Endocrine Abstracts

Introduction: It has been suggested that sexual dysfunction affects as many as 43% of women in the population. In relation to this, symptoms of hypoactive sexual desire disorder (HSDD) can be alleviated with testosterone replacement.

Aim: To determine what is the pre- and 24-hour post dose circulating level of testosterone in women applying Testogel 16.2 mg/g.

Methods: In a group of 10 menopausal women applying Testogel 16.2 mg/g at the dose of 20.25 mg every 3-4 days as part of their usual care together with oestrogen +/- progestogen HRT, we measured serum testosterone/free androgen index (FAI) pre-application of Testogel and 24 hours after its application. Testosterone was measured by mass spectrometry. The Female Sexual functioning Index (FSFI) was completed by the women.

Results: Mean pre-Testogel administration testosterone level (corresponding to a trough level) was 0.7: 0.65-1.5 nmol/l (median: 25-75% interquartile range) rising at 24 hours post Testogel to 3.2: 2.7-5.3) nmol/l. Free Androgen Index (testosterone/SHBGx100) pre-Testogel was 1.5:0.6-3.7) (ref range 4.5 or less) rising to 5.7: 3.4-7.2) at 24 hours post Testogel. The rise in serum testosterone was not associated with any untoward effects in terms of hirsutism/acne. Range of duration of treatment with Testogel was 6 months-12 years. All women reported an improvement in sexual function with Testogel. FSFI median score was 24.5/36(25-75% interquartile range 18-28 with highest domain scores for sexual satisfaction and arousal (4.2/6) and moderate scores for orgasm and desire (3.6/6) with lowest domain score for lubrication (2.4/6) and no reported issues re pain on intercourse.

Conclusions: The increase in serum testosterone level after application of Testogel was not associated with untoward reported/manifest consequences, likely because the elevation is short-lived. FSFI score indicated reasonable sexual function in this group of women treated with Testogel for HSDD. Next step will be a 24hour day-curve pharmacokinetic profile.