Testosterone increases sex drive in women



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Testosterone increases sex drive in women


Testosterone therapy is an effective treatment for low libido in postmenopausal women, suggest results of an international study of more than 800 women.

Previous research has shown that testosterone therapy is useful for restoring libido in women when used in conjunction with estrogen replacement therapy. However, this study is the first to show that testosterone by itself can enhance sexual wellbeing in postmenopausal women.

For the year-long study researchers randomly assigned 814 women with hypoactive sexual desire disorder to receive a skin patch delivering 150 or 300 µg of testosterone per day or placebo. The primary endpoint of the study was the change from the start of the study to week 24 in the 4-week frequency of satisfying sexual episodes.

Results showed that women receiving 300 µg of testosterone per day experienced a significant increase in satisfying sexual episodes compared to women receiving the placebo (2.1 episodes versus 0.7). Women receiving 150 µg testosterone per day did experience an increase in satisfying sexual episodes (1.2 episodes), however the increase was not statistically significant. In comparison with the placebo group, women receiving both doses of testosterone experienced significant increases in desire.

The researchers concluded: “In postmenopausal women not receiving estrogen therapy, treatment with a patch delivering 300 µg of testosterone per day resulted in a modest but meaningful improvement in sexual function.”

Davis SR, Moreau M, Kroll R, et al. Testosterone for low libido in postmenopausal women not taking estrogen. NEJM 2008:359:2005-2017.



Testosterone for Low Libido in Postmenopausal Women Not Taking Estrogen

Susan R. Davis, M.D., Ph.D., Michele Moreau, M.D., Robin Kroll, M.D., Céline Bouchard, M.D., Nick Panay, M.D., Margery Gass, M.D., Glenn D. Braunstein, M.D., Angelica Linden Hirschberg, M.D., Ph.D., Cynthia Rodenberg, Ph.D., Simon Pack, Ph.D., Helga Koch, Ph.D., Alain Moufarege, M.D., John Studd, M.D., for the APHRODITE Study Team

Background The efficacy and safety of testosterone treatment for hypoactive sexual desire disorder in postmenopausal women not receiving estrogen therapy are unknown.

Methods We conducted a double-blind, placebo-controlled, 52-week trial in which 814 women with hypoactive sexual desire disorder were randomly assigned to receive a patch delivering 150 or 300 µg of testosterone per day or placebo. Efficacy was measured to week 24; safety was evaluated over a period of 52 weeks, with a subgroup of participants followed for an additional year. The primary end point was the change from baseline to week 24 in the 4-week frequency of satisfying sexual episodes.

Results At 24 weeks, the increase in the 4-week frequency of satisfying sexual episodes was significantly greater in the group receiving 300 µg of testosterone per day than in the placebo group (an increase of 2.1 episodes vs. 0.7, P<0.001) but not in the group receiving 150 µg per day (1.2 episodes, P=0.11). As compared with placebo, both doses of testosterone were associated with significant increases in desire (300 µg per day, P<0.001; 150 µg per day, P=0.04) and decreases in distress (300 µg per day, P<0.001; 150 µg per day, P=0.04). The rate of androgenic adverse events — primarily unwanted hair growth — was higher in the group receiving 300 µg of testosterone per day than in the placebo group (30.0% vs. 23.1%). Breast cancer was diagnosed in four women who received testosterone (as compared with none who received placebo); one of the four received the diagnosis in the first 4 months of the study period, and one, in retrospect, had symptoms before undergoing randomization.

Conclusions In postmenopausal women not receiving estrogen therapy, treatment with a patch delivering 300 µg of testosterone per day resulted in a modest but meaningful improvement in sexual function. The long-term effects of testosterone, including effects on the breast, remain uncertain. (ClinicalTrials.gov number, NCT00131495 [ClinicalTrials.gov] .)


Source Information

From the Women's Health Program, Monash University, Alfred Hospital, Prahran, Australia (S.R.D.); Centre d'Étude Clinique, Montreal (M.M.); Women's Clinical Research Center and the Menopause Center of Seattle, Seattle (R.K.); Université Laval, Quebec, QC, Canada (C.B.); Queen Charlotte's and Chelsea Hospital, London (N.P.); University of Cincinnati College of Medicine, Cincinnati (M.G.); Cedars–Sinai Medical Center, Los Angeles (G.D.B.); Karolinska University Hospital, Stockholm (A.L.H.); Procter & Gamble Pharmaceuticals, Mason, OH (C.R., S.P., H.K.); Debiopharm Group, Charenton-le-Pont, France (A.M.); and Chelsea and Westminster Hospital, London (J.S.).



Address reprint requests to Dr. Davis at the Women's Health Program, Department of Medicine, Monash University, Alfred Hospital, Commercial Rd., Prahran VIC 3181, Australia, or at susan.davis@med.monash.edu.au .

This article has been cited by other articles:

  • (2008). All you need to read in the other general journals. BMJ 337: a2463-a2463 [Full Text]  

  • Heiman, J. R. (2008). Treating Low Sexual Desire -- New Findings for Testosterone in Women. NEJM 359: 2047-2049 [Full Text]  

  • (2008). Testosterone's Effect on Sexual Function in Postmenopausal Women Distressed by Low Libido. JWatch Women's Health 2008: 1-1 [Full Text]  

  • (2008). Testosterone for Low Libido in Postmenopausal Women: Not Ready for Prime Time. JWatch General 2008: 1-1 [Full Text]  

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