Background: Multifactorial sexual dysfunction due to estrogen deprivation may be experienced during postmenopause. Testosterone administration has been shown to improve women's desire, however, there is controversy about its effectiveness. Objective: To evaluate the effectiveness of testosterone in postmenopausal women for the improvement of female sexual dysfunction. Methodology: Systematic review of the literature. Including menopausal women and sexual dysfunction compared to any comparator. Pubmed, EMBASE and Cochrane were searched. Randomized clinical trials were included, duplicates were removed, and titles and abstracts were screened with the support of Rayyan software. Information was extracted using a standardized format. The results were presented qualitatively and a grouped analysis was performed by type of testosterone administration route. Clinical, methodological and statistical heterogeneity were explored. Meta-analysis was performed for the oral administration subgroup. Results: 13 articles were included in the final review. Regarding treatment, 4 studies evaluated testosterone in suppositories, 3 studies used oral treatment, 3 patches, 2 creams, and 1 gel. The combined estimate of the studies in which oral testosterone was used was positive towards the intervention (mean difference 6.36 [CI95%=0.09-12.62; I2=87%]), but with serious methodological limitations and high heterogeneity. There were no evidence of adverse events that suspended participation in the studies. Conclusions: The quality of the evidence is weak and moderate. Clinical, methodological and statistical heterogeneity was found, which does not allow to conclude on the effectiveness of testosterone therapy on sexual function in postmenopausal women.
