Testosterone Improves Antidepressant-Emergent Loss of Libido in Women: Findings from a Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

Introduction Female sexual dysfunction is a side effect of selective serotonin reuptake inhibitor (SSRI)/serotonin noradrenalin reuptake inhibitor (SNRI) therapy. Aims The aim of this study is to investigate the efficacy of transdermal testosterone (TT) as a treatment for SSRI/SNRI-emergent loss of libido. Methods This was a double-blind, randomized, placebo-controlled study. Forty-four women, aged 35–55 years, on a stable dose of SSRI or SNRI with treatment-emergent loss of libido were randomly allocated to treatment with a TT patch delivering 300 mcg of testosterone/day or an identical placebo patch (Pl) for 12 weeks. Main Outcome Measures The primary outcome measure was the change in the Sabbatsberg Sexual Self-rating Scale (SSS) total score over 12 weeks. The 4-week frequency of Satisfactory Sexual Events (SSEs) and the Female Sexual Distress Scale-Revised (FSDS-R) were also measured. Results At baseline, there were no differences between the treatment groups. At week 12, the change in the SSS score did not differ between the two groups. The increase in the 4-week frequency of SSEs was significantly greater for the TT group than for the Pl group (an increase of 2.3 events vs. 0.1, P = 0.02). The between-group difference in the change in the FSDS-R score approached statistical significance (P = 0.06). The mean total serum testosterone level at 12 weeks in the TT group was 2.1 nmol/L. No women withdrew because of androgenic adverse events. Conclusions TT therapy resulted in a significant increase in the number of SSEs compared with Pl therapy in women with SSRI/SNRI-emergent loss of libido. The lack of improvement in the SSS total score may reflect lack of sensitivity of this instrument for the measurement of change in sexual function. This provides the first evidence that TT therapy may be a treatment option for women with SSRI/SNRI-emergent loss of libido who need to remain on their antidepressant therapy.

Effects of testosterone administration on cognitive function in hysterectomized women with low testosterone levels: a dose–response randomized trial

“…Although testosterone administration has been reported to improve some domains of sexual function and body composition in menopausal women as well as women with antidepressant-induced sexual dysfunction [1–3], the effects of testosterone therapy on cognitive function remain unclear.…”

Sex drive and sexual desire

“…Improvements in desire were also found in women treated with topical oestrogen and polyacrylic acid. TRT has been shown to improve desire in women with selective serotonin reuptake inhibitor induced loss of desire, where discontinuation of serotonin reuptake inhibitor is not an option [30]. Dehydroepisterone (DHEA), a precursor of testosterone and oestrogens, has also been suggested as a treatment for loss of desire.…”

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

“…10,11 Over the years, there has been an increasing interest regarding the determination of which symptoms could be used to precisely define testosterone deficiency in women. [12][13][14][15] There is an on going debate for the establishment of an absolute cutoff level for testosterone deficiency in peri-and postmenopausal women. 16 In different studies, testosterone supplementation have been linked to meaningful benefits in the fields of arousal, orgasm and well-being.…”

“…16 In different studies, testosterone supplementation have been linked to meaningful benefits in the fields of arousal, orgasm and well-being. [11][12][13] MedicalExpress (São Paulo, online) 2015 October;2(5):M150503…”

“…Is it well established that postmenopausal women continue to be sexually active despite sexual complaints. [2][3][4][5][6][7][8][9][10][11][12][13] Sexual activity is a useful tool to maintain a healthy life. Women were allocated to this study if they reported significant loss of sexual desire.…”