Tip sheet for the Annals of Internal Medicine, April 15, 2008, issue

1. Testosterone Spray Improves Sexual Satisfaction Slightly in Premenopausal Women But So Does Placebo; Editorial Says Treat Women Conventionally

A study that randomized 261 women aged 35 to 46 with self-reported low libido and low serum free testosterone levels to a group that received one of three different doses of a testosterone spray or placebo daily for 16 weeks found that all groups -- including those taking placebo--reported increased frequency of sexually satisfying events (Article, p. 569).

The difference between testosterone spray and placebo was statistically significant only for the middle dose of testosterone.

Overall, 81 percent to 86 percent of women in the active treatment groups and 70 percent of the women in the placebo group reported adverse events. The most common event in the treatment group was hair growth on the abdomen, where the testosterone was sprayed.

An editorial writer says that just because testosterone levels and women’s libidos may decline as women age does not mean that lack of testosterone explains sexual dissatisfaction (Editorial, p. 620).

“We do not have a fully satisfactory rationale for testosterone therapy,” the writer says, and there is also a “lack of long-term safety data.” Rather than prescribe testosterone, the writer advises primary physicians to address women’s mental health and relationship issues, sexual dysfunction in the partner and treat problems by conventional therapy, such as cognitive behavioral therapy, sex therapy, and psychotherapy.

2. Risks and Benefits of Buying Prescription Drugs from Foreign Countries