Comparison of Androgens in Women with Hypoactive Sexual Desire Disorder: Those on Combined Oral Contraceptives (COCs) vs. Those not on COCs
ABSTRACT Introduction. Approximately one out of four sexually active women in the United States uses some form of hormonal contraceptive method because they provide the most effective reversible method of birth control available. However, little attention has been paid to possible adverse effects of combined oral contraceptives (COCs) on sexual functioning.
Aims. The aim of this study was to examine the potential effects of COCs on women with hypoactive sexual desire disorder (HSDD). It was hypothesized that female patients with generalized, acquired HSDD on COCs have lower androgen levels than those not on COCs.
Methods. The patients were healthy premenopausal women with HSDD, aged 22–50 years. Subjects had a history of adequate sexual desire, interest, and functioning. Participants were required to be in a stable, monogamous, heterosexual relationship and were screened for any medication or medical or psychiatric disorders that impact desire. The patients met operational criteria for global, acquired HSDD. The 106 patients were divided into two groups: those on COCs (N = 43) and those not on COCs (N = 63). A two-tailed t-test comparison was made between the two groups comparing free and total testosterone and sex hormone-binding globulin (SHBG).
Main Outcome Measures. The main outcome measures are the differences between the two groups comparing free testosterone, total testosterone, and SHBG.
Results. These patients with HSDD on COCs had significantly lower free and total testosterone levels compared with those who were not on COCs. The SHBG was significantly higher in the group on COCs compared with those who were not on COCs.
Conclusion. The result of this study suggests that COCs in premenopausal women with HSDD are associated with lower androgen levels than those not on COCs. Further research is required to determine if low androgen levels secondary to COCs impact female sexual desire. Warnock JK, Clayton A, Croft H, Segraves R, and Biggs FC. Comparison of androgens in women with hypoactive sexual desire disorder: Those on combined oral contraceptives (COCs) vs. those not on COCs. J Sex Med 2006;3:878–882.
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- "rilmifltir (Guay ve ark. 2004b). Oral kontraseptif alan ve almayan hipoaktif cinsel istek bozuklu¤u olan premenopozal kad›nlarda androjen düzeylerinin k›yasland›¤› bir çal›flmada, oral kontraseptif kullanan grupta serbest ve total T düzeylerinin oral kontraseptif almayan gruptan anlaml› olarak düflük, SHBG düzeyinin ise yüksek oldu¤u bulunmufltur (Warnock ve ark. 2006). Transdermal testosteron jel verilerek hipoaktif cinsel istek bozuklu¤u tedavi edilen premenopozal kad›nlarda plasebo grubundan anlaml› olarak daha fazla düzelme tesbit edilmifltir (Chudakov ve ark. 2007). Ancak , premenopozal kad›nlarda düflük androjen düzeyinin KC‹B ile iliflkisi henüz aç›k de¤ildir ve daha fazla araflt›rma yap›lmas›"
ABSTRACT: ÖZET Pek çok çal›flma cinsel ifllev bozukluunun kad›nlarda erkeklerden daha yayg›n olduunu düflün- dürtmekle birlikte, kad›n cinsel ifllev bozukluklar› (KC‹B) tedavisinde kullan›labilecek onaylanm›fl bir ilâç henüz mevcut deildir. Bununla birlikte, KC‹B tedavisiyle iliflkili birkaç ana farmakolojik yo- lak mevcuttur. Bunlar dopaminerjik agonistler, melanokortin stimüle edici hormon, adrenerjik ago- nistler, nitrik oksit sistemi, prostaglandinler ve androjenleri içerir. Bu yaz› KC‹B tedavisinde yararl› olmas› beklenen ilâç gruplar›n› gözden geçirmektedir. Anahtar Kelimeler: kad›n cinsel ifllev bozukluu, farmakolojik tedavi, kad›n cinsellii ABSTRACT The Role of Pharmacotherapy in Female Sexual Dysfunctions. Although most studies suggest that sexual dysfunctions are more prevalent in women than in men, there are currently no approved drugs for the treatment of female sexual dysfunction. However, there are several major pharmacological paths of interest related to female sexual dysfunction. These include dopaminergic agonists and related substances, melanocortin-stimulating hormones, adrenoreceptor antagonists, nitric oxide delivery systems, prostaglandins and androgens. This paper reviews the drug classes which expected to be beneficial in female sexual dysfunction.
