Hypoactive sexual desire disorder (HSDD) is a deficiency of sexual desire that causes marked personal or interpersonal distress. It occurs in approximately 1 in 10 adult women. A number of potential contributory factors (hormonal, neurobiological and psychosocial) have been identified. Testosterone plays an excitatory role in sexual desire but the mechanism is not yet well understood. Treatment with testosterone has been shown to improve sexual desire in menopausal women with HSDD. However, there are limited data concerning premenopausal women and long-term safety. At present, physiological testosterone preparations for use in women are not available in Switzerland.