Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
Gynecol Endocrinol. 2012 Mar;28 Suppl 1:46-9. doi: 10.3109/09513590.2012.651925.
Transdermal testosterone supplementation is a treatment option for postmenopausal women with distressful decreased libido. Side effects are minor, but there is a long-term safety concern with respect to breast cancer, as women with high testosterone serum levels appear to be at a significantly increased risk to have or to develop breast cancer within a few years. Epidemiological studies of sufficient duration to study long-term effects of testosterone supplementation are limited, both in number and in methodological quality and are, therefore, inconclusive. Preclinical studies do not provide evidence for an androgen receptor-mediated stimulating effect of androgens on breast epithelium. However, one biologically plausible possibility, which cannot be ruled out, is that exogenous androgens become mitogenic after aromatization into bioactive oestradiol, either in peripheral fat or within the breast or even within small occult tumours. The evidence available so far makes counselling women interested in testosterone supplementation for distressful low sexual desire, more of an art than science.
经皮补充睾酮是治疗绝经后女性性欲降低所致痛苦的一种选择。副作用较小，但长期安全性令人担忧，因为高血清睾酮水平的女性似乎在数年内发生或发展乳腺癌的风险显著增加。关于睾酮补充剂的长期影响，已有足够的研究时间进行研究的流行病学研究数量有限，且在方法学质量方面也存在不足，因此结论并不明确。临床前研究并未提供雄激素受体介导的雄激素对乳腺上皮刺激作用的证据。然而，有一种生物学上合理的可能性，即外源性雄激素在外周脂肪或乳腺内，甚至在小的隐匿性肿瘤内转化为生物活性雌二醇后具有促有丝分裂作用，这种可能性不能排除。到目前为止，现有证据使得为有性欲降低困扰而有意补充睾酮的女性提供咨询，更多的是一门艺术而非科学。
