Testosterone Therapy for Female Sexual Dysfunction

Khera, Mohit

doi:10.1002/smrj.53

Cited by 29 publications

(14 citation statements)

References 70 publications

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“…While androgen deficiency is linked to reduced sexual drive (42,43), data in women with PCOS are limited with conflicting results (11,33,44). Nevertheless, our findings were similar to a Brazilian study involving 88 women with PCOS (mean age 27 years), which showed a positive association of either androgen excess or an elevated LH level with FSD (45).…”

Section: Discussionsupporting

confidence: 73%

Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis

et al. 2020

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Background Polycystic ovarian syndrome is a common disorder characterized by clinical or biochemical hyperandrogenism and ovulary dysfunction. Female sexual dysfunction can have adverse effects on quality of life and interpersonal relationship. Methods We conducted a meta-analysis to evaluate the prevalence and severity of sexual dysfunction in women with PCOS. Results Compared to women without PCOS, those with PCOS were younger (28.90±3.11 versus 31.42±3.37 years; p<0.0001) and had higher body mass index (27.76±3.79 versus 24.95±3.71 kg/m2; p=0.002), Ferriman-Gallwey score (9.90±3.37 versus 4.11±2.17; p<0.0001) and serum total testosterone level (2.26±0.59 versus 1.51±0.49 nmol/L; p<0.0001). There was no significant difference in mean total FSFI score (25.72±2.33 versus 26.62±3.38; p=0.608) in women with and without PCOS. For the FSFI subscales, women with PCOS had a lower score for the pain subscale than women without PCOS (4.60±0.71 versus 5.24±0.39; p<0.001). Other subscales were not significantly different between the two groups. Women with PCOS had a 1.39 higher odds (95% CI 1.13, 1.72; p=0.002, I2 11.9%) of having FSD than women without PCOS. Conclusion FSD is a prevalent and disabling condition in young women with PCOS. Sensitive probing into the intimate aspects of their sex lives is needed to further understand the struggles that afflict women with PCOS. Parallel efforts should be undertaken to investigate the impact of new treatment strategies.

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Section: Discussionsupporting

confidence: 73%

Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis

et al. 2020

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“…26 Normal testosterone ranges have been reported for women of different age groups, but there is no minimal value for any androgen that can be used to identify women with HSDD. 65,181 Most circulating testosterone is bound to proteins (ie, SHBG, albumin), and only 1% to 2% of the total testosterone is unbound or free and biologically active. 65 Sex hormoneebinding globulin levels vary considerably among individuals 58 and may be increased by oral estrogens, hormonal contraception, and thyroid hormone replacement and lowered by central adiposity and oral androgen therapy.…”

Section: Third-line Treatment Optionsmentioning

confidence: 99%

“…65 Sex hormoneebinding globulin levels vary considerably among individuals 58 and may be increased by oral estrogens, hormonal contraception, and thyroid hormone replacement and lowered by central adiposity and oral androgen therapy. 181,182 Most radioimmunoassays lack the precision to accurately measure total testosterone levels in women 183 such that, when possible, testosterone should be measured by liquid chromatographyemass spectrometry, which is increasingly becoming available to clinicians. 184 Free testosterone levels can be calculated from measured total testosterone and SHBG levels using an online calculator.…”

Section: Third-line Treatment Optionsmentioning

confidence: 99%

The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women

Clayton

Goldstein

Kim³

et al. 2018

Mayo Clinic Proceedings

174

131

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The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10% of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines. The POC starts with the health care professional asking about sexual concerns, focusing on issues related to low sexual desire/interest. Diagnosis includes distinguishing between generalized acquired HSDD and other forms of low sexual interest. Biopsychosocial assessment of potentially modifiable factors facilitates initiation of treatment with education, modification of potentially modifiable factors, and, if needed, additional therapeutic intervention: sex therapy, central nervous system agents, and hormonal therapy, guided in part by menopausal status. Sex therapy includes behavior therapy, cognitive behavior therapy, and mindfulness. The only central nervous system agent currently approved by the US Food and Drug Administration (FDA) for HSDD is flibanserin in premenopausal women; use of flibanserin in postmenopausal women with HSDD is supported by data but is not FDA approved. Hormonal therapy includes off-label use of testosterone in postmenopausal women with HSDD, which is supported by data but not FDA approved. The POC incorporates monitoring the progress of therapy. In conclusion, the International Society for the Study of Women's Sexual Health POC for the management of women with HSDD provides a rational, evidence-based guideline for health care professionals to manage patients with appropriate assessments and individualized treatments.

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“…This alternative may be a better choice in female patients to avoid the expected and unavoidable virializing effect of testosterone in female patients. However, Khera reported in his review the safety of using testosterone replacement therapy in female patients with OHG.…”

Section: Therapeutic Strategies In Opioid‐induced Hypogonadismmentioning

confidence: 99%

Opioid‐induced hypogonadism: Pathophysiology, clinical and therapeutics review

Antony

Alzaharani

El-Ghaiesh

2020

Clin Exp Pharma Physio

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Opioids are pivotal therapeutics in the management of escalated chronic pain (moderate–severe). In the last two decades, the increased prescription rate and the prolonged usage of opioids shed light on opioid‐induced endocrinopathy. Opioid‐induced hypogonadism (OHG) results upon long‐term opioid therapy. Clinically, patients with OHG are presented mainly by sexual dysfunction and infertility. Opioid clinical use in pain therapy is indispensable. However, the resultant sexual endocrinopathy cannot be overlooked and hence hormonal replacement therapy with regular monitoring of the patients represents a potential therapeutic strategy while avoiding opioids in patients with guaranteed long therapeutic exposure and switching to using low‐dose naltrexone as alternative represents a possible prophylactic measure to ensure therapeutic compliance and secure a good life quality of patients.

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Testosterone Therapy for Female Sexual Dysfunction

Cited by 29 publications

References 70 publications

Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis

Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis

The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women

Opioid‐induced hypogonadism: Pathophysiology, clinical and therapeutics review

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