Transdermal Testosterone Treatment in Women with Impaired Sexual Function after Oophorectomy

Shifren, Jan; Braunstein, Glenn D.; Simon, James A.; Casson, Peter R.; Buster, John E.; Redmond, Geoffrey P.; Bürki, Regula E.; Ginsburg, Elizabeth S.; Rosen, Raymond C.; Leiblum, Sandra R.; Caramelli, Kim; Mazer, Norman A.

doi:10.1056/nejm200009073431002

Cited by 874 publications

(444 citation statements)

References 25 publications

Supporting

Mentioning

404

Contrasting

Unclassified

Order By: Relevance

“…Many of these studies were performed in women who received concomitant estrogen therapy. [107][108][109][110][111] Safety data are limited; long-term effects of testosterone, including effects on the breast, are unknown. Thus, applicability of testosterone is limited in women who have a history of breast cancer and in women who are unable to receive estrogen therapy.…”

Section: Low Libido and Sexual Dysfunctionmentioning

confidence: 99%

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Bakkum-Gamez

Laughlin

Jensen

et al. 2011

Mayo Clinic Proceedings

View full text Add to dashboard Cite

). © 2011 Mayo Foundation for Medical Education and ResearchB reast cancer is the leading cause of cancer death in women in the United States who are aged 20 to 59 years. 1 In 2010, an estimated 207,090 new cases of breast cancer were identified in the United States. 2 Although breast cancer risk increases with age, approximately 35% of breast cancers occur during the reproductive and perimenopausal years. 3 The 5-year relative survival rate for women of all ages with breast cancer diagnosed between 1999 and 2005 is 89%. 3 Of the premenopausal breast cancers diagnosed, approximately 58% are both estrogen receptor (ER) and progesterone receptor (PR) positive, 6% are ER positive only, 17% are PR positive only, and 20% are both ER and PR negative. 4 The management and treatment of breast cancer in premenopausal women can affect menstruation, reproduction, and gynecologic health. Breast cancer treatment can have a marked affect on fertility in women who have delayed childbearing and have fewer remaining reproductive years. Among premenopausal women with breast cancer, more than 50% wish to retain their fertility. 5 AUB = abnormal uterine bleeding; E2 = estradiol; EA = endometrial ablation; EC = endometrial cancer; ER = estrogen receptor; FDA = Food and Drug Administration; GnRH = gonadotropin-releasing hormone; IUD = intrauterine device; LNG = levonorgestrel; NSAID = nonsteroidal anti-inflammatory drug; PR = progesterone receptor; SHBG = sex hormone-binding globulin gynecologic issues and conditions are prevalent in reproductive-age women. In the general population, more than 30% of reproductive-age women fulfill criteria for the diagnosis of menorrhagia, 6 25% have symptomatic fibroids, 7 and nearly 67% have an underlying uterine disorder with potential to cause abnormal uterine bleeding (AUB). 8 Among premenopausal women with breast cancer, management of menstrual disorders, contraception, vasomotor symptoms, and fertility presents a challenge. Common and effective hormonal options are less well studied in this population because of significant concern about recurrence of breast cancer. Herein,we present the challenges and discuss management options for young women with breast cancer who present with various common gynecologic conditions.Articles for this review were identified by searching the PubMed database with no date limitations. PREMENoPAUSAL SEx STERoIDS AND THEIR PHARMACoLoGyPhysiologically, premenopausal women with regular cycles have cyclic variation in levels of estradiol (E2) (15-350 pg/ mL [to convert to pmol/L, multiply by 3.671]) and progesterone (0.2-27 ng/mL [to convert to nmol/L, multiply by 3.18]). These "free" (unbound) hormones are biologically active and can enter a target cell and activate its receptor.

