Review Article

Sexual Dysfunction in Women with Diabetic Kidney

Table 2

What the guidelines say you should do: treatment of sexual dysfunction in women and the opportunity for psychosexual and/or couples counseling.

(i) The generalized use of testosterone by women has been advised against, because of inadequate indications and lack of long-term data. However, postmenopausal women who are distressed by their decreased sexual desire and who have other identifiable causes may be candidates for testosterone therapy. Androgens which may also be used by those women are hypogonadal as a result of pituitary problems in premenopause.
(ii) Although there is no consistent correlation between sexual functioning and levels of androgens (free and total testosterone, androstenedione, dehydroepiandrosterone, and SHBG) across wide age range, in some women androgen therapy can improve sexual desire.
(iii) Transdermal patches and topical gel or creams are preferred over oral products because of first pass hepatic effects documented with oral formulation.
(iv) The major side effects of androgens are hirsutism and acne. No safety with regard to testosterone implants. There is no indication for increased frequency of breast cancer [20, 21, 2729].