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|Androgen Therapy in Women -- A Review of Clinical Trial Data|
E-Newsletter No. 54
Several studies have examined the efficacy of androgen therapy in women. Preliminary results suggest efficacy in a subset of women, primarily when testosterone was administered at doses that raised serum free testosterone to the upper limits of normal. Libido, the endpoint for which the most data are available, was increased in some women. Mood and quality of life were also improved, as was bone mineral density. However, data related to these endpoints are scant.
Androgens are known to be involved in womens arousability, response, pleasure, excitement, and intensity and ease of orgasm, as well as in initial spontaneous desire. Androgens are also involved in the active neurovascular smooth muscle response of swelling and increased lubrication, and likely affect genital sexual sensitivity.
Estrogens directly affect vulval, vaginal congestive responses and, because of their impact on mood and sleep, indirectly affect sexual interest. The link to sexual motivation and arousability has been shown in many studies of menopausal women.Surgically Menopausal Women
In one study, naturally menopausal women receiving implants of estradiol plus testosterone had a higher increase in bone density than those receiving estradiol alone. Another investigation examined bone density in surgically menopausal women receiving either oral estrogen alone or oral estrified estrogen plus methyltestosterone. An increase in bone density greater than that observed with estrogen alone was seen only in the women on the highest dose of methyltestosterone (2.5 milligrams).
Preliminary data regarding efficacy of androgens on some endpoints in a subset of women, and regarding short-term safety, are promising, but more are needed.
1. Shifren et al. N Engl J Med. 2000;343:682-8.
2. Laughlin et al. J Clin Endocrinol Metab. 2000;85:645-51.
3. Arlt et al. N Engl J Med. 1999;341:1013-20.
4. Goldstat et al. Menopause. 2003;10:390-8.
5. Lobo et al. Fertil Steril. 2003;79:1341-52.
6. Davis et al. Maturitas. 1995;21:227-36
7. Miller et al. J Clin Endocrinol Metab. 2002;87:2770-6.
8. Raisz et al. J Clin Endocrinol Metab. 1996;81:37-43.
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