Third Annual Female Sexual Function Forum: New Perspectives in the Management of Female Sexual Dysfunction

Lorraine Dennerstein, AO, MBBS, PhD, DPM, FRANZCP


December 05, 2000

In This Article


There was a great deal of interest in the role androgen insufficiency may be playing in complaints of female sexual dysfunction. Dr. Andre Guay,[33] of the Lahey Clinic, Peabody, Massachusetts, presented a literature review and findings from a small sample of women presenting with sexual dysfunction, which suggested that both premenopausal and postmenopausal women with sexual dysfunction may have lower androgen levels (total testosterone, free