Maria Uloko, MD, presented “Primer on Testosterone Therapy for Women: Treatment of HSDD” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.
How to cite: Uloko, Maria. “Primer on Testosterone Therapy for Women: Treatment of HSDD” March 10, 2023. Accessed Oct 2024. https://grandroundsinurology.com/primer-on-testosterone-therapy-for-women-treatment-of-hsdd/
Primer on Testosterone Therapy for Women: Treatment of HSDD – Summary
Maria Uloko, MD, discusses testosterone therapy for women with hypoactive sexual desire disorder (HSDD). She explains that people with HSDD have higher rates of impaired body image, low self-confidence and self-worth, relationship stress, depression and anxiety, and increased healthcare costs.
Dr. Uloko shares the Basson Model of Sexual Motivation and emphasizes there is no “quick fix” for low libido. Dr. Uloko advocates a biopsychosocial approach that incorporates the biological, psychological, and social aspects that can affect HSDD. She explains the importance of patient education and therapy as well as medication treatments like flibanserin and testosterone.
Dr. Uloko emphasizes that testosterone is not FDA-approved for women, and it remains challenging to dose women appropriately. She cites studies that conclude testosterone, either alone or in concert with estrogen therapy, can be effective and safe for the treatment of HSDD. Dr. Uloko states that symptomatic improvement takes approximately 12 weeks, and treatment should be discontinued if no improvement occurs within six months.
Dr. Uloko then concludes that HSDD is a common but multifactorial condition for women with significant detriment to quality of life. She re-emphasizes the importance of a biopsychosocial approach to diagnosis and treatment that may include treatment with testosterone therapy.
About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
ABOUT THE AUTHOR
Maria Uloko, MD, is a urologist who specializes in the treatment of female sexual dysfunction, female sexual pain, low libido/desire, regenerative ED treatments, advanced erectile dysfunction, symptomatic menopause, atrophic vaginitis, urologic prosthetic surgery, Peyronie's disease, and hormone therapy. Dr. Uloko has expertise in providing gender-affirming care to transgender and nonbinary patients.
Dr. Uloko is an assistant professor at UC San Diego School of Medicine, she is involved in training medical students, residents, and fellows in urology and sexual health.
Dr. Uloko completed a fellowship in comprehensive sexual health with a focus on prosthesis/reconstruction at San Diego Sexual Medicine and Scripps. She completed residencies in urology and general surgery at the University of Minnesota Medical School in Minneapolis and earned her medical degree from the University of Missouri - Kansas City School of Medicine.
Dr. Uloko is a strong advocate of improving the quality of life of her patients by providing a comprehensive, compassionate, and inclusive approach to often stigmatized subjects. She believes in empowering her patients to take ownership of their sexual health by providing a shame-free space to ask questions and share their stories. She seeks to close gaps in care disparities and implement systems that promote diversity and inclusivity.
