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Wow! A Drug That Will Let Me Have Sex Once More a Month? Sign Me Up!

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I don't care if it may give me breast cancer or heart disease. Thanks, APHRODITE Study Team!

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APHRODITE Study Team? ROTFL!

I swear to God I am not making up this goofy study name.

I wonder if the study investigators ever got horny at one of their research meetings? Or by looking at their data?

Anyway, seriously folks. The results of the "A Phase III Research Study of Female Sexual Dysfunction in Women on Testosterone Patch without Estrogen (APHRODITE)" study published in the NEJM this week showed that if post-menopausal women who have a loss of libido put a testosterone patch on their arms that they will have satisfying sex once a month more than they are currently having, although there may be a risk of breast cancer or cardiovascular disease.

I've got a tip for the marketers of this testosterone patch. If the women are having satisfying sex only once a month, and now they have it twice, why don't you say that the drug results in a 100% increase in satisfying sex!

Ha ha ha ha ha!

Okay, folks, all fun aside, lets look at the data. In this study 814 women were treated for 52 weeks with 300 or 150 microgram testosterone patches or placebo patches. There was an increase in "satisfying sexual episodes" of 2.1 in treated versus 0.7 for placebo, an increase that was statistically significant. There was about a 10% difference in scores on a sexual pleasure scale. 30% grew unwanted hair v 23% for placebo. Breast cancer was diagnosed in 4 out of 527 treated women and in none of the women on placebo.

That's right folks, sex once a month. And possible risk of getting breast cancer.

And a beard.

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Nonconclusive results about cancer, you say. And Mrs Robinson asks if she has anything to worry about.

Well a recent study found that women who naturally had the highest testosterone levels (top 25%) had a two fold increase in breast cancer compared to women in the lowest 25%.

And another study found that postmenopausal women with elevated testosterone had increases in markers of inflammation and endothelial dysfunction, C-reactive protein (CRP) and endothelin, that have been associated with increased risk of atherosclerosis.

And let's not forget the increased risk of heart disease and cancer associated with hormone replacement therapy (HRT) which I have written about before, and testosterone has to have a suspicion of similar risk.

The authors of the current study point to the fact that about a third of post-menopausal women have sexual dysfunction, and imply that even the meager gain they eak out with their patch is worth it in terms of keeping their mans happy. However they need to provide evidence for their implied claim that libido is killed by menopause and that women need to use a hormonal patch for that. They seem to hark back to the physician author of Feminine Forever, who implied that menopause was a disease to be treated with HRT, and that women became old crones, wrinkled and ugly, nasty, and incapable of sex, and that they needed HRT to treat this malady. Well, I won't belabor that now, and you can follow the links on this web site if you want to learn more about HRT, but I can tell you that controlled studies show it has no effect on libido, and only increases risk of cancer and heart disease. So there.

The authors imply that menopause is associated with an inevitable decline in libido for women, and that they need to take a drug to correct that. But I am not aware of any literature to support this conclusion, and if anyone has something, let me know. I mean, Mrs. Bremner seems to be doing okay so far.

As far as I know these testosterone patches are approved for hypogonadism in men with low testosterone, but are widely used off label for loss of libido in men and women. The APHRODITE study results may be used to promote off label use of the patches. Stay tuned.

Doug Bremner MD is author of Before You Take That Pill

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