The effects of postmenopausal hormone therapies on female sexual functioning: a review of double-blind, randomized controlled trials

Alexander, Jeanne Leventhal; Kotz, Krista; Dennerstein, Lorraine; Kutner, S. Jerome; Wallen, Kim; Notelovitz, Morris

doi:10.1097/01.gme.0000142887.31811.97

Cited by 93 publications

(72 citation statements)

References 42 publications

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“…3,4 Previous clinical studies have shown that women treated with testosterone were more likely to report benefits in different aspects related to sexual activity. 13,14 Regarding, other studies related with testosterone therapy in postmenopausal where taking estrogen failed, 20 our findings in this present study are contrary to previous ones 21,22 that have shown that the concurrent estrogen therapy interferes with exogenous testosterone. A recent study by Botelho et al 4 evaluated the comparative effects of transdermal estrogen therapy associated with progesterone.…”

Section: ■ Conclusioncontrasting

confidence: 57%

Effects of a transdermal testosterone metered-dose nanoemulsion in peri- and postmenopausal women: a novel protocol for treating low libido

Botelho¹,

Queiróz²,

Carvalho³

et al. 2015

Medical Express

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OBJECTIVE:To investigate the efficacy of a transdermal nanoemulsion testosterone associated with transdermal estrogen therapy as a novel protocol treatment for emergent loss of libido. METHODS: Twenty-four women, aged 31-75 years (mean age, 51.7), with emergent loss of libido were allocated to treatment with a novel transdermal formulation of 500 µg/day of testosterone (Biolipid/B2®-testosterone) for 12 weeks, as part of an open label prospective study on peri-and post-menopausal women. Subjects applied the formulation on the right forearm. Clinical and laboratorial parameters including the sexual complaints; serum concentrations of testosterone, insulin, C-reactive protein, weight, blood pressure; body mass index and waist circumference were compared between baseline and 12 weeks after treatment. RESULTS:The mean total serum testosterone increased significantly (p = 0.009) after 12 weeks of treatment. No adverse or androgenic events were observed. There were positive and significant differences (p < 0.05) on sexual complaints, blood pressure, body mass index and waist circumference after transdermal nanoemulsion testosterone treatment. CONCLUSION: This protocol is effective in increasing testosterone levels in peri-and postmenopausal women with low libido. KEYWORDS: androgen deficiency; menopause; nanotechnology; transdermal delivery; testosterone; nanoparticles.

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Section: ■ Conclusioncontrasting

confidence: 57%

Effects of a transdermal testosterone metered-dose nanoemulsion in peri- and postmenopausal women: a novel protocol for treating low libido

Botelho¹,

Queiróz²,

Carvalho³

et al. 2015

Medical Express

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“…Thus, this finding may reflect type I error. Despite previous randomized controlled trials showing estrogen therapy effects on sexual satisfaction, 59 hormone therapy did not have a significant impact on sexual satisfaction. Confounding by indication suggests that women with sexual dissatisfaction due to atrophic vaginitis may take exogenous estrogen.…”

Section: Discussionmentioning

confidence: 57%

Correlates of Sexual Satisfaction Among Sexually Active Postmenopausal Women in the Women’s Health Initiative-Observational Study