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ABSTRACT: The reduced levels of testosterone in postmenopausal women are associated with loss of libido, decreased sexual activity, diminished feelings of physical well-being, and fatigue. A bilateral oophorectomy can lead to decreases in sexual desire in 50% of cases by removing ovarian contribution to the circulating levels of testosterone. Testosterone therapy is an option for the restoration of sexual drive. Transdermal testosterone administration may bypass the effects of first pass hepatic metabolism. To this end a series of studies have been carried out using a novel transdermal testosterone system. A review of the results from these studies are presented here. A key feature of these studies was the use of validated study instruments to measure sexual function: Sexual Activity Log (SAL), Profile of Female Sexual Function (PFSF) and Personal Distress Scale. The data from the Phase III studies, known as the Investigation of Natural Testosterone in Menopausal women Also Taking Estrogen in Surgically Menopausal women (INTIMATE SM) 1 and 2 were reviewed and the salient information is presented here. Both INTIMATE 1 and 2 showed a significant increase in total satisfying sexual activity, via the SAL in those women receiving testosterone, compared with those women in the placebo group. Total satisfying sexual activity increased by 74% and 51% for INTIMATE 1 and 2, respectively. The PFSF instrument demonstrated significant improvements in INTIMATE 1 and 2 in all domains of sexual function in testosterone-treated women compared with the placebo patients. In both studies, personal distress decreased in those patients receiving testosterone, compared with the placebo group. The most commonly reported adverse events were application site reactions. Eight-five percent of patients said they would probably or definitely continue treatment. Conclusions. The transdermal testosterone patch is an effective treatment for hypoactive sexual desire disorder in surgically postmenopausal women receiving concomitant estrogen therapy. The treatment has a favorable safety profile.Journal of Sexual Medicine 03/2007; 4 Suppl 3:227-34. DOI:10.1111/j.1743-6109.2007.00449.x · 3.15 Impact Factor
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ABSTRACT: Although women may undergo changes in sexual function during pregnancy, there are limited studies correlating possible sexual function changes to androgen blood levels during the pregnancy. To search for a possible correlation, we performed a cross-sectional observational study to assess sexual function scores and androgen blood levels of women during pregnancy. A total of 589 healthy pregnant women were recruited to the present cross-sectional study. Of these patients, 116 (19.6%), 220 (37.3%), and 253 (42.9%) were in their first, second, and third trimesters, respectively. They were evaluated with a detailed medical and sexual history, including IFSF questionnaire. In addition, maternal serum androgen levels (testosterone, dehydroepiandrosterone sulphate, free testosterone) were determined in each trimester during regular follow-ups. Assessment of Index of Female Sexual Function (IFSF) domains and serum androgen levels in each trimester. The mean age of the three groups were similar (P > 0.05). Overall, total IFSF scores of women in the first and second trimesters were 21.4 +/- 10.1 and 22.3 +/- 10, respectively, while it was 15.9 +/- 12.3 during the third trimester (P < 0.05). The most common sexual dysfunction symptom was diminished clitoral sensation, observed in 94.2% of the patients, followed by lack of libido in 92.6% and orgasmic disorder in 81%. No correlation was detected between total IFSF score and serum androgen levels. In this cross-sectional study, we noted lower sexual function scores in women in the third trimester of their pregnancies compared with those in their first two trimesters of pregnancy. These lower sexual function scores in the third trimester were not associated with lower androgen levels. We plan to perform a future prospective study to better assess both the change in sexual function and also its possible relation to androgen levels in pregnant women.Journal of Sexual Medicine 10/2007; 4(5):1381-7. DOI:10.1111/j.1743-6109.2007.00559.x · 3.15 Impact Factor