show abstract

Section: Low Libido and Sexual Dysfunctionmentioning

confidence: 99%

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Bakkum-Gamez

Laughlin

Jensen

et al. 2011

Mayo Clinic Proceedings

View full text Add to dashboard Cite

show abstract

“…36 The fact that this was not a placebocontrolled study is a limitation. However, this study tried to avoid any possibility of affecting how participants answered the questionnaire by not discussing sexual issues throughout the treatment period, and by emphasizing weight reduction.…”

Section: Discussionmentioning

confidence: 99%

Influence of weight reduction by sibutramine on female sexual function

et al. 2006

View full text Add to dashboard Cite

Background: It is well known that selective serotonin reuptake inhibitors (SSRIs) can cause sexual dysfunction, so it is possible that sibutramine, a serotonin and norepinephrine reuptake inhibitor, could induce sexual dysfunction. Design and subjects: The effect of sibutramine on sexual function was evaluated in 46 overweight and obese (body mass index (BMI) X23 kg/m 2 ) but otherwise healthy married women (28-44 years). Participants were randomly assigned at baseline to either the sibutramine or control group. The Female Sexual Function Index (FSFI) questionnaire was used to assess sexual function at baseline and after treatment with behavioral therapy plus sibutramine 10 mg once daily or behavioral therapy alone (control) for 8 weeks.Results: Mean weight loss from baseline to week 8 was À6.03% in sibutramine group and À0.38% in the control group. There was significant improvement of FSFI total score, arousal domain score and lubrication domain score in the sibutramine group (Po0.05), and significant differences in arousal, orgasm, satisfaction domain score and total score (Po0.05) in favor of sibutramine. Decreases in body weight and BMI were correlated with the improvement of arousal (r ¼ À0.44 and r ¼ À0.48, respectively) and orgasm (r ¼ À0.45 and r ¼ À0.46, respectively) domains. Conclusion: Treatment with sibutramine plus behavioral therapy did not induce sexual dysfunction and sibutramine-induced weight reduction appeared to have a positive impact on sexual function in this small group of overweight and moderately obese women. The degree of improvement in sexual function was correlated with the degree of weight reduction.

show abstract

“…In several studies addition of testosterone to estrogen therapy has been reported to improve sexual function and well-being. 120,121 In addition, beneficial effects on bone mineral density have been observed. 122 Despite the large number of studies investigating the effects of testosterone coadministration, there are limited long-term data regarding the cardiovascular safety of this combination therapy.…”

Section: Postmenopausal Testosterone Therapymentioning

confidence: 99%

Testosterone, SHBG and cardiovascular health in postmenopausal women

Brand

Schouw

2010

Int J Impot Res

View full text Add to dashboard Cite

Cardiovascular disease (CVD) affects men and women differently with women having a lower incidence and later onset of disease. Research has recently refocused interest on the cardiovascular role of androgens. The purpose of this review is to summarize the evidence available on the association between testosterone and cardiovascular health in postmenopausal women. Published studies relating testosterone and sex hormone-binding globulin (SHBG) to CVD and its risk factors were reviewed. Studies included in this review suggest that increased androgenicity, characterized by high testosterone and low SHBG levels, is associated with an adverse CVD risk factor profile in postmenopausal women. However, evidence for an association with cardiovascular events is lacking and it is uncertain whether the observed associations with endogenous testosterone have clinical implications regarding the use of postmenopausal testosterone therapy. Large-scale, longitudinal studies relating testosterone and SHBG levels to cardiovascular risk factors and endpoints are needed to determine the temporal relationship between androgenicity and cardiovascular risk and to ascertain the long-term efficacy and safety of testosterone therapy in postmenopausal women.

show abstract

Transdermal Testosterone Treatment in Women with Impaired Sexual Function after Oophorectomy

Abstract: In women who have undergone oophorectomy and hysterectomy, transdermal testosterone improves sexual function and psychological well-being.

Cited by 874 publications

References 25 publications

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Influence of weight reduction by sibutramine on female sexual function

Testosterone, SHBG and cardiovascular health in postmenopausal women

Contact Info

Product

Resources

About