December 11, 2013
Higher Testosterone Doses Improve Women’s Posthysterectomy Symptoms

Boston—Should testosterone be considered for treatment of women who suffer sexual dysfunction, fatigue, low mood, and decreased muscle mass after surgical removal of their uterus and/or ovaries?

Testosterone supplements aren’t currently FDA-approved for use in women, but new research from Brigham and Women’s Hospital (BWH) has found that the male hormone can help manage some of the undesirable symptoms that result from postsurgical declines in both estrogen and testosterone. The report was published online recently by the journal Menopause.

“Recently, there has been a lot of interest in testosterone treatment in postmenopausal women for sexual dysfunction and other various health conditions. However, no previous studies have evaluated the benefits and negative effects of testosterone replacement over a wide range of doses,” explained lead author Grace Huang, MD, a research physician in BWH’s Department of Endocrinology.

For the 24-week study, researchers measured the dose-dependent effects of testosterone on sexual function, body composition, muscle performance, and physical function in 71 women with low testosterone levels who had undergone hysterectomy with or without oophorectomy.

Participants were randomly assigned either to placebo or one of four testosterone dosage levels—3, 6.25, 12.5, or 25 mg—administered weekly.

Researchers found that “changes in composite Brief Index of Sexual Functioning for Women scores, thoughts/desire, arousal, frequency of sexual activity, lean body mass, chest-press power, and loaded stair-climb power were significantly related to increases in free testosterone concentrations; compared with placebo,” with changes significantly greater in women assigned to the 25-mg group, although not in the lower dosage groups.

The frequency of androgenic adverse events was low, according to the authors.

“A primary concern with testosterone therapy is that it can cause symptoms of masculinization among women. These symptoms include unwanted hair growth, acne and lower voice tone. It’s important to note that very few of these side effects were seen in our study,” Huang pointed out.

Because of inadequate long-term safety data, the FDA has not approved testosterone therapy for women. Study authors called for extended studies to determine if testosterone can safely be used without increasing women’s risks for heart disease and breast cancer.

“Testosterone administration in hysterectomized women with or without oophorectomy for 24 weeks was associated with dose and concentration-dependent gains in several domains of sexual function, lean body mass, chest-press power, and loaded stair-climb power,” the researchers conclude. “Long-term trials are needed to weigh improvements in these outcomes against potential long-term adverse effects.”

U.S. Pharmacist Social Connect