Evaluation of an Estrogen, Androgen, Estrogen-Androgen Combination, and a Placebo in the Treatment of the Menopause*

Greenblatt, Robert B.; Barfield, William E.; Garner, Joseph F.; Calk, Guy L.; Harrod, John P.

doi:10.1210/jcem-10-12-1547

Cited by 99 publications

(35 citation statements)

References 8 publications

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“…The addition of androgens to HRT is known to have beneficial effects on these problems (Greenblatt et al 1950, Grody et al 1953, Leiblum et al 1983, Sherwin & Gelfand 1987, Sherwin 1988. Shifren et al (2000) have found that transdermal testosterone administered by patch improved sexual frequency, pleasure and mood in surgically menopausal women.…”

Section: Effect Of Androgens On Libido Hot Flushes and Quality Of Lifementioning

confidence: 99%

Is dehydroepiandrosterone a hormone?

Labrie¹,

Luu‐The²,

Bélanger³

et al. 2005

Journal of Endocrinology

384

242

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Dehydroepiandrosterone (DHEA) is not a hormone but it is a very important prohormone secreted in large amounts by the adrenals in humans and other primates, but not in lower species. It is secreted in larger quantities than cortisol and is present in the blood at concentrations only second to cholesterol. All the enzymes required to transform DHEA into androgens and/or estrogens are expressed in a cellspecific manner in a large series of peripheral target tissues, thus permitting all androgen-sensitive and estrogensensitive tissues to make locally and control the intracellular levels of sex steroids according to local needs. This new field of endocrinology has been called intracrinology. In women, after menopause, all estrogens and almost all androgens are made locally in peripheral tissues from DHEA which indirectly exerts effects, among others, on bone formation, adiposity, muscle, insulin and glucose metabolism, skin, libido and well-being. In men, where the secretion of androgens by the testicles continues for life, the contribution of DHEA to androgens has been best evaluated in the prostate where about 50% of androgens are made locally from DHEA. Such knowledge has led to the development of combined androgen blockade (CAB), a treatment which adds a pure anti-androgen to medical (GnRH agonist) or surgical castration in order to block the access of the androgens made locally to the androgen receptor. In fact, CAB has been the first treatment demonstrated to prolong life in advanced prostate cancer while recent data indicate that it can permit long-term control and probably cure in at least 90% of cases of localized prostate cancer. The new field of intracrinology or local formation of sex steroids from DHEA in target tissues has permitted major advances in the treatment of the two most frequent cancers, namely breast and prostate cancer, while its potential use as a physiological HRT could well provide a physiological balance of androgens and estrogens, thus offering exciting possibilities for women's health at menopause.

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Section: Effect Of Androgens On Libido Hot Flushes and Quality Of Lifementioning

confidence: 99%

Is dehydroepiandrosterone a hormone?

Labrie¹,

Luu‐The²,

Bélanger³

et al. 2005

Journal of Endocrinology

384

242

View full text Add to dashboard Cite

show abstract

“…The first randomized, double-blind, placebocontrolled trial of the effects of testosterone therapy for the treatment of low libido came in 1950 when Greenblat et al 30 reported an improvement in libido and well being in women treated with methyltestosterone (MT). Since that time there have been a number of studies looking at the effects of testosterone for the treatment of low libido and sexual function.…”

Section: Changes To Androgen Status With Age Menopause and Medicationsmentioning

confidence: 99%

“…29,32,35,37 Additionally, several of the trials demonstrated that the addition of androgens improved sense of well being and other 'psychological factors'. 30,38,42,43,46 In the one trial of premenopausal women, testosterone therapy was also found to be effective in improving sexual desire, arousal and satisfaction. 33 …”

Section: Changes To Androgen Status With Age Menopause and Medicationsmentioning

confidence: 99%

Testosterone therapy in women: a review

Bolour

Braunstein

2005

Int J Impot Res

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Female sexual dysfunction is a complex problem with multiple overlapping etiologies. Androgens play an important role in healthy female sexual function, especially in stimulating sexual interest and in maintaining desire. There are a multitude of reasons why women can have low androgen levels with the most common reasons being age, oophorectomy and the use of oral estrogens. Symptoms of androgen insufficiency include absent or greatly diminished sexual motivation and/or desire, that is, libido, persistent unexplainable fatigue or lack of energy, and a lack of sense of well being. Although there is no androgen preparation that has been specifically approved by the FDA for the treatment of Women's Sexual Interest/Desire Disorder or for the treatment of androgen insufficiency in women, androgen therapy has been used off-label to treat low libido and sexual dysfunction in women for over 40 y. Most clinical trials in postmenopausal women with loss of libido have demonstrated that the addition of testosterone to estrogen significantly improved multiple facets of sexual functioning including libido and sexual desire, arousal, frequency and satisfaction. In controlled clinical trials of up to 2 y duration of testosterone therapy, women receiving androgen therapy tolerated androgen administration well and demonstrated no serious side effects. The results of these trials suggest that testosterone therapy in the low-dose regimens is efficacious for the treatment of Women's Sexual Interest and Desire Disorder in postmenopausal women who are adequately estrogenized. Based on the evidence of current studies, it is reasonable to consider testosterone therapy for a symptomatic androgen-deficient woman with Women's Sexual Interest and Desire Disorder.

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“…Results of the first randomized, doubleblind placebo-controlled trial of T therapy for menopausal women, published in 1950 by Greenblatt and coworkers, demonstrated an improvement in libido (5). Subsequently, numerous trials of T treatment for women with low libido have generally demonstrated efficacy for sexual desire, arousal, pleasure, responsiveness, and satisfaction (6)(7)(8).…”

mentioning

confidence: 99%

Safety of testosterone treatment in postmenopausal women

Braunstein¹

2007

Fertility and Sterility

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Evaluation of an Estrogen, Androgen, Estrogen-Androgen Combination, and a Placebo in the Treatment of the Menopause*

Cited by 99 publications

References 8 publications

Is dehydroepiandrosterone a hormone?

Is dehydroepiandrosterone a hormone?

Testosterone therapy in women: a review

Safety of testosterone treatment in postmenopausal women

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