{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T20:55:57Z","timestamp":1783025757537,"version":"3.54.6"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":79,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Princess Margaret Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Female sexual dysfunction is common, distressing, and notoriously difficult to treat. In the last two decades, short-course (\u201con-demand\u201d) testosterone (T) regimens\u2014delivered sublingually, intranasally, inhaled, topically, or intramuscularly\u2014have been explored as rapid-acting prn enhancers of female libido. The objective of this study is to quantify efficacy, safety, and pharmacokinetics (PK) of short-term T therapy (prn) in women with sexual dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PRISMA 2020 guidelines for systematic reviews were followed. Twelve RCTs and five PK studies (n\u2009=\u2009940) were identified via Embase\/MEDLINE\/Web of Science (inception\u2013March 2025). Outcomes included desire\/arousal scores, satisfying sexual events (SSE), pharmacokinetics, and adverse events. Risk of bias was assessed using the Cochrane risk-of-bias tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Although absolute serum T excursions differ widely across formulations, most achieve supra-physiological free-T peaks within 15\u00a0min and return to baseline within 2-6\u00a0h. There is mixed evidence that this window coincides with maximal central arousal effects. However, when combined with phosphodiesterase-5 or 5-HT1A agonists, there tends to be improved genital vasocongestion and sexual satisfaction. Adverse events were mild but tended to be common.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Short-term T therapy combined with phosphodiesterase-5 inhibitors or 5-HT1A agonists may be benefit select subgroups of women with sexual dysfunction with a favorable short-term safety, however, sample sizes remain small and further research is required.<\/jats:p>\n                    <jats:p>Registration: This study was registered in PROSPERO: CRD42024615106.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sxmrev\/qeag014","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T10:25:20Z","timestamp":1774088720000},"source":"Crossref","is-referenced-by-count":1,"title":["On-demand testosterone for the treatment of female sexual dysfunction: a systematic review"],"prefix":"10.1093","volume":"14","author":[{"given":"Leyi B","family":"Yin","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto , Toronto, ON M5S 3K3 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui M","family":"Bernardino","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre , Toronto, ON M5G 2C4 ,","place":["Canada"]},{"name":"Computational and Experimental Biology Group, NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, Universidade NOVA de Lisboa , Lisbon, 1099-085 ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiran","family":"Pace","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto , Toronto, ON M5S 3K3 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Mansouri","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto , Toronto, ON M5S 3K3 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanchit","family":"Kaushal","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, University of Toronto , Toronto, ON M5S 3K3 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica G","family":"Cockburn","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre , Toronto, ON M5G 2C4 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil E","family":"Fleshner","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgical Oncology, University of 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