Goldstat Rebecca, Briganti Esther, Tran Jane, Wolfe Rory, Davis Susan R
Jean Hailes Foundation Research Unit, Clayton, Victoria, Australia.
Menopause. 2003 Sep-Oct;10(5):390-8. doi: 10.1097/01.GME.0000060256.03945.20.
Circulating testosterone in women declines during the late reproductive years such that otherwise healthy women in their 40s have approximately half the testosterone level as women in their 20s. Despite this, research showing the benefits of androgen replacement has been limited to the postmenopausal years. In view of the known premenopausal physiological decline in testosterone, we have evaluated the efficacy of transdermal testosterone therapy on mood, well-being, and sexual function in eugonadal, premenopausal women presenting with low libido.
Premenopausal women with low libido participated in a randomized, placebo-controlled, crossover, efficacy study of testosterone cream (10 mg/day) with two double-blind, 12-week, treatment periods separated by a single-blind, 4-week, washout period.
Thirty-four women completed the study per protocol, with 31 women (mean age 39.7 +/- 4.2 years; serum testosterone 1.07 + 0.50 nmol/L) providing complete data. Testosterone therapy resulted in statistically significant improvements in the composite scores of the Psychological General Well-Being Index [+12.9 (95% CI, +4.6 to +21.2), P = 0.003] and the Sabbatsberg Sexual Self-Rating Scale [+15.7 (95% CI, +6.5 to +25.0), P = 0.001] compared with placebo. A mean decrease in the Beck Depression Inventory score approached significance [-2.8 (95% CI, -5.7 to +0.1), P = 0.06]. Mean total testosterone levels during treatment were at the high end of the normal range, and estradiol was unchanged. No adverse effects were reported.
Testosterone therapy improves well-being, mood, and sexual function in premenopausal women with low libido and low testosterone. As a substantial number of women experience diminished sexual interest and well-being during their late reproductive years, further research is warranted to evaluate the benefits and safety of longer-term intervention.
女性体内循环睾酮水平在生殖后期会下降，以至于40多岁的健康女性的睾酮水平约为20多岁女性的一半。尽管如此，显示雄激素替代疗法益处的研究仅限于绝经后阶段。鉴于已知绝经前睾酮的生理性下降，我们评估了经皮睾酮疗法对性腺功能正常、有性欲减退问题的绝经前女性的情绪、幸福感和性功能的疗效。
有性欲减退问题的绝经前女性参与了一项关于睾酮乳膏（10毫克/天）的随机、安慰剂对照、交叉疗效研究，该研究有两个双盲、为期12周的治疗期，中间间隔一个单盲、为期4周的洗脱期。
34名女性按照方案完成了研究，其中31名女性（平均年龄39.7±4.2岁；血清睾酮1.07 + 0.50纳摩尔/升）提供了完整数据。与安慰剂相比，睾酮疗法使心理总体幸福感指数的综合得分[提高12.9（95%可信区间，+4.6至+21.2），P = 0.003]和萨巴特贝格性自我评定量表得分[提高15.7（95%可信区间，+6.5至+25.0），P = 0.001]有统计学显著改善。贝克抑郁量表得分平均下降接近显著水平[-2.8（95%可信区间，-5.7至+0.1），P = 0.06]。治疗期间平均总睾酮水平处于正常范围的高端，雌二醇未发生变化。未报告有不良反应。
睾酮疗法可改善有性欲减退和低睾酮水平的绝经前女性的幸福感、情绪和性功能。由于大量女性在生殖后期会出现性兴趣和幸福感下降，有必要进一步开展研究以评估长期干预的益处和安全性。