et al. 2008

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BACKGROUND: Satisfaction with sexual activity is important for health-related quality of life, but little is known about the sexual health of postmenopausal women.OBJECTIVE: Describe factors associated with sexual satisfaction among sexually active postmenopausal women. DESIGN:Cross-sectional analysis.PARTICIPANTS: All members of the Women's Health Initiative-Observational Study (WHI-OS), ages 50-79, excluding women who did not respond to the sexual satisfaction question or reported no partnered sexual activity in the past year (N=46,525). MEASUREMENTS:Primary outcome: dichotomous response to the question, "How satisfied are you with your sexual activity (satisfied versus unsatisfied)?" Covariates included sociodemographic factors, measures of physical and mental health, and gynecological variables, medications, and health behaviors related to female sexual health. RESULTS:Of the cohort, 52% reported sexual activity with a partner in the past year, and 96% of these answered the sexual satisfaction question. Nonmodifiable factors associated with sexual dissatisfaction included age, identification with certain racial or ethnic groups, marital status, parity, and smoking history. Potentially modifiable factors included lower mental health status and use of SSRIs. The final model yielded a c-statistic of 0.613, reflecting only a modest ability to discriminate between the sexually satisfied and dissatisfied.CONCLUSIONS: Among postmenopausal women, the variables selected for examination yielded modest ability to discriminate between sexually satisfied and dissatisfied participants. Further study is necessary to better describe the cofactors associated with sexual satisfaction in postmenopausal women.

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“…Additionally, we operationally defined a substantial decline in sexual function as a 50% or greater reduction in the total DISF score relative to baseline scores. This criterion was intended to serve as a proxy for a clinically significant decrease in sexual function (Alexander et al, 2004) and was based on a similar threshold employed in pharmacologic studies of depression, in which a 50% improvement in rating scores is considered to be clinically significant. We compared the number of men and women who experienced a 50% or greater reduction (relative to baseline) in their total DISF scores by w 2 analysis.…”

Section: Discussionmentioning

confidence: 99%

Pharmacologically Induced Hypogonadism and Sexual Function in Healthy Young Women and Men

Schmidt

Steinberg

Negro

et al. 2008

Neuropsychopharmacol

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Studies fail to find uniform effects of age-related or induced hypogonadism on human sexual function. We examined the effects of induced hypogonadism on sexual function in healthy men and women and attempted to identify predictors of the sexual response to induced hypogonadism or hormone addback. The study design used was a double-blind, controlled, crossover (self-as-own control). The study setting was an ambulatory care clinic in a research hospital, and the participants were 20 men (average ± SD age ¼ 28.5 ± 6.2 years) and 20 women (average ± SD age ¼ 33.5 ± 8.7 years), all healthy and with no history of psychiatric illness. A multidimensional scale assessing several domains of sexual function was the main outcome measure. Participants of the study received depot leuprolide acetate (Lupron) every 4 weeks for 3 months (men) or 5 months (women). After the first month of Lupron alone, men received (in addition to Lupron) testosterone enanthate (200 mg intramuscularly) or placebo every 2 weeks for 1 month each. Women received Lupron alone for 2 months, and then, in addition to Lupron, they received estradiol and progesterone for 5 weeks each. The results of the study: in women, hypogonadism resulted in a significant decrease in global measures of sexual functioning, principally reflecting a significant decrease in the reported quality of orgasm. In men, hypogonadism resulted in significant reductions in all measured domains of sexual function. Testosterone restored sexual functioning scores in men to those seen at baseline, whereas neither estradiol nor progesterone significantly improved the reduced sexual functioning associated with hypogonadism in women. Induced hypogonadism decreased sexual function in a similar number of men and women. No predictors of response were identified except for levels of sexual function at baseline. In conclusion, our data do not support a simple deficiency model for the role of gonadal steroids in human sexual function; moreover, while variable, the role of testosterone in sexual function in men is more apparent than that of estradiol or progesterone in women.

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The effects of postmenopausal hormone therapies on female sexual functioning: a review of double-blind, randomized controlled trials

Cited by 93 publications

References 42 publications

Effects of a transdermal testosterone metered-dose nanoemulsion in peri- and postmenopausal women: a novel protocol for treating low libido

Effects of a transdermal testosterone metered-dose nanoemulsion in peri- and postmenopausal women: a novel protocol for treating low libido

Correlates of Sexual Satisfaction Among Sexually Active Postmenopausal Women in the Women’s Health Initiative-Observational Study

Pharmacologically Induced Hypogonadism and Sexual Function in Healthy Young Women and Men

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