Characteristics of Systemic Testosterone Therapy for Female Hypoactive Sexual Desire Disorder – A Claims Database Analysis

Abstract

ABSTRACT Introduction Hypoactive sexual desire disorder (HSDD) is estimated to impact ∼10% of women but is commonly undiagnosed. Systemic testosterone therapy (alone or with estrogen) improves libido in women with HSDD; however, concern for adverse effects may limit broad utilization. Objective Our objective is to describe trends in systemic testosterone for HSDD using a large US claims database. Methods The TriNetX Diamond Network database was queried: a US health research network of 190 million patients, encompassing healthcare encounters and prescriptions. We identified female patients with HSDD (ICD-10 F52.0) without age limitation from 2010 to September 2021. Testosterone prescription trends (total prescriptions, number per patient, incidence over time [prescriptions/person-day] assessed in 2010-2012, 2013-2015, 2016-2018, and 2019-2021), route of administration, and coadministration with estrogen were extracted. Significance over time was assessed using Chi Square for trend. Results 37,491 women diagnosed with HSDD were identified with mean age 46.5±12.4 years. Only 3.9% of women with HSDD (n=1444) were prescribed systemic testosterone (mean age 50.6±10.0 years). Over the past decade, there was a statistically significant increase in testosterone prescriptions for HSDD, specifically for women age 18-40 years and 41-55 years, as seen in Figure 1 (p<0.05). Most prescriptions were for injectable testosterone (56.8%), while 29.3% were for topical testosterone and 13.9% with route unknown. 556 women received only 1 prescription for systemic testosterone, 327 received 2-3 prescriptions, 262 received 4-9 prescriptions, and 299 received 10+ prescriptions. Systemic estrogen was co-prescribed for 543 women and vaginal estrogen was co-prescribed for 259 women; 642 women received no estrogen prescription. Conclusions Systemic testosterone therapy for HSDD remains rare but its use has increased over time; duration, route, and co-administration with estrogen remain highly variable. Long-term compliance with systemic testosterone therapy remains relatively low. Disclosure No