Table 3.

Agents used off-label for the treatment of HSDD

Agent	Study	Study design	Key findings
Transdermal testosterone	Achilli et al, 201767	Meta-analysis of 7 RCTs68, 69, 70, 71, 72, 73, 74; postmenopausal women (N = 3,035); testosterone patch vs placebo or no-treatment control	Significantly greater improvement in number of SSEs, sexual desire, and personal distress with testosterone vs placebo; no significant difference between testosterone patch and placebo in overall incidence of AEs, severe AEs, or study discontinuation; significantly more androgenic AEs (ie, acne, hair growth) for testosterone vs placebo
	Waldman et al, 201275; NCT00613002, NCT00657501	2 R, DB, PC studies; surgically menopausal women with HSDD (N = 1,172); testosterone gel (300 μg/d)	No significant differences between testosterone gel and placebo in sexual desire or number of SSEs
Bupropion	Segraves et al, 200476	R, DB, PC study; 16 wk; premenopausal women with HSDD (n = 31 bupropion SR, n = 35 placebo); bupropion SR 300 mg/d with optional increase to 400 mg/d	Significant increase for bupropion SR vs placebo on some measurements of sexual function (CSFQ total, arousal, and orgasm scores) but not others (CSFQ desire score, Brief Index of Sexual Functioning in Women)
	Segraves et al, 200177	4-wk single-blinded baseline phase followed by 8-wk single-blinded treatment phase; premenopausal and postmenopausal women with HSDD (N = 51); bupropion SR 150 mg bid	29% of patients were treatment responders (“much improved” or “very much improved” on CGI-I); most common AEs with bupropion (≥5% of patients and > placebo) were insomnia, tremor, and rash

AE = adverse event; bid = twice daily; CGI-I = Clinical Global Impression–Improvement; CSFQ = Changes in Sexual Functioning Questionnaire; DB = double-blinded; HSDD = hypoactive sexual desire disorder; PC = placebo-controlled; R = randomized; RCT = randomized controlled trial; SR = sustained release; SSE = satisfying sexual event.