Costa TJ, Ceravolo GS, dos Santos RA, de Oliveira MA, Araújo PX, Giaquinto LR, Tostes RC, Akamine EH, Fortes ZB, Dantas AP, Carvalho MH. Association of testosterone with estrogen abolishes the beneficial effects of estrogen treatment by increasing ROS generation in aorta endothelial cells. Am J Physiol Heart Circ Physiol 308: H723-H732, 2015. First published January 30, 2015; doi:10.1152/ajpheart.00681.2014.-Testosterone has been added to hormone replacement therapy to treat sexual dysfunction in postmenopausal women. Whereas estrogen has been associated with vascular protection, the vascular effects of testosterone are contradictory and the effects of its association with estrogen are largely unknown. In this study we determined the effects of testosterone associated with conjugated equine estrogen (CEE) on vascular function using a model of hypertensive postmenopausal female: ovariectomized spontaneously hypertensive rats. Female spontaneously hypertensive rats were divided into sham-operated, ovariectomized (OVX), and OVX treated for 15 days with either CEE alone (OVXϩCEE) or associated with testosterone (OVXϩCEEϩT). Angiotensin II (ANG II)-induced contraction was markedly increased in aortic rings from OVX compared with sham-operated rats. CEE treatment restored ANG-II responses, a beneficial effect abrogated with CEEϩT. CEE treatment also increased endothelium-dependent relaxation, which was impaired in OVX rats. This effect was lost by CEEϩT. Treatment of aortas with losartan (ANG-II type-1 receptor antagonist) or apocynin (NADPH-oxidase inhibitor) restored the endothelium-dependent relaxation in OVX and CEEϩT, establishing an interplay between ANG-II and endothelial dysfunction in OVX and CEEϩT. The benefits by CEE were associated with downregulation of NADPH-oxidase subunits mRNA expression and decreased reactive oxygen species generation. The association of testosterone with CEE impairs the benefits of estrogen on OVX-associated endothelial dysfunction and reactive oxygen species generation in rat aorta by a mechanism that involves phosphorylation of the cytosolic NADPHoxidase subunit p47 phox .testosterone; estrogen; endothelium; ROS; angiotensin II; NADPH oxidase; cardiovascular disease; hypoactive sexual desire disorder AMONG THE HEALTH ISSUES associated with menopause, hypoactive sexual desire disorder (HSDD) is one of the most common (18, 28). Nearly 10% of postmenopausal women are affected by HSDD worldwide, and in most patients, the exact cause of HSDD is never fully elucidated (28). Specifically to menopausal women, the drop of estrogen levels has been considered as a major cause of HSDD. Nevertheless, hormonal therapy (HT) with estrogen has not demonstrated beneficial effect in sexual dysfunction in many cases of HSDD. In addition to the decline in estrogen levels, ovarian senescence also results in diminished levels of androgens, although transient increases of testosterone levels are observed in several stages of menopause (49). In fact, the combined loss of physiological levels of estrogens ...