In the story “Goldilocks and the Three Bears,” Goldilocks searches for a bowl of porridge, a chair, and a bed that are “just right.” Similarly, Braunstein and colleagues1 report in this issue of the ARCHIVES their attempt to find the “just right” dose of testosterone for the treatment of surgically menopausal women with hypoactive sexual desire disorder (HSDD) in a well-designed randomized, double-blind, placebo-controlled trial. They report an increase in sexual desire and satisfying sexual activity in a group of surgically menopausal women who received 300 μg daily of a transdermal testosterone preparation for 24 weeks. This is not a surprising outcome given the known effects of this hormone and their previous publication on this subject.2 However, while their results add to the growing literature about the use of androgens for HSDD, they also raise many questions about what is the “just right” dose of testosterone.
Vigersky RA. Goldilocks and Menopause. Arch Intern Med. 2005;165(14):1571-1572. doi:10.1001/archinte.165.14.1571