A new analysis of published research suggests that testosterone therapy may aid many post-menopausal women dealing with loss of libido. The analysis -- labeled a position statement from the North American Menopause Society (NAMS) and published in its journal, Menopause -- states that testosterone "has a positive effect on sexual function, primarily desire, arousal, and orgasmic response, in women after spontaneous or surgically induced menopause."
The report was sponsored by Proctor & Gamble, the maker of Intrinsa, a women's testosterone patch rejected by the Food and Drug Administration (FDA) last year. It recommends testosterone for post-menopausal women with diminished sexual function, but it says this advice applies only to women taking concurrent estrogen therapy. Not enough evidence exists to make recommendations for women not taking estrogen or for those who wish to use testosterone therapy for longer than six months, the report states. The report's conclusions are based on randomized, controlled clinical trials, as well as meta-analyses and systematic reviews. Safety and efficacy data regarding pre-menopausal and peri-menopausal women are lacking, according to the report.
The statement is based on an analysis of data involving prescription testosterone products available in the United States and Canada. NAMS said it conducted the inquiry to respond to the need for clearer clinical standards in treating menopause-associated health conditions.
NAMS -- a nonprofit that reports a membership of 2,000 practitioners, scientists and other professionals and receives funding from various industry sources -- acknowledges that published data on testosterone are limited, but it says the evidence is consistent.
"Adding either oral or nonoral testosterone to estrogen therapy results in a positive effect on sexual function, primarily an increase in sexual desire," the statement says. It suggests the use of transdermal patches and topical creams or gels rather than oral medications because adverse liver effects have been associated with oral testosterone.
But some women's health groups have concerns about the long-term safety of testosterone and oppose use of the drug until more research is competed. Several argued against approval of Intrinsa, and an FDA advisory committee decided that such concerns outweighed the product's potential benefits.
"The world changed when the Women's Health Initiative (WHI) revealed the negative long-term health effects of hormone therapy," wrote Amy Allina, program director of the National Women's Health Network (a nonprofit that says it does not receive industry funding), in a statement to the FDA in December. "A six-month study of a testosterone patch that would be the first drug of its kind may have seemed adequate before, but it's not today. . . . In the wake of the WHI, it's appropriate and necessary to exercise special caution about the safety of long-term hormone use without long-term data."
-- January W. Payne