom frequency and severity at baseline and 4 months after initiating treatment.ResultsAll nine cognitive and mood symptoms significantly improved across the study period. Mood improved more than cognition (47% of women reported an improvement in mood vs. 39% reported an improvement in cognition; 34% vs. 22% decrease in mean symptom scores, respectively). Regarding libido, 52% of women reported an improvement; mean symptom score decreased by 33%.ConclusionTransdermal testosterone therapy for 4 months was associated with significant improvements in mood and cognition. Further research including randomised clinical trials are needed to establish the long-term efficacy and safety of testosterone for the treatment of menopausal cognitive and psychological symptoms. The findings of this pilot study suggest that transdermal testosterone therapy has a beneficial effect on cognitive and mood-related symptoms in peri- and postmenopausal women. Mood improved more than cognition, suggesting that testosterone may have differential effects on neuropsychiatric symptoms and highlighting the need for further research to determine which women are most likely to benefit from testosterone therapy.Mood and libido improved to a similar degree, suggesting that testosterone may have benefits beyond the treatment of Hypoactive Sexual Desire Disorder in postmenopausal women, the only indication for which testosterone is currently licensed.