A study conducted by the Cedars-Sinai Medical Center has found that a testosterone patch may produce modest increases in sexual desire in women who develop low sexual desire following hysterectomy. While the study, appearing in the Journal of the American Medical association, reports only modest gains in desire, it seemingly conflicts with other recent studies showing that testosterone had no effect on libido. The trial, funded by Procter & Gamble Pharmaceuticals, ran for six months with over 400 women who developed low sexual desire after surgical menopause and who were receiving oral estrogen therapy. Diminished sexual desire has been reported in up to 50 percent of women who undergo surgical menopause (the removal of both ovaries). When the ovaries are removed, blood levels of sex hormones, including testosterone, drop. Although some women see improvements in sexual functioning with estrogen therapy alone, some researchers suggest that the combination of estrogen and testosterone is more effective in preserving libido.
The trial was randomized so that women used either a placebo patch or a testosterone patch. Testosterone levels were checked at the beginning, middle and end of the trial. Changes in sexual desire and the frequency of satisfying sexual activity were determined by questionnaires and a sexual activity log.
The researchers, led by Glenn D. Braunstein, found that compared with the women receiving placebo, the women receiving the middle dosage (300 micrograms per day) of testosterone had greater increases in sexual desire (a 67 percent increase compared with 48 percent for placebo). The frequency of satisfying sexual activity was also greater (79 percent compared with 43 percent for the placebo group).
Women in the low dosage group showed no evidence of any effect from the testosterone and women in the high dosage group had increases similar to the middle dosage group. The researchers contend that testosterone, in the middle dosage range, significantly improved sexual desire and the frequency of total satisfying sexual activity in surgically menopausal women.
Other health experts were, however, less enamored with the results. Commenting on the study, Robert A. Vigersky, of Walter Reed Army Medical Center in Washington, said, "The benefits found by Braunstein and colleagues are modest and not clearly dose related. They found a statistically significant increase in only two of the seven domains of sexual function at the 300-ìg/d [middle] dose but not at the 450-ìg/d dose [high dose] of a transdermal testosterone patch."
Vigersky added that the percentage increases noted were not as impressive once they were put in a real-world context. "When put in the descriptive terms of the questionnaire, the testosterone treatment only raised the level of sexual function from 'seldom' to 'sometimes.' Similarly, the frequency of satisfying sexual activity increased by 79 percent in the testosterone-treated group compared with 43 percent in the placebo group, but on a monthly basis this was an absolute increase from three to five episodes."
But Braunstein is upbeat. "These findings were generally consistent across all sexual function instruments and highlight the important role that testosterone may play in women's sexual health. Additional studies should be undertaken to further assess the efficacy and safety of this treatment," he concluded.
