Comparative effects of oral esterified estrogens with and without methyltestosterone on
endocrine profiles and dimensions of sexual function in postmenopausal women with hypoactive sexual desire
and Sterility, Volume 79, Issue 6, Pages 1341-1352
In some women, a decline in sexual interest accompanies a relative
androgen insufficiency after menopause. We sought to characterize the hormonal effects of the combination of oral esterified
estrogens and methyltestosterone and to investigate whether this regimen improves hypoactive sexual desire.
Double-blind randomized trial.
Healthy volunteers in a multicenter research environment.
Postmenopausal women taking estrogen therapy who were experiencing
hypoactive sexual desire.
4 months of treatment with 0.625 mg of esterified estrogens (n
= 111) or the combination of 0.625 mg of esterified estrogens and 1.25 mg of methyltestosterone (n = 107).
Main outcome measure(s)
Baseline and end-of-study measurements of total and bioavailable
testosterone and sex hormone–binding globulin (SHBG), and mean change in level of sexual interest or desire as rated
on the Sexual Interest Questionnaire.
Treatment with the combination of esterified estrogens and methyltestosterone
significantly increased the concentration of bioavailable testosterone and suppressed SHBG. Scores measuring sexual interest
or desire and frequency of desire increased from baseline with combination treatment and were significantly greater than those
achieved with esterified estrogens alone. Treatment with the combination was well tolerated.
levels of unbound testosterone and suppression of SHBG provide a plausible hormonal explanation for the significantly improved
sexual functioning in women receiving the combination of esterified estrogen and methyltestosterone.
J Reprod Med. 1998 Oct;43(10):847-56.
RESULTS: Estrogen-androgen therapy significantly improved
sexual sensation and desire after four and eight weeks of double-blind treatment in comparison to previous estrogen therapy
and postplacebo baseline assessments. . . . CONCLUSION: Sexual desire, satisfaction and frequency in postmenopausal women
taking hormonal therapy were improved significantly by combined estrogen-androgen therapy but not by estrogen or estrogen-progestin
therapy. Sexual function improved with estrogen-androgen therapy even though circulating estrogen levels were lower than those
measured during previous estrogen therapy. This leads to the conclusion that androgens play a pivotal role in sexual function
but that estrogens are not a significant factor determining levels of sexual drive and enjoyment.