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Doktorsavhandling vid Karolinska Institutet |
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Flöter Rådestad, AngeliqueTestosterone treatment in women : Aspects on sexuality, well-being and metabolismFredagen den 26 november 2004, kl. 9.00. Skandiasalen, Astrid Lindgrens Barnsjukhus, Karolinska Universitetssjukhuset, Solna. |
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| ISBN: 91-7140-083-4 | Diss: 04:491 |
Abstract:
Oophorectomy reduces by half the levels of testosterone in serum and may be associated with sexual problems and a decrease in psychological well-being. Several studies show positive effects of testosterone treatment on psychosexual function and physical as well as psycho-logical well-being in women. Androgens may also have positive metabolic effects on bone and body composition.
The aims of this thesis were to explore the associations between androgens and sexual function and study the effects on sexuality, well-being, lipids, bone and body composition of testosterone undecanoate (TU) when added to estrogen treatment in oophorectomized women.
Sexual function, as assessed by the McCoy female sexuality questionnaire, showed
positive associations between psychosexual function i.e. arousal, desire, satisfaction
and various endogenous androgens. The oral administration of 40 mg TU resulted
in a median serum testosterone level of 3.2 nmol/L. The addition of testosterone
to estrogen for 6 months significantly improved 10 of 14 items on the McCoy
scale and had a better effect on interest in sex, satisfaction with frequency
of sexual activity and enjoyment of sex, as compared to estrogen alone. Improvements,
as judged by the Psychological General Well-Being (PGWB) questionnaire, were
similar with both treatments. The change in the serum markers PICP and IGF-I
suggested that combined estrogen/testosterone therapy also had a positive effect
on bone, but there was no measurable effect on bone mineral density after 6
months. Lean body mass increased, but no changes were found in BMI or fat distribution.
TU affected liver metabolism, as assessed by a 13% reduction in HDL-cholesterol.
Only mild virilizing side effects occurred during 6 months.
In conclusion, androgens were found to play an important role in women’s
sexual life. The addition of TU to estrogen treatment in oophorectomized women
improved psychosexual function. Both estrogen and testosterone improved women’s
well-being. TU may offer an oral alternative for androgen treatment in women.
However, regular monitoring is recommended during therapy because of considerable
individual variations in absorption and androgen levels in serum.
Keywords: Androgens, testosterone, testosterone undecanoate, sexuality, well-being, oophorectomy, lipids, lipoproteins, bone markers, body composition, female androgen insufficiency
List of papers
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Androgen status and sexual life in perimenopausal women. Floter A, Nathorst-Boos J, Carlstrom K, von Schoultz B Menopause, 1997; 4: 95-100 |
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Administration of testosterone undecanoate in postmenopausal women: effects on androgens, estradiol, and gonadotrophins. Floter A, Carlstrom K, von Schoultz B, Nathorst-Boos J Menopause, 2000; 7(4): 251-6 |
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Addition of testosterone to estrogen replacement therapy in oophorectomized women: effects on sexuality and well-being. Floter A, Nathorst-Boos J, Carlstrom K, von Schoultz B Climacteric, 2002; 5(4): 357-65 |
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Serum lipids in oophorectomized women during estrogen and testosterone replacement therapy. Floter A, Nathorst-Boos J, Carlstrom K, von Schoultz B Maturitas, 2004; 47(2): 123-9 |
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Effects of combined estrogen/teststerone therapy on bone and body composition in oophorectomized women. Floter A, Nathorst-Boos J, Carlstrom K, Ohlsson C, Ringertz H, von Schoultz B Gynecological Endocrinology, 2004 In Print |
