title: Serum Androgen Levels and Sexual Function Before and One Year After Treatment of Uterine Cervical Cancer: A Pilot Study.
abstract: BACKGROUND
  Radiotherapy or radical hysterectomy with salpingo-oophorectomy (SOE) as treatment for uterine cervical cancer causes estrogen deprivation in premenopausal women. The effects on androgen production have rarely been examined but could be relevant for survivors of cervical cancer because insufficiency has been associated with low sexual function.
  
  
  OBJECTIVE
  To investigate the effects of pelvic radiotherapy, hysterectomy with SOE, or surgery without SOE on androgen levels and to explore potential associations with sexual function.
  
  
  METHODS
  Patients with cervical cancer (N = 60) were prospectively examined through blood sampling and questionnaires before and 1 year after treatments.
  
  
  METHODS
  Serum testosterone (measured by liquid chromatography and tandem mass spectrometry), sex hormone-binding globulin, androstenedione, dehydroepiandrosterone sulfate, follicle-stimulating hormone, luteinizing hormone, and estradiol levels and Female Sexual Function Index scores.
  
  
  RESULTS
  In women treated with radiotherapy (n = 38), median total and free testosterone levels were significantly decreased at 1-year follow-up compared with baseline in premenopausal women (n = 16; total testosterone -29%, P = .01; free testosterone -22%, P = .007) and postmenopausal women (n = 22; total testosterone -25%, P = .03; free testosterone -29%, P = .03). Androstenedione was decreased in premenopausal women only and dehydroepiandrosterone sulfate was decreased in postmenopausal women only after radiotherapy. In women treated with hysterectomy and SOE (n = 10), testosterone levels were lower but not significantly lower, and there was no change in those having surgery without SOE (n = 12). Female Sexual Function Index scores lower than 26.5 in sexually active women were reported by 80% 1 year after radiotherapy, by 44% after hysterectomy with SOE, and by 40% after surgery without SOE, with no significant differences compared with baseline values. No direct correlation between androgen levels and Female Sexual Function Index scores were found at 1-year follow-up.
  
  
  CONCLUSIONS
  Total and free testosterone levels decreased slightly but significantly after pelvic radiotherapy in pre- and postmenopausal women. The clinical importance of this decrease is unclear, but androgen levels were not directly related to sexual function in this pilot setting.
authors: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden. Electronic address: asa.hallqvist-everhov@ki.se.
authors: Åsa H
authors: ÅH
authors: Everhov
authors: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors: Angelique
authors: A
authors: Flöter Rådestad
authors: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors: Tommy
authors: T
authors: Nyberg
authors: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
authors: Karin E
authors: KE
authors: Smedby
authors: Department of Oncology, Sahlgrenska Academy, Gothenburg, Sweden.
authors: Karin
authors: K
authors: Bergmark
authors: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors: Angelica
authors: A
authors: Lindén Hirschberg
mesh_terms: D000368:Aged; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood*; D003075:Coitus / Q000523:psychology*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007044:Hysterectomy; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D010052:Ovariectomy; D010865:Pilot Projects; D017697:Premenopause; D058994:Salpingectomy; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*
chemical_list: D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000735:Androstenedione; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: Androstenedione; Female Sexual Function Index; Radiotherapy; Sexual Function; Testosterone; Uterine Cervical Cancer