A Yale University study appearing in the October issue of The Journal of Reproductive Medicine reported that estrogen-androgen therapy improved sexual sensation and desire in post-menopausal women who were dissatisfied with estrogen alone.
"These findings have significant implications for women who are taking hormone replacement therapy, particularly for long-term benefits," according to Philip Sarrel, M.D., professor of obstetrics and gynecology and of psychiatry at Yale University School of Medicine, who was principal investigator for the study. The most common reasons women discontinue hormone replacement therapy (HRT) are failure of the treatment to meet the patient's needs and side effects.
Twenty healthy post-menopausal women who were dissatisfied with their current estrogen treatment participated in a double-blind, randomized trial at Yale University. In the first two weeks, study participants continued their original estrogen-only treatments. In the following two weeks, all participants received a placebo to wash out steroid hormones that might interfere with the study.
In the final eight-week phase of the study, participants were given either a supply of estrogens (1.25 milligrams esterified estrogens) or estrogen-androgen (1.25 milligrams esterified estrogens, and 2.5 mg methyltestosterone). During estrogen-androgen therapy, estradiol and sex hormone binding globulin (SHBG) levels decreased while beta-endorphin levels did not change significantly. Estrogen increased SHBG levels and did not alter beta-endorphin levels.
Sexual function improved markedly with estrogen-androgen therapy, according to scores on several items of the Sexual Activity and Libido Scale. Statistically significant improvements were reported for combined ratings of sexual sensation and desire compared to the placebo group and previous treatment.
In general, menopausal symptoms such as hot flashes and sleep disturbance were well controlled throughout the study. "The study underscores the important role that androgen plays in the psychosexual function of women during menopause," Sarrel said. Changes in sexual function may be related to decreasing production of androgens in peri- and post-menopausal women.
The fact that loss of sexual desire was not being relieved by menopausal women taking estrogen alone was observed in a survey by Sarrel. He found that there was almost no difference when women using HRT were compared to age-matched women not using HRT. Approximately 54 percent of women taking estrogen alone complained of loss of sexual desire versus 55 percent of untreated women.
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