Effects of testosterone replacement in androgen-deficient women with hypopituitarism: a randomized, double-blind, placebo-controlled study.
BACKGROUND
Hypopituitarism in women is characterized by profound androgen deficiency due to a loss of adrenal and/or ovarian function. The effects of testosterone replacement in this population have not been reported.


OBJECTIVE
The objective of the study was to determine whether physiologic testosterone replacement improves bone density, body composition, and/or neurobehavioral function in women with severe androgen deficiency secondary to hypopituitarism.


METHODS
This was a 12-month randomized, placebo-controlled study.


METHODS
The study was conducted at a general clinical research center.


METHODS
Fifty-one women of reproductive age with androgen deficiency due to hypopituitarism participated.


METHODS
Physiologic testosterone administration using a patch that delivers 300 microg daily or placebo was administered.


METHODS
Bone density, fat-free mass, and fat mass were measured by dual x-ray absorptiometry. Thigh muscle and abdominal cross-sectional area were measured by computed tomography scan. Mood, sexual function, quality of life, and cognitive function were assessed using self-administered questionnaires.


RESULTS
Mean free testosterone increased into the normal range during testosterone administration. Mean hip (P = 0.023) and radius (P = 0.007), but not posteroanterior spine, bone mineral density increased in the group receiving testosterone, compared with placebo, as did mean fat-free mass (P = 0.040) and thigh muscle area (P = 0.038), but there was no change in fat mass. Mood (P = 0.029) and sexual function (P = 0.044) improved, as did some aspects of quality of life, but not cognitive function. Testosterone at physiologic replacement levels was well tolerated, with few side effects.


CONCLUSIONS
This is the first randomized, double-blind, placebo-controlled study to show a positive effect of testosterone on bone density, body composition, and neurobehavioral function in women with severe androgen deficiency due to hypopituitarism.
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. kkmiller@partners.org
K K
KK
Miller
B M K
BM
Biller
C
C
Beauregard
J G
JG
Lipman
J
J
Jones
D
D
Schoenfeld
J C
JC
Sherman
B
B
Swearingen
J
J
Loeffler
A
A
Klibanski
D000309:Adrenal Insufficiency / Q000209:etiology; D000328:Adult; D000339:Affect; D000728:Androgens / Q000097:blood / Q000172:deficiency*; D001143:Arousal / Q000502:physiology; D001823:Body Composition; D015519:Bone Density; D003071:Cognition / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D020249:Hormone Replacement Therapy; D006728:Hormones / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000209:etiology; D007018:Hypopituitarism / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D012725:Sexual Behavior; D013739:Testosterone / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*
D000728:Androgens; D006728:Hormones; D013739:Testosterone