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| |  DG DISPATCH - ENDO 99: Testosterone Patch Improves Sex Drive Post-Menopause By Cameron Johnston Special to DG News SAN DIEGO, CA -- June 17, 1999 -- Women who find their sex lives stuck in park because they have had either a hysterectomy (removal of the uterus) or oopherectomy (removal of the ovaries) may find some new drive with testosterone patches. At the Endocrine Society meeting in San Diego, researchers presented the findings of a multi-centre study in which 75 women who were menopausal as a result of either hysterectomy or oopherectomy used testosterone patches in an attempt to restore some of their lost libido. The results of this study were presented by Dr. Glenn Braunstein, endocrinologist and chairman of the department of medicine, University of California at Los Angeles (UCLA) School of Medicine. Testosterone patches are already available for men who suffer from hypogonadism. The patches the women used in this study, however, were an experimental type that would deliver the equivalent of either 150 mcg or 300 mcg (micrograms) per day twice weekly -- considerably lower than men would receive. One-half of a woman’s circulating testosterone is produced by the ovaries. Therefore, hysterectomy or oopherectomy leaves them hormone deficient, Dr. Braunstein explained. Women enrolled in the trial ranged in age from 20 to 55 and, on average, it was four years since their surgery. They all experienced mild to moderate menopausal symptoms - fewer than 20 severe hot flushes per week -- and were taking a mean dose of 0.88 mg day of conjugated estrogen (Premarin). The women had a large number of hormonal measurements including sex hormone binding globulin, leutenizing hormone (LH), follicle stimulating hormone (FSH), free testosterone, and total testosterone - and others measured on a daily basis over the course of the nine-month study. Besides having testosterone that was lower than normal and sex hormone binding globulin that was higher than normal, the women also scored poorly on two psychological questionnaires -- the Basic Inventory of Sexual Function for Women (BISF-W) and the Psychological General Well-Being Index. Dr. Braunstein explained women who used the higher-dose patch (300 mcg) saw their free testosterone, LH and FSH levels return to normal and their total testosterone levels return to above normal during the study. There was a statistically significant improvement in their BISF-W score and a significant improvement in the depression component of the psychological general well-being questionnaire. More important, Dr, Braunstein said, was that they reported more interest in sexual activity, greater frequency of intercourse and more -- and better -- orgasms when they were using the patch versus the placebo. The women did not report any incidence of acne or hirsutism as a result of taking the testosterone. Critics of the study pointed out that the questionnaires used had a rather limited definition of success because sexual happiness was defined only as frequency of intercourse and whether they had an orgasm. Other forms of intimate contact that did not involve intercourse were not considered. Also, there is no clinical definition of androgen deficiency in women and, therefore, it might be difficult for a doctor to diagnose the condition or to recommend androgen replacements for these women. One drawback to the apparent success of the study, Dr. Braunstein explained, is that younger women --those under 47 years of age -- experienced such a high incidence of placebo effect, which dampened the study results. It could not be said that those women actually benefited from the testosterone to the same extent that the older women did, he said.
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