A Single Centre Study to Describe the Changes in Serum Testosterone Concentration Following Application of Testosterone Gel in Post-Menopausal Women with Hypoactive Sexual Desire Disorder (HSSD) Already Receiving this as Part of Usual Care in Conjunction with Oestrogen Containing Hormone Replacement Treatment (HRT)

Adrian Heald; Yasitha Illangasekera; Hassan Rehman; Mark Livingston; Anne Keen; Rupinder Kochhar; Nicholas Panay; Joanna Borzomato; Mathilde Mordaunt; Peter Taylor; Geoff Hackett

doi:10.1530/endoabs.117.OP7.3

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Endocrine Abstracts (2026) 117 OP7.3 | DOI: 10.1530/endoabs.117.OP7.3

SFEBES2026 Oral Poster Presentations Reproductive Endocrinology (4 abstracts)

A Single Centre Study to Describe the Changes in Serum Testosterone Concentration Following Application of Testosterone Gel in Post-Menopausal Women with Hypoactive Sexual Desire Disorder (HSSD) Already Receiving this as Part of Usual Care in Conjunction with Oestrogen Containing Hormone Replacement Treatment (HRT)

Adrian Heald ^1,2 , Yasitha Illangasekera ^3,4 , Hassan Rehman ¹ , Mark Livingston ⁵ , Anne Keen ¹ , Rupinder Kochhar ¹ , Nicholas Panay ⁶ , Joanna Borzomato ¹ , Mathilde Mordaunt ² , Peter Taylor ⁷ & Geoff Hackett ⁸

Author affiliations

¹Salford Royal Hospital, Salford, United Kingdom; ²University of Manchester, Manchester, United Kingdom; ³Sheffield Hallam University, Sheffield, United Kingdom; ⁴University of Peradeniya, Peradeniya, Sri Lanka; ⁵Black Country Pathology Services, Wolverhampton, United Kingdom; ⁶Queen Charlotte’s & Chelsea and Westminster Hospitals, London, United Kingdom; ⁷University of Cardiff, Cardiff, United Kingdom; ⁸Aston University, Birmingham, United Kingdom

Introduction: Hypoactive Sexual Desire Disorder (HSDD) is characterized by a persistent reduction in sexual desire causing personal distress, commonly affecting post-menopausal women or those who are post-oophorectomy. Although testosterone therapy may alleviate symptoms, evidence in women remains limited. Testosterone, licensed for men, has been used off-label at modified doses for women. This study assessed serum testosterone levels in post-menopausal women with HSDD treated with testosterone gel (Testogel 16.2 mg/g, Besins Healthcare UK Ltd).

Methods: Twenty-four post-menopausal women using Testogel 16.2 mg/g via pump every 3–4 days for 6 months, in addition to oestrogen +/- progesterone -based HRT, were included. Participants applied 20.25 mg of Testogel following a baseline blood sample. Blood samples were collected every two hours for 10 hours and at 24 hours post-application. Testosterone concentrations were measured by mass spectrometry. The Female Sexual Function Index (FSFI) assessed sexual function. Pharmacokinetic parameters—Cmax, Cavg, Tmax, AUC and t½—were calculated with and without baseline testosterone adjustment.

Results: Mean age was 53.7 ± 6.8 years; mean BMI 27.4 ± 4.3 kg/m²; mean blood pressure 126/75 mmHg. Unadjusted median Cmax was 6.25 nmol/l (range 1.3–26.1) and Cavg 4.51 nmol/l (range 0.93–20.21). Median AUC was 121.8 nmol•h/l (range 35.9–458). Baseline-adjusted median Cmax was 3.55 nmol/l, Cavg 1.64 nmol/l, and AUC 39.45–181.8 nmol•h/l. Median FSFI score was 26.5/36 (IQR 18–30), with highest domain scores for arousal and satisfaction. All women reported subjective improvement in sexual function, with no androgenic side effects.

Conclusion: Marked variability was observed in testosterone pharmacokinetics among women applying Testogel 16.2 mg/g every 3–4 days. Despite this, all reported clinical benefit and no adverse effects. Development of a licensed daily testosterone formulation for women would provide a consistent, evidence-based therapeutic option for managing HSDD.