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Testosterone for peri- and postmenopausal women.
The Cochrane Database of Systematic Reviews
|October 20, 2005
Summary
Adding testosterone to hormone therapy (HT) can improve sexual function in postmenopausal women but may lower HDL cholesterol. More research is needed for perimenopausal women and specific HT combinations.
Area of Science:
- Reproductive Endocrinology
- Menopause Management
- Pharmacological Interventions
Background:
- The role of testosterone supplementation in hormone therapy (HT) for peri- and postmenopausal women remains controversial.
- Existing evidence on testosterone's benefits and risks alongside HT has not been systematically reviewed.
- This review addresses the uncertainty surrounding testosterone's value in menopausal hormone therapy.
Purpose of the Study:
- To systematically review the benefits and risks of incorporating testosterone therapy with standard hormone therapy.
- To evaluate testosterone's impact on sexual function and safety profiles in peri- and postmenopausal women.
- To synthesize evidence from randomized controlled trials comparing testosterone plus HT versus HT alone.
Main Methods:
- Comprehensive literature search across multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to November 2003.
- Inclusion of randomized controlled trials comparing testosterone + HT versus HT alone in peri- or postmenopausal women.
- Independent quality assessment and data extraction, with statistical analysis using Peto odds ratios and mean differences; random-effects models used for heterogeneity.
Main Results:
- Twenty-three trials involving 1957 participants were analyzed, with a median study duration of 6 months.
- Testosterone addition to HT significantly improved sexual function scores in postmenopausal women.
- A notable adverse effect was a decrease in high-density lipoprotein (HDL) cholesterol; no significant increase in discontinuation rates was observed.
Conclusions:
- Evidence suggests testosterone supplementation enhances sexual function in postmenopausal women using HT, despite a reduction in HDL cholesterol.
- Limited study numbers and heterogeneity in testosterone regimens restrict definitive conclusions on efficacy and safety.
- Further research is required to clarify effects in perimenopausal women and specific HT combinations.