Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
J Sex Med. 2014 Mar;11(3):831-9. doi: 10.1111/jsm.12426. Epub 2014 Jan 16.
Female sexual dysfunction is a side effect of selective serotonin reuptake inhibitor (SSRI)/serotonin noradrenalin reuptake inhibitor (SNRI) therapy.
The aim of this study is to investigate the efficacy of transdermal testosterone (TT) as a treatment for SSRI/SNRI-emergent loss of libido.
This was a double-blind, randomized, placebo-controlled study. Forty-four women, aged 35-55 years, on a stable dose of SSRI or SNRI with treatment-emergent loss of libido were randomly allocated to treatment with a TT patch delivering 300 mcg of testosterone/day or an identical placebo patch (Pl) for 12 weeks.
The primary outcome measure was the change in the Sabbatsberg Sexual Self-rating Scale (SSS) total score over 12 weeks. The 4-week frequency of Satisfactory Sexual Events (SSEs) and the Female Sexual Distress Scale-Revised (FSDS-R) were also measured.
At baseline, there were no differences between the treatment groups. At week 12, the change in the SSS score did not differ between the two groups. The increase in the 4-week frequency of SSEs was significantly greater for the TT group than for the Pl group (an increase of 2.3 events vs. 0.1, P = 0.02). The between-group difference in the change in the FSDS-R score approached statistical significance (P = 0.06). The mean total serum testosterone level at 12 weeks in the TT group was 2.1 nmol/L. No women withdrew because of androgenic adverse events.
TT therapy resulted in a significant increase in the number of SSEs compared with Pl therapy in women with SSRI/SNRI-emergent loss of libido. The lack of improvement in the SSS total score may reflect lack of sensitivity of this instrument for the measurement of change in sexual function. This provides the first evidence that TT therapy may be a treatment option for women with SSRI/SNRI-emergent loss of libido who need to remain on their antidepressant therapy.
女性性功能障碍是选择性 5-羟色胺再摄取抑制剂（SSRIs）/5-羟色胺去甲肾上腺素再摄取抑制剂（SNRIs）治疗的副作用。
本研究旨在探讨经皮睾酮（TT）治疗 SSRIs/SNRIs 引起的性欲丧失的疗效。
这是一项双盲、随机、安慰剂对照研究。44 名年龄在 35-55 岁之间的女性，正在服用稳定剂量的 SSRIs 或 SNRIs，出现性欲丧失，随机分配接受 TT 贴剂（每天 300 mcg 睾酮）或相同的安慰剂贴剂（Pl）治疗 12 周。
主要观察指标为 12 周内 Sabbatsberg 性自评量表（SSS）总分的变化。还测量了 4 周内满意性事件（SSEs）的频率和女性性困扰量表修订版（FSDS-R）。
基线时，两组间无差异。12 周时，两组间 SSS 评分的变化无差异。TT 组 4 周内 SSEs 频率的增加明显大于 Pl 组（增加 2.3 次 vs. 0.1，P=0.02）。FSDS-R 评分变化的组间差异接近统计学意义（P=0.06）。TT 组在 12 周时的平均总血清睾酮水平为 2.1 nmol/L。没有女性因雄激素不良反应而退出。
与 Pl 治疗相比，TT 治疗可显著增加 SSRIs/SNRIs 引起的性欲丧失女性的 SSEs 数量。SSS 总分无改善可能反映出该工具对性功能变化测量的敏感性不足。这首次证明 TT 治疗可能是需要继续抗抑郁治疗的 SSRIs/SNRIs 引起的性欲丧失女性的治疗选择。
