Testosterone increases sexual desire

Testosterone increases sexual desire in oophorectomized women, according to two randomized, double-blind trials presented at ACM. One study compared methyltestosterone (MT) combined with esterified estrogens (EE) versus EE alone; the second study evaluated oral or transdermal estrogen in combination with transdermal testosterone (T) or placebo. In the study of MT and EE, conducted by researchers at Gynecology of South Florida, Aventura, Fla., one group consisted of surgically menopausal patients and the second was a mix of surgically and naturally menopausal women. MT was used at doses of 1.25 and 2.5 mg and EE at doses of 0.625 and 1.25 mg.

The surgically menopausal group had better scores in the Menopausal Sexual Interest Questionnaire when they received the higher doses than did the women in the "mixed" group (9.1 for EE + MT, 4.6 for EE; P=0.02 vs. 7.3 for EE + MT, 2.9 for EE; P<0.01). Statistically significant differences in sex hormone-binding globulin changes were noted between treatments (P<0.10 and 0.001).

The transdermal patch study, headed by a researcher from George Washington University, Washington, D.C., enrolled 562 women with a mean age of 49 who averaged 8.5 years since oophorectomy. All were diagnosed with hypoactive sexual desire disorder and were on stable doses of oral or transdermal estrogen; their mean relationship length was 19 years. These women received placebo or 300 µg/d of T in a patch twice weekly for 24 weeks.

The primary endpoint was change in total satisfying sexual activity from the Sexual Activity Log at 24 weeks. Seven domains of sexual function were assessed with the Profile of Female Sexual Function (PFSF). At 24 weeks, the T group had a 74% increase in frequency of total satisfying sexual activity and a 56% increase in sexual desire compared with baseline. The women on T experienced 2.13 satisfying sexual episodes per week for 4 weeks, compared with 0.98 for those on placebo. Statistically significant improvements also were seen in all other PFSF domains.

Goldsmith CL, Maly J, Swanson S, et al. Esterified estrogens and methyltestosterone: effects on sexual interest and hormone profiles. Obstet Gynecol. 2004;103(4 suppl):63S.

Simon JA, Nachtigal LE, Davis SR, et al. Transdermal testosterone patch improves sexual activity and desire in surgically menopausal women. Obstet Gynecol. 2004;103(4 suppl):64S.