No link found between low androgen levels and low sexual function in women


No link found between low androgen levels and low sexual
function in women
July 06, 2005
No single androgen (sex hormone) level was found to be
predictive of low sexual function in women, according to a study in
the July 6 issue of JAMA.


Sexual dysfunction, primarily low libido, is common among women,
with prevalences of 8 percent to 50 percent, according to
background information in the article. Although multiple
psychosocial and health factors contribute to low sexual desire and
arousal, it has been proposed that androgen levels are significant
independent determinants of sexual behavior in women. It is widely
believed that a low serum free testosterone level is the diagnostic
marker for the cluster of symptoms described as characterizing
"female androgen insufficiency" based on therapeutic trials, and
expert opinion. However, evidence that a low serum testosterone
level distinguishes women with low sexual function from others, is
lacking.


Susan R. Davis, M.D., Ph.

D., of Monash Medical School, Alfred
Hospital, Victoria, Australia, and colleagues conducted a study to
determine if low self-reported sexual function is associated with
low serum androgen levels. The study included 1,423 women aged 18
to 75 years who were randomly recruited from April 2002 to August
2003. Women were excluded from the analysis if they were younger
than 45 years and using oral contraception.

Women were surveyed
with the Profile of Female Sexual Function (PFSF) and serum levels
of total and free testosterone, androstenedione (an androgenic
steroid), and dehydroepiandrosterone sulfate (DHEAS, a natural
steroid hormone) were measured.
The researchers write: "We found no evidence of associations
between low scores for any of the sexual domains evaluated and low
serum total and free testosterone levels. In contrast, we observed
significant associations between low sexual desire, arousal, and
responsiveness in younger women [aged 18 to 44 years] and low
responsiveness in older women [aged 45 years or older] and low
serum DHEAS level relative to age."
"In addition to demonstrating that the measurement of
testosterone is not useful for the diagnosis of the proposed female
androgen insufficiency syndrome, our findings also do not support a
diagnostically useful role for the measurement of DHEAS.

This is
because despite the increased likelihood that women with low sexual
function have a low DHEAS level, the majority of women with a low
DHEAS level did not report low sexual function," the authors
write.
"Our results are not in conflict with testosterone being used
pharmacologically to treat [abnormally inactive] sexual desire
disorder, nor do they provide support for efficacy of DHEA therapy.
Rather, our data, taken together with what is already known about
the intracrine [a type of hormone function] physiology, suggest
that sex steroids influence female sexual function, but that there
is no serum androgen level that defines female androgen
insufficiency. The measurement of serum testosterone, free
testosterone, or DHEAS in individuals presenting with low sexual
function is not informative and levels of these hormones should not
be used for the purpose of diagnosing androgen insufficiency in
women," the researchers conclude.


JAMA and Archives Journals

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