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COMO SABER SE A TESTOSTERONA NA MULHER ESTÁ BAIXA?
A maioria dos métodos de dosagem laboratorial de Testosterona tem pobre sensibilidade e acurácia na faixa normalmente encontrada em mulheres (20-60 ng/dl). Ela é padronizada para dosagem da Testosterona em homens. Assim sendo, não há um método padrão de dosagem de testosterona PARA MULHER.
O Diagnóstico de Insuficiência Androgênica Feminina (deficiência de testosterona) é essencialmente clínico e complexo, como por exemplo:
- diminuição da sensação de bem-estar
- humor disfórico
- fadiga persistente
- diminuição da libido, do prazer sexual e da receptividade sexual
- perda de massa óssea e massa muscular
- persistência dos fogachos
- rarefação de pelos pubianos
- alterações na memória
O diagnóstico da insuficiência de testosterona é mais claro em mulheres que se submeteram a cirurgia de retirada de ovários bilateralmente porque os ovários são órgãos produtores dos hormônios Estrógeno e Testosterona na mulher.
Esse assunto, como é controverso, foi recentemente analisado pelos maiores especialistas em Endocrinologia Feminina no Brasil e foi publicado um consenso na revista da Sociedade Brasileira de Endocrinologia e Metabologia (2019).
QUAIS OS EFEITOS COLATERAIS DA TESTOSTERONA EM MULHERES?
A mulher pode sofrer muitos efeitos colaterais devido ao uso da Testosterona, veja os exemplos:
- aumento de pilificação, engrossamento de voz e queda de cabelos
- acne, oleosidade da pele
- sangramento endometrial anormal
- preocupação com câncer de mama ( controverso)
- possível aumento de risco de doença cardiovascular
A TESTOSTERONA PODE SER PRESCRITA PARA MULHERES?
Existem algumas questões a serem avaliadas pelo Endocrinologista antes de prescrever testosterona para uma mulher:
- A testosterona pode ter efeito positivo no desejo sexual de mulheres mas de pequena magnitude
- Faltam dados de segurança à longo prazo
- Não há ampla recomendação de uso de testosterona em mulheres
- Não existem formulações de testosterona aprovadas para mulheres pelas agências reguladoras dos EUA, Brasil e da maioria dos países
- Ao considerar a terapia com testosterona para mulheres, todos os riscos e benefícios devem ser cuidadosamente discutidos
Sob esse ponto vista, o uso da Testosterona na Mulher precisa ser avaliado com muita cautela pelo Endocrinologista.
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