Testosterone Therapy Improves Sexual Function in Post-Menopausal Women


Testosterone Therapy Improves Sexual Function in
Post-Menopausal Women
October 24, 2005
The addition of testosterone to hormone therapy in women after
menopause enhances their sexual function.

However, it may also
reduce HDL cholesterol (the "good" cholesterol) in women, according
to a systematic review of current evidence.
"If the reduction in HDL had been associated with an increase in
triglycerides [fatty acids] or LDL cholesterol it would be of great
concern," said Dr. Susan Davis, professor of medicine at Monash
University, Melbourne, Australia, and study co-author "However, as
an isolated finding the significance is difficult to interpret."
She added, "Testosterone has not been found to alter other coronary
heart disease risk factors.

"
The review appears in the most recent issue of The Cochrane
Library, a publication of The Cochrane Collaboration, an
international organization that evaluates medical research.
Systematic reviews draw evidence-based conclusions about medical
practice after considering both the content and quality of existing
medical trials on a topic.
The study team reviewed 23 randomized clinical trials involving
1,957 patients who had testosterone added to their hormone
replacement therapy (either estrogen or combined
estrogen/progestin) for an average of six months. Testosterone was
given orally in a majority of the studies in doses of either 1.

25
mg. or 2.5 mg. Participants completed questionnaires that measured
their sexual activity and libido, and were assessed for other side
effects.


Other benefits and side effects measured in the studies included
in the review included sense of well-being, unexplained fatigue,
breast cancer, mood changes, acne and increased hair growth; none
were significant enough to be linked definitively to the addition
of testosterone to hormone replacement therapy.
In the United States, about 37.5 million women ages 40 to 49 are
reaching or currently at menopause, according to the Centers for
Disease Control and Prevention.
Menopause generally begins around age 40, inducing declining
levels of the hormones estrogen and progesterone which are known to
keep the vagina and uterus healthy; estrogen is also involved in
the
health of bones and keeping HDL
at healthy levels.

Changes brought on by menopause can cause
unwelcome side effects in women such as "hot flashes" and
problems with mood, sleep, memory and joint stiffness.
Many women also experience changes in sexual function; the
genital area can become drier and thinner during and after
menopause, making sexual intercourse painful and undesirable. Also,
the menopausal
years bring on a decrease in sex
drive and slower sexual response in some women.
Although testosterone, a sex hormone produced by the endocrine
system, is thought of as a male hormone, women secrete small
amounts of it as well.

According to background information in the
review, testosterone has previously been shown to improve sexual
function, bone mineral density, muscle mass, increased lean body
mass, mood, energy and psychological well being.
However, there may be side effects in further studies of
testosterone use, according to Nanette Santoro, M.D., professor and
director of the Albert Einstein College of Medicine's Division of
Reproductive Endocrinology.

"It is possible that long-term side
effects that have not been observed with six month's use could
occur," Santoro cautioned.
"Long-term use of testosterone in women concerns include voice
changes, increased body and facial hair, acne and other undesirable
defeminizing side-effects; these have not been reported with
short-term use." Santoro adds. In men, according to Santoro, large
doses can cause growth and cancer of the prostate, blood clotting
problems and increased red blood cell counts.


Davis said that unwanted side effects, such as acne and
hairiness, would be noted by women taking testosterone and that the
does of testosterone dose could be reduced appropriately.
The authors do caution that adding testosterone to HT is not a
panacea for sexual dysfunction in women and that a comprehensive
approach is recommended. "Because of the complex
nature of female sexual dysfunction
it is often difficult to establish the meaningful steps in
treatment," they write. "Treatment options for sexual
dysfunction include identification of correctable causes,
education and counseling, and medical therapy.

"
They add that limitations of the review include the small number
of studies suitable for inclusion and the fact that some of the
studies included various interventions.
Davis has acted as a consultant for companies that have tested
testosterone therapies for women: Solvay Pharmaceuticals, Acrux
Ltd, Cellegy, Procter & Gamble and Organon and has received
honoraria for lectures sponsored by the last two companies.
Center for the Advancement of
Health

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