ReviewCureus2025
Testosterone Pellets in Women: Revisiting Safety and Clinical Outcomes.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Testosterone is the most abundant biologically active gonadal steroid in women, yet its therapeutic role remains controversial. Current guidelines restrict its use to hypoactive sexual desire disorder (HSDD) with transdermal formulations, while subcutaneous pellets are used off-label in clinical practice despite unresolved concerns about pharmacokinetics, efficacy, and safety. The objective of this study is to critically evaluate the pharmacokinetics, clinical efficacy, and safety of subcutaneous testosterone pellets in peri- and postmenopausal women. A structured narrative review was conducted using PubMed/MEDLINE, covering studies published from January 1980 to August 2025. Other databases were not systematically searched. Search terms included "testosterone", "pellets", "implants", "subcutaneous", "women", and "menopause", combined with Boolean operators. Eligibility criteria comprised original pharmacokinetic or clinical studies in women, defined by STRAW+10 when available, reporting outcomes on pharmacokinetics, efficacy, or safety. Narrative synthesis was chosen due to heterogeneity in design, dosing, comparators, and outcome definitions. From 455 records, 38 studies were included. Pellets provided sustained release over four to six months with supraphysiologic early peaks (>100-250 ng/dL) and wide interindividual variability. The only randomized controlled trial showed improved sexual activity, orgasm, and satisfaction at 24 weeks with testosterone plus estradiol implants. Observational cohorts reported improvements in sexual function (Female Sexual Function Index, Female Sexual Distress Scale-Revised, and satisfying sexual events), mood, energy, and bone density, but findings are limited by non-randomized designs, lack of blinding, and conflicts of interest. Safety data, dominated by practice-based registries, indicated mild androgenic events (acne and hair growth) and rare transient voice changes; signals of reduced breast cancer incidence were reported but derive from cohorts without adequate adjustment for confounders, precluding causal inference. Data on cardiovascular, metabolic, and endometrial outcomes remain sparse and inconsistent. Testosterone pellets provide long-term delivery but at the cost of supraphysiologic peaks, dosing variability, and reliance on observational evidence. Reported benefits for sexual function and well-being are hypothesis-generating, while safety cannot be confirmed. Until adequately powered randomized trials with standardized formulations are conducted, pellet use should remain individualized, off-label, and accompanied by structured monitoring rather than routine adoption.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.