“…Androgen therapy for the treatment of fibromyomas of the uterus increased libido and improved feeling of well‐being in many patients [18]. This observation was confirmed by Abel [10]. Kennedy and Nathanson found that treatment of patients with breast cancer with androgens resulted in 37% of patients experiencing increased libido [19].…”
Section: Androgen Therapy Of Sexual Dysfunctionmentioning
confidence: 87%
“…(a) Its ability to inhibit the gonadotropic activity of the hypophysis; (b) to suppress or decrease estrogen function; (c) to nullify or modify the activity of the gynecogens; (d) to inhibit the proliferative processes in the endometrium; and (e) to inhibit the reactivity of the uterine musculature. [10]…”
Section: Testosterone Therapy In Patients With Gynecological and Sexumentioning
confidence: 99%
“…If such is the case, administration of testosterone with the resultant depression of pituitary hormone would again seem logical and warranted. [10]…”
Section: Testosterone Therapy In Patients With Gynecological and Sexumentioning
Introduction
Although the term “medicalization” has been used by some to describe contemporary testosterone use in women with sexual disorders and testosterone deficiency syndrome, testosterone therapy for women with various gynecological and sexual disorders has been practiced since the late 1930s.
Aim
The study aimed to perform a historical review of testosterone use in women with sexual and gynecological disorders. This review is necessary to bridge important knowledge gaps in the clinical use of testosterone in women with sexual health concerns and to provoke new thoughts and understanding of the multidisciplinary role of testosterone in women’s overall health.
Methods
Review of medical literature on androgen therapy in women was carried out from 1938 through 2008.
Results
Approximately 70 years ago, clinicians from various disciplines relied on personal experience and clinical observations for outcome assessment of testosterone therapy in women. These early reports on testosterone use in women with sexual medical problems served as a foundation for the development of contemporary approaches and subsequent testosterone treatment regimens. Testosterone use was reported for sexual dysfunction, abnormal uterine bleeding, dysmenorrhea, menopausal symptoms, chronic mastitis and lactation, and benign and malignant tumors of the breast, uterus, and ovaries.
Conclusions
Health-care professionals engaged in the management of women’s health issues have observed the benefits of androgen therapy throughout much of the 20th century. Despite this clinical use of testosterone in women for more than seven decades, contemporary testosterone therapy in women is hotly debated, misunderstood, and often misrepresented in the medical community.
“…Androgen therapy for the treatment of fibromyomas of the uterus increased libido and improved feeling of well‐being in many patients [18]. This observation was confirmed by Abel [10]. Kennedy and Nathanson found that treatment of patients with breast cancer with androgens resulted in 37% of patients experiencing increased libido [19].…”
Section: Androgen Therapy Of Sexual Dysfunctionmentioning
confidence: 87%
“…(a) Its ability to inhibit the gonadotropic activity of the hypophysis; (b) to suppress or decrease estrogen function; (c) to nullify or modify the activity of the gynecogens; (d) to inhibit the proliferative processes in the endometrium; and (e) to inhibit the reactivity of the uterine musculature. [10]…”
Section: Testosterone Therapy In Patients With Gynecological and Sexumentioning
confidence: 99%
“…If such is the case, administration of testosterone with the resultant depression of pituitary hormone would again seem logical and warranted. [10]…”
Section: Testosterone Therapy In Patients With Gynecological and Sexumentioning
Introduction
Although the term “medicalization” has been used by some to describe contemporary testosterone use in women with sexual disorders and testosterone deficiency syndrome, testosterone therapy for women with various gynecological and sexual disorders has been practiced since the late 1930s.
Aim
The study aimed to perform a historical review of testosterone use in women with sexual and gynecological disorders. This review is necessary to bridge important knowledge gaps in the clinical use of testosterone in women with sexual health concerns and to provoke new thoughts and understanding of the multidisciplinary role of testosterone in women’s overall health.
Methods
Review of medical literature on androgen therapy in women was carried out from 1938 through 2008.
Results
Approximately 70 years ago, clinicians from various disciplines relied on personal experience and clinical observations for outcome assessment of testosterone therapy in women. These early reports on testosterone use in women with sexual medical problems served as a foundation for the development of contemporary approaches and subsequent testosterone treatment regimens. Testosterone use was reported for sexual dysfunction, abnormal uterine bleeding, dysmenorrhea, menopausal symptoms, chronic mastitis and lactation, and benign and malignant tumors of the breast, uterus, and ovaries.
Conclusions
Health-care professionals engaged in the management of women’s health issues have observed the benefits of androgen therapy throughout much of the 20th century. Despite this clinical use of testosterone in women for more than seven decades, contemporary testosterone therapy in women is hotly debated, misunderstood, and often misrepresented in the medical community.
“…In the 1940s, androgen therapy was utilized in the treatment of certain cancers, as well as in the treatment of urinary and menstrual problems. There were cases reports of increased libido as a side effect of androgen therapy [46–50]. A small number of clinicians began using androgen therapy for such complaints.…”
Introduction
Hypoactive sexual desire disorder (HSDD) is a common problem that is often treatment refractory. This refractoriness to treatment is reflective of our lack of knowledge concerning the determinants of sexual libido in women.
Aim
To review the development and current status of information concerning the diagnosis and treatment of HSDD.
Methodology
Literature on HSDD published between 1950 and 2005 was reviewed.
Results
Historically, HSDD was considered to be a psychiatric disorder. Thus, the diagnostic criteria utilized in studies of interventions for this disorder are based on the Diagnostic and Statistical Manual of the American Psychiatric Association. This system was never designed to encompass organic causes of sexual dysfunction and has evolved by expert opinion. If the syndrome is poorly defined by these diagnostic criteria, this could limit progress in this field. Epidemiological studies have found that approximately 24–43% of women complain of low sexual desire in the preceding year. The percentage of the population meeting diagnostic criteria for HSDD is probably much lower. There has been considerable progress in the development of psychometrically sound instruments for the assessment of libido. The development of approaches to treatment was reviewed. Approaches to treatment have evolved in three major areas: psychological, hormonal, and use of psychopharmacological agents. There is some evidence of efficacy utilizing all three approaches. The major evidence of efficacy concerns the use of testosterone therapy. Long-term safety data concerning this treatment are absent.
Conclusion
There is a rapidly expanding knowledge base concerning the diagnosis and treatment of HSDD. However, the contemporary clinician is faced with the absence of an approved treatment for this disorder and the lack of clear guidelines concerning the indications and safety of the use of non-approved agents.
“…Although Loeser (80) and Salmon (81) demonstrated in the early 1940s that women with androgen deficiency treated with T experienced an enlargement of the clitoris, increased libido and heightened sense of well-being, such clinical observations were not seriously considered by many in the medical community. Subsequent studies in women treated with T have demonstrated that androgen therapy increased libido and improved feeling of well-being in many women (82)(83)(84)(85). Salmon and Geist (86) postulated that androgens manifest their action by heightening the response to psychosexual stimulation, causing the external genitalia to become more sensitive, and increasing the intensity of sexual gratification (86).…”
Section: Androgens Modulate Sexual Function In Womenmentioning
Advancement in basic and clinical research has provided considerable evidence suggesting a key role of androgens in the physiology and pathophysiology of sexual function. Evidence from clinical studies in men and women with androgen deficiency support a role of androgens in maintaining sexual function in men and women and are integral in maintaining sexual health. Preclinical studies utilizing male animal models demonstrated a role of androgens in maintenance of: (i) penile tissue structural integrity, (ii) penile trabecular smooth muscle growth and function, (iii) integrity of penile nerve fiber network, (iv) signaling pathways in the corpora cavernosa, (v) myogenic and adipogenic differentiation in the corpora cavernosa, (vi) physiological penile response to stimuli, and (vii) facilitating corporeal hemodynamics. These findings strongly suggest a role for androgen in the physiology of penile erection. In addition, clinical studies in hypogonadal men with erectile dysfunction treated with testosterone provided invaluable information on restoring erectile function and improving ejaculatory function. Similarly, clinical studies in surgically or naturally postmenopausal women with androgen deficiency suggested that androgens are important for maintaining sexual desire and testosterone treatment was shown to improve sexual desire, arousal and orgasm. Furthermore, studies in female animal models demonstrated that androgens maintain the integrity of vaginal nerve fiber network, muscularis volume, and enhance genital blood flow and mucification. Based on the biochemical, physiological and clinical findings from human and animal studies, we suggest that androgens are integral for maintaining sexual function and play a critical role in maintaining sexual health in men and women.
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