Testosterone may raise sexual desire after surgical menopause

OB/GYN News,  Oct 15, 2004  by Miriam E. Tucker

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LISBON -- Use of a transdermal testosterone patch was associated with significantly increased sexual activity and desire in surgically menopausal women in two large randomized, placebo-controlled phase III trials, Dr. Glenn D. Braunstein reported at the 12th International Congress of Endocrinology.

The two Procter & Gamble studies, conducted in the United States, Canada, and Australia, included 562 women at 49 sites and 533 women at 50 sites, with about 80% completing the entire 24 weeks of the study.

All of the study participants (mean age 49 years) had undergone bilateral oophorectomy and hysterectomy at least 6 months before the study (average 8-9 years), and were taking stable doses of oral or transdermal estrogen. Although none had depression, all had developed low sexual desire accompanied by distress (hypoactive sexual desire disorder) after surgery.

All were in stable relationships with a mean duration of 19 years, said Dr. Braunstein, who is the chair of the department of medicine at Cedars-Sinai Medical Center and professor of medicine at the University of California, Los Angeles.

Increases from baseline in total satisfying sexual activity, as measured by the weekly Sexual Activity Log, occurred in all subjects at 24 weeks but were greater in those who wore the testosterone patch, which delivered 300 [micro]g testosterone/day.

Those wearing the active patch reported 74% greater satisfaction in the first study and 57% in the second, compared with 33% and 23% in the two placebo groups, respectively.

Patients wearing the active patch also demonstrated greater increases in sexual desire as measured by the 30-day Profile of Female Sexual Function (PFSF) inventory (56% and 49% with the patch versus 29% and 18% with the placebo).

The women wearing the testosterone patch also reported greater decreases in stress on the 30-day Personal Distress Scale, 65% and 68%, compared with 48% and 40% with placebo.

Other domains covered by the PFSF in which those on the patch showed greater improvement included arousal, orgasm, pleasure, responsiveness, and self-image.

Adverse events occurred in about 2%-3% of both treatment and placebo groups, and withdrawals due to those events occurred in 6%-8%, without significant differences among the groups, Dr. Braunstein said.

The most frequent adverse event reported was application-site reactions, which occurred at the same rate with the placebo patch as with the one containing testosterone.

Androgenic side effects, including acne, alopecia, hirsutism, and voice deepening, occurred in 3%-10% of subjects in both the treatment and placebo groups. Differences were not significantly different, although the rate of hirsutism did reach 9% in the treatment group in the second study, compared with 5.3% in the placebo group.

There were no clinically significant differences in lipids, carbohydrate metabolism, or liver function, Dr. Braunstein said.

Miriam E. Tucker

Senior Writer

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