A patient recently told me that she wanted to have her testosterone level checked because she had heard that belly fat was in part related to low testosterone levels in men and in women. Is there any truth to this? And if it is true, what is the appropriate way to treat low testosterone in a woman? — KEIRA DILLON, FNP, Vista, Calif.

Physiologic studies indicate that, for reasons not well understood, the usual low-level processes of androgen conversion seen in fat cells is turned off in female abdominal adipose tissue, specifically in the presence of abdominal visceral obesity (J Clin Endocrinol Metab. 2003;88:5944-5950).

In a position statement on postmenopausal testosterone supplementation, The North American Menopause Society (NAMS) stated that women with decreased sexual desire associated with personal distress and with no other identifiable cause may be candidates for testosterone therapy. The NAMS statement went on to recommend that laboratory testing of testosterone levels should be used only to monitor for supraphysiologic levels before and during therapy, not to diagnose testosterone insufficiency.

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Transdermal patches and topical gels or creams are preferred over oral products because of first-pass hepatic effects documented with oral formulations. Finally, testosterone therapy is contraindicated in women with breast or uterine cancer and in those with cardiovascular or liver disease (Menopause. 2005;12:496-511). — Sherril Sego, FNP-C, DNP (180-1)

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