Prof. Susan Davis
1Women’s Health Research Program, Monash University, Melbourne, Australia
Biography:
Professor Susan R Davis AO, MBBS, FRACP, PhD, FAHMS is Director, Monash University Women’s Health Research Program, Head of the Women’s Endocrine Clinic, Alfred Hospital Melbourne
She is internationally for her research on sex hormones, menopause and its health sequelae (>470 publications). Her research across the adult female lifespan focuses on determinants of physical, psychological and sexual wellbeing. Her clinical trials have led to paradigm shifts in the understanding of testosterone in women, with current trials examining the role of hormones on cardiometabolic health and musculoskeletal health. She has received numerous prestigious research awards, most recently the Elizabeth Blackburn Award of the NHMRC (2023), Ross Hohnen Award of the Australian Heart Foundation (2022), and the RACP College Medal (2022). Professor Davis is a past President of the International Menopause and the Australasian Menopause Societies and is an Executive Council Member of the Australian Academy of Health and Medical Sciences.
Abstract:
Testosterone is an important sex steroid in women as well as men, with both direct actions, and actions mediated by its aromatisation to estradiol in both sexes. In men testosterone is primarily of gonadal origin lifelong. In contrast, in women about 50% of circulating testosterone is of ovarian origin and 50% produced in peripheral tissues from adrenal precursors in the premenopausal years, and primarily from the adrenal precursors postmenopause. Therefore, the physiology of testosterone in women is complex and circulating blood concentrations may not be a reliable representation of tissue exposure ore effects. Added to this measurement of testosterone in women is challenging, with commercially available immunoassays unable to reliable measure blood testosterone concentrations in women. With studies not having precisely measured testosterone in relation to the menopause transition, whether the menopause meaningfully impacts blood testosterone levels has been an unanswered question.
There is irrefutable evidence from randomised, placebo-controlled trials that testosterone improves sexual desire in the majority of postmenopausal women who seek treatment for low sexual desire that is causing them distress. Evidence for this use in premenopausal women is insufficient and warrants further research. There is widespread promotion of testosterone therapy for postmenopause women with claims that it improves mood, energy, wellbeing and might prevent bone and muscle loss. The evidence that supports or refutes these claims, and the risks of over use will be discussed. "