Testosterone for midlife women

Testosterone declines with aging, so most midlife women have "low" testosterone levels. Because libido also declines with aging, and distressing sexual problems peak at midlife, should midlife women with low libido and associated distress be treated with testosterone? This Practice Pearl reports clinical trial evidence, reviews the risks, and explains how testosterone might be used in a clinical setting. For women who may be considering a trial of testosterone therapy, limitations and adverse effects should be disclosed and appropriate monitoring instituted once treatment has begun.