Comparative effects of oral esterified estrogens with and without methyltestosterone on endocrine profiles and dimensions of sexual function in postmenopausal women with hypoactive sexual desire.
OBJECTIVE
In some women, a decline in sexual interest accompanies a relative androgen insufficiency after menopause. We sought to characterize the hormonal effects of the combination of oral esterified estrogens and methyltestosterone and to investigate whether this regimen improves hypoactive sexual desire.


METHODS
Double-blind randomized trial.


METHODS
Healthy volunteers in a multicenter research environment.


METHODS
Postmenopausal women taking estrogen therapy who were experiencing hypoactive sexual desire.


METHODS
4 months of treatment with 0.625 mg of esterified estrogens (n = 111) or the combination of 0.625 mg of esterified estrogens and 1.25 mg of methyltestosterone (n = 107).


METHODS
Baseline and end-of-study measurements of total and bioavailable testosterone and sex hormone-binding globulin (SHBG), and mean change in level of sexual interest or desire as rated on the Sexual Interest Questionnaire.


RESULTS
Treatment with the combination of esterified estrogens and methyltestosterone significantly increased the concentration of bioavailable testosterone and suppressed SHBG. Scores measuring sexual interest or desire and frequency of desire increased from baseline with combination treatment and were significantly greater than those achieved with esterified estrogens alone. Treatment with the combination was well tolerated.


CONCLUSIONS
Increased circulating levels of unbound testosterone and suppression of SHBG provide a plausible hormonal explanation for the significantly improved sexual functioning in women receiving the combination of esterified estrogen and methyltestosterone.
Lobo
Rogerio A
RA
Department of Obstetrics and Gynecology, Columbia University, College of Physicians and Surgeons and New York Presbyterian Hospital, New York, New York 10032, USA. ral35@columbia.edu
Rosen
Raymond C
RC
Yang
Hwa Ming
HM
Block
Barbara
B
Van Der Hoop
Roland Gerritsen
RG
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D005260:Female; D006801:Humans; D008777:Methyltestosterone / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D012725:Sexual Behavior / Q000187:drug effects*; D013739:Testosterone / Q000097:blood
D004967:Estrogens; D013739:Testosterone; D008777:Methyltestosterone