Testosterone and Female Sexual Satisfaction
 
 Study reports that “A daily 90-microL dose of transdermal testosterone improves
 self-reported sexual satisfaction for premenopausal women with reduced libido and
 low serum-free testosterone levels by a mean of 0.8 SSE per month.

 Safety and efficacy of a testosterone metered-dose transdermal spray for treating decreased
 sexual satisfaction in premenopausal women: a randomized trial.”
 
 S. Davis, M.A. Papalia, R.J. Norman, S. O’Neill, M. Redelman, M. Williamson, B.G.
 Stuckey, J. Wlodarczyk, K. Gardner, A. Humberstone,Women's Health Program,
 Department of Medicine, Monash University, Alfred Hospital, Prahran, Victoria, Australia.
 susan.davis@med.monash.edu.au, Ann Intern Med. 2008 Apr 15;148(8):620-1.

 BACKGROUND: It is not known whether premenopausal women who report low sexual
 satisfaction and have low circulating testosterone levels will benefit from testosterone
 therapy. OBJECTIVE: To evaluate the effects of exogenous testosterone in premenopausal
 women reporting diminished sexual function. DESIGN:  Randomized, double-blind,
 placebo-controlled, dose-ranging trial. SETTING: 6 Australian medical centers.
 PATIENTS: 261 women age 35 to 46 years who reported a decrease in satisfying sexual
 activity relative to their younger years and had a morning serum free testosterone level less
 than 3.8 pmol/L (<1.1 pg/mL). INTERVENTION: 3 different doses of testosterone
 administered by a metered-dose transdermal spray for 16 weeks or placebo.
 MEASUREMENTS: The primary outcome was the mean number of self-reported
 satisfactory sexual events (SSEs) over 28 days at week 16. The frequency of SSEs, total
 number of sexual events (every 4 weeks), scores from the modified Sabbatsberg Sexual
 Self-Rating Scale and the Psychological General Well-Being Index, and safety variables
 were also measured. RESULTS: The number of SSEs increased during the treatment period
 in the active treatment groups and the placebo group. The mean number of SSEs over 28
 days at week 16 was statistically significantly greater for women treated with the
 intermediate dose of testosterone therapy (one 90-microL spray) than for women treated
 with placebo. The least-squares mean was 2.48 versus 1.70 SSEs, respectively (event rate
 ratio, 1.49 [95% CI, 1.01 to 2.18]; P = 0.04). The frequency of SSEs in women treated
 with low and high doses of testosterone did not differ from that in women who took
 placebo. The rate ratios based on the least- squares mean rates of SSEs during weeks 4 to
 16 for each treatment group showed statistically significant or borderline significant increases
 in all testosterone groups compared with the placebo group. The rate ratios for the one 56-
 microL spray, one 90-microL spray, and two 90-microL sprays treatment groups were
 1.34 (CI, 0.97 to 1.85; P = 0.081), 1.48 (CI, 1.07 to 2.06; P = 0.018), and 1.38 (CI,
 1.00 to 1.92; P = 0.052), respectively. At week 16, 95% of women treated with the one
 90- microL dose had a free testosterone level less than the upper limit of the reference range
 for women. The most frequently reported adverse event was hypertrichosis, which was
 dose-related and mostly confined to the application site. No clinically relevant changes in
 blood test values, serum biochemical variables, or vital signs occurred. LIMITATION: The
 study duration was short, and the placebo effect was strong. CONCLUSION: A daily 90-
 microL dose of transdermal testosterone improves self-reported sexual satisfaction for
 premenopausal women with reduced libido and low serum-free testosterone levels by a
 mean of 0.8 SSE per month. The rate of SSEs with higher and lower testosterone doses did
 not differ from that with placebo.
 
 PMID: 18413618 [PubMed - indexed for MEDLINE]