Safety and Efficacy of a Testosterone Metered-Dose Transdermal Spray for Treating Decreased Sexual Satisfaction in Premenopausal Women

Davis, Susan R.; Papalia, Mary-Anne; Norman, Robert J.; O’Neill, Sheila; Redelman, Margaret; Williamson, Margaret; Stuckey, Bronwyn; Wlodarczyk, John; Gard'ner, K.; Humberstone, Andrew

doi:10.7326/0003-4819-148-8-200804150-00001

Cited by 134 publications

(89 citation statements)

References 21 publications

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“…The findings of the present study are consistent with other studies that have shown that the side-effect profile of the testosterone patch appears to be acceptable to women receiving estrogen treatment and those who have undergone natural menopause and are taking estrogens with a progestin, as well as those being treated with testosterone alone (17,19,20,22). Although the evidence of the potential benefit of testosterone treatment in women suffering from HSDD is very convincing, there has been a lack of such data for treatment options in transsexual women.…”

Section: Discussionsupporting

confidence: 82%

Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study

Kronawitter

Gooren

Zollver³

et al. 2009

European Journal of Endocrinology

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Objective: It has been reported that hypoactive sexual desire disorder (HSDD) affects one-third of transsexual women (defined as postoperative male-to-female transsexuals) receiving estrogen replacement whose bioavailable androgen levels are lower than in ovulating women and comparable with those in surgically postmenopausal women. The aim of this study was to evaluate the efficacy of transdermal testosterone treatment and of oral dydrogesterone in transsexual women with HSDD receiving estrogens. Methods: Seven transsexual women with HSDD were treated with a testosterone patch and nine transsexual women with HSDD were treated with oral dydrogesterone over 24 weeks. The primary end point was the change in the brief profile of female sexual function (B-PFSF) score. Secondary end points were changes in hormonal parameters and side effect assessments. Results: A significant increase in total testosterone and free testosterone levels was observed in the group receiving transdermal testosterone. At 24 weeks, there was a significant improvement in the B-PFSF score showing an improvement in sexual desire among transsexual women treated with the testosterone patch, whereas no change in the B-PFSF score was observed in transsexual women treated with oral dydrogesterone. No side effects were reported. Conclusions: In this pilot study, sexual desire in transsexual women improved significantly after treatment with the testosterone patch, without noticeable side effects.

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Section: Discussionsupporting

confidence: 82%

Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study

Kronawitter

Gooren

Zollver³

et al. 2009

European Journal of Endocrinology

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“…77 Another showed marginal benefit from one of three doses of transdermal testosterone in premenopausal women with early morning serum free testosterone of less than or equal to 1.1 pg/ml. 78 The highest of the three doses, aimed to raise free testosterone levels to at least the 75th percentile failed to show benefit beyond placebo as did the smallest (one-third) dose. The one-half dosage allowed 0.7 more sexually satisfactory events per month than placebo, but outcome as measured by the Sabbatsberg Sexual Self-rating Scale was similar to placebo.…”

Section: Systemic Estrogenmentioning

confidence: 99%

Women's sexual function and dysfunction: current uncertainties, future directions

Basson

2008

Int J Impot Res

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There is increasing evidence that women at the outset of sexual activity do not need to have sexual desire, as in 'drive', and that many do not distinguish desire from arousal. Multiple modes of investigation confirm poor correlation between women's subjective arousal and measured genital congestion. Suggested revisions to the DSM-IV definitions of sexual disorder have been published: there is now need to align interview assessments and screening questionnaires with contemporary understanding of women's sexual response. Whereas the psychological factors associated with women's sexual function and resilience to biological insults and external stressors are well documented, the role of biological factors is less clear. Variations in the rate of decline of adrenal and ovarian pro-hormones, activity of converting enzymes in peripheral cells, sensitivity of androgen and estrogen receptors and cerebral production of sex steroids may all be involved. Thus there is great complexity underlying the question of sex hormone supplementation, and in particular, little clarity as to which women have decreased brain and/or peripheral androgen activity. When psychosexual etiological factors appear to be minimal and investigational testosterone supplementation is considered, it would be appropriate to target women with disordered arousal and desire in keeping with the recently recommended revised definitions.

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“…Adding oestrogen or testosterone treatment to the antipsychotic medication may assist these sexual dysfunction problems in postmenopausal and premenopausal women (Davis et al, 2008), but the possible risks of these treatments must be considered. High prolactin levels can also cause anovulatory menstrual cycles and hence infertility.…”

Section: Development Of Schizophrenia In Womenmentioning

confidence: 99%

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Galletly

Castle

Dark

et al. 2016

Aust N Z J Psychiatry

665

672

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Objectives: This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. Methods:The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. RANZCP GuidelinesGalletly et al. 411 Australian & New Zealand Journal of Psychiatry, 50(5)Results: The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice. Conclusions:This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges.

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Safety and Efficacy of a Testosterone Metered-Dose Transdermal Spray for Treating Decreased Sexual Satisfaction in Premenopausal Women

Cited by 134 publications

References 21 publications

Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study

Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study

Women's sexual function and dysfunction: current uncertainties, future directions

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

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