Nelson Vergel
Founder, ExcelMale.com
Androgens and Female Sexual Function and Dysfunction—Findings From the Fourth International Consultation of Sexual Medicine
The literature supports an important role for androgens in female sexual function. There is no blood androgen level below which women can be classified as having androgen deficiency. Clinical trials have consistently demonstrated that transdermal testosterone (T) therapy improves sexual function and sexual satisfaction in women who have been assessed as having hypoactive sexual desire disorder. The use of T therapy is limited by the lack of approved formulations for women and long-term safety data. Most studies do not support the use of systemic dehydroepiandrosterone therapy for the treatment of FSD in women with normally functioning adrenals or adrenal insufficiency. Studies evaluating the efficacy and safety of vaginal testosterone and dehydroepiandrosterone for the treatment of vulvovaginal atrophy are ongoing.
Article Outline
Introduction
Methods
Overview of Androgen Physiology in Women
Sex Steroid Measurements: Problems of Quality Control, Accuracy, and Sensitivity for T Assays
Evidence From Observational Studies That T and Other Androgens Play an Important Role in Human FSD (Level 2 Evidence)
Studies to Elucidate the Role of T in Female Sexual Function (Level 2 Evidence)
Evidence of T Effects From Clinical Trials of Systemic T Therapy
Clinical Trials of Naturally and Surgically Postmenopausal Women (Level 1 Evidence)
Clinical Trials of T Therapy in Women Taking Antidepressant Therapy (Level 1 Evidence)
Evidence From Studies of Women With POF/POI (Level 2 and 3 Evidence)
Recommendations
Evidence of Benefits of Topical Vaginal T (Level 2 and 3 Evidence):
Use of DHEA for Treatment of FSD
Evidence of Effects From Clinical Trials of Systemic DHEA Therapy (Level 1 Evidence)
Recommendation
Evidence of Benefits of Topical Vaginal DHEA (Level 2 Evidence):
Recommendation
Conclusions
References
The literature supports an important role for androgens in female sexual function. There is no blood androgen level below which women can be classified as having androgen deficiency. Clinical trials have consistently demonstrated that transdermal testosterone (T) therapy improves sexual function and sexual satisfaction in women who have been assessed as having hypoactive sexual desire disorder. The use of T therapy is limited by the lack of approved formulations for women and long-term safety data. Most studies do not support the use of systemic dehydroepiandrosterone therapy for the treatment of FSD in women with normally functioning adrenals or adrenal insufficiency. Studies evaluating the efficacy and safety of vaginal testosterone and dehydroepiandrosterone for the treatment of vulvovaginal atrophy are ongoing.
Article Outline
Introduction
Methods
Overview of Androgen Physiology in Women
Sex Steroid Measurements: Problems of Quality Control, Accuracy, and Sensitivity for T Assays
Evidence From Observational Studies That T and Other Androgens Play an Important Role in Human FSD (Level 2 Evidence)
Studies to Elucidate the Role of T in Female Sexual Function (Level 2 Evidence)
Evidence of T Effects From Clinical Trials of Systemic T Therapy
Clinical Trials of Naturally and Surgically Postmenopausal Women (Level 1 Evidence)
Clinical Trials of T Therapy in Women Taking Antidepressant Therapy (Level 1 Evidence)
Evidence From Studies of Women With POF/POI (Level 2 and 3 Evidence)
Recommendations
Evidence of Benefits of Topical Vaginal T (Level 2 and 3 Evidence):
Use of DHEA for Treatment of FSD
Evidence of Effects From Clinical Trials of Systemic DHEA Therapy (Level 1 Evidence)
Recommendation
Evidence of Benefits of Topical Vaginal DHEA (Level 2 Evidence):
Recommendation
Conclusions
References
