Testosterone improves sexual health in post-menopausal women

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An international study showed testosterone, when used with no other hormone therapy, is an effective treatment for low libido in postmenopausal women. More than 800 women from 65 centers in the United States, Canada, Australia, the United Kingdom and Sweden participated in the study, the first to show that testosterone administered by a skin patch can boost sex drive in postmenopausal women.

Previous studies have shown testosterone treatment for low libido is beneficial for women undergoing estrogen therapy. However, this study shows testosterone by itself could be a good alternative for women who do not want to take estrogen.

Glenn Braunstein, M.D., chairman of the Department of Medicine at Cedars-Sinai Medical Center, is a primary investigator of the study of testosterone and woman's sexual health and a co-author of an article in the New England Journal of Medicine. He is an expert in endocrinology, diabetes and metabolism, with a major research focus on androgen physiology in women and androgen treatment of women.

The study on female sexual well-being and testosterone will be published in the Nov. 6 issue of the New England Journal of Medicine. Dr. Braunstein is available for interviews by appointment.

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The study was supported by funding from Proctor & Gamble Pharmaceuticals USA. Dr. Braunstein has previously served as a paid consultant for Proctor & Gamble and he reviewed this study data on behalf of the company.

Below is the abstract of the study on testosterone and female sexual well being.

The efficacy and safety of testosterone treatment for hypoactive sexual desire disorder in postmenopausal women not receiving estrogen therapy are unknown.

Methods We conducted a double-blind, placebo-controlled, 52-week trial in which 814 women with hypoactive sexual desire disorder were randomly assigned to receive a patch delivering 150 or 300 µg of testosterone per day or placebo. Efficacy was measured to week 24; safety was evaluated over a period of 52 weeks, with a subgroup of participants followed for an additional year. The primary end point was the change from baseline to week 24 in the 4-week frequency of satisfying sexual episodes.

Results At 24 weeks, the increase in the 4-week frequency of satisfying sexual episodes was significantly greater in the group receiving 300 µg of testosterone per day than in the placebo group (an increase of 2.1 episodes vs. 0.7, P<0.001) but not in the group receiving 150 µg per day (1.2 episodes, P=0.11). As compared with placebo, both doses of testosterone were associated with significant increases in desire (300 µg per day, P<0.001; 150 µg per day, P=0.04) and decreases in distress (300 µg per day, P<0.001; 150 µg per day, P=0.04). The rate of androgenic adverse events - primarily unwanted hair growth — was higher in the group receiving 300 µg of testosterone per day than in the placebo group (30.0% vs. 23.1%). Breast cancer was diagnosed in four women who received testosterone (as compared with none who received placebo); one of the four received the diagnosis in the first 4 months of the study period, and one, in retrospect, had symptoms before undergoing randomization.

Conclusions In postmenopausal women not receiving estrogen therapy, treatment with a patch delivering 300 µg of testosterone per day resulted in a modest but meaningful improvement in sexual function. The long-term effects of testosterone, including effects on the breast, remain uncertain. (ClinicalTrials.gov number, NCT00131495 [ClinicalTrials.gov] .)

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