The benefits of androgens combined with hormone replacement therapy regarding to patients with postmenopausal sexual symptoms

• Published in: Maturitas Vol. 56; no. 1; pp. 69 - 77
• Main Authors: de Paula, Fernando J.F, Soares, José M, Haidar, Mauro A, Lima, Geraldo Rodrigues de, Baracat, Edmund C
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 20.01.2007; Elsevier Science
• Subjects: Biological and medical sciences; Cross-Over Studies; Double-Blind Method; Drug Therapy, Combination; Estrogen Replacement Therapy; Estrogens - pharmacology; Female; Gynecology. Andrology. Obstetrics; Hormone replacement therapy; Humans; Internal Medicine; Libido - drug effects; Medical sciences; Medroxyprogesterone Acetate - pharmacology; Methyltestosterone; Methyltestosterone - pharmacology; Middle Aged; Obstetrics and Gynecology; Postmenopause; Postmenopause - physiology; Puberal and climacteric disorders (male and female); Sexual Behavior - drug effects; Sexual disturbance; Testosterone Congeners - pharmacology; Postmenopause; Methyltestosterone; Hormone replacement therapy; Sexual disturbance; Human; Drug combination; Replacement therapy; Androgen; Sexual dysfunction; Menopause; Androgen hormone; Symptomatology; Treatment; Female; Sex steroid hormone
• ISSN: 0378-5122; 1873-4111
• DOI: 10.1016/j.maturitas.2006.06.005

Abstract Objective To evaluate the benefits and risks of hormone replacement therapy (HRT) combined with methyltestosterone (MT) in postmenopausal women with sexual dysfunction. Design This study was a randomized, double-blind, placebo-controlled and crossover trial. Eighty-five women using HRT were divided into four treatment groups: GI–HRT plus placebo for 4 months; GII–HRT plus MT 2.5 mg/day for 4 months; GIII–HRT plus placebo for 2 months and then replaced with HRT plus MT 2.5 mg/day for 2 months; GIV–HRT plus MT 2.5 mg/day and then replaced with HRT plus placebo for 2 months. Blood was collected at baseline, after 2 months (T1) and 4 months (T2) of treatment for hormone determinations of estradiol, FSH, total and free testosterone, GOT, GPT, glucose, total and fractions of cholesterol and triglycerides. All participants answered clinical questions and a validated questionnaire of modified McCoy's sex scale. Results The association of HRT with MT 2.5 mg/day did not significantly change liver enzymes or increase cardiovascular risk factors. The patients of GII, GIIII and GIV when using MT presented amelioration of sex symptoms, mainly satisfaction and desire ( p < 0.01); however, GIII at T1 (1.3 ± 0.3) presented similar problem score results as compared to GIII at T2 (1.5 ± 0.6). Conclusion All data suggest that combined HRT-androgen therapy may be beneficial for postmenopausal women receiving HRT who continue to complain of sexual difficulties or for postmenopausal women with sexual complaints who are not undergoing estrogen therapy.