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Testosterone patch improves sexual function in women, study shows
BOSTON (CNN) -- A study in this week's New England Journal of Medicine indicates that using a testosterone patch could be helpful in treating women whose sexual functioning is impaired by early menopause caused by surgery.
"We know that women who have gone through menopause after surgical removal of their ovaries have decreased testosterone levels," said Dr. Jan Shifren of the Massachusetts General Hospital's Vincent Memorial Obstetrics and Gynecology Service and the study's lead author. "Women who have experienced a loss of sexual functioning after such surgery may benefit from returning their testosterone levels to normal through use of a testosterone skin patch."
Testosterone is primarily considered a male hormone, but it also is important for women. About half of a woman's testosterone comes from the ovaries, so ovary removal results in a significant loss, as well as a loss of 80 percent of the female hormone estrogen.
Estrogen replacement therapy can relieve other menopausal symptoms such as hot flashes, vaginal dryness and osteoporosis, but many women still suffer from diminished sexual desire, pleasure and activity.
The study, done in a number of research centers, acknowledged earlier researchers who "recognized the potential of testosterone to improve sexual functioning in women after surgical menopause," said Dr. Norm Mazer, a senior medical research fellow at Watson Laboratories Inc., developers of the patch. Earlier treatment tended to involve injections or implants, resulting in higher-than-necessary doses of the hormone.
"Women need testosterone to have arousal, and it's unbelievable how many women have low values of testosterone," said urologist Irwin Goldstein of the Boston University School of Medicine. "It's startling."
Although Goldstein took no part in the Shifren-Mazer research, he studies sexual dysfunction in women and men. Goldstein and his colleagues take a different approach, treating their female patients with the over-the-counter nutritional supplement dehydroepiandrosterone, better known as DHEA. In the body, DHEA is converted to testosterone and estrogen.
"We've given it to between 70 and 80 women," explained Dr. Andre Guay, an assistant clinical professor of medicine at the Harvard Medical School's Center for Sexual Dysfunction. "And we're running about two-thirds to three-quarters who have a positive clinical response."
Goldstein and Guay caution that women should not take DHEA unsupervised. Short-term use is thought to be safe, but no one has done long-term studies on the substance.
One woman, who asked not to be identified, told CNN she had never had an interest in sex. Told by her doctor to take DHEA, she was startled by the results.
"Suddenly, when I would look at someone who was attractive, or something that was sexually stimulating, I started feeling things that I never felt before," she said. "There are a lot of women out there whose lives would be so much better ... if they knew that there was help for this."
In the New England Journal study, researchers followed 75 women between the ages of 31 and 56 who had undergone surgical removal of the uterus and ovaries -- some as long as 10 years prior to the study.
In three 12-week periods, the women were given daily patches to wear in combination. Some were false patches, while others delivered doses of testosterone. Neither the participants nor the researchers knew which combinations were used for which patients.
Blood testing of hormone levels revealed that women reported greater sexual satisfaction and performance when testosterone levels were normalized, the researchers wrote.
Enrollment is currently underway for a larger study of women are experiencing impair sexual functioning following surgical menopause. For information, call 1-877-549-6636.
The Shifren-Mazer study was funded in part by Proctor and Gamble Pharmaceuticals. The company has licensed marketing rights for the testosterone patch, which is being developed by Watson Pharmaceuticals.
CNN Medical Correspondent Elizabeth Cohen contributed to this report.
Massachusetts General Hospital
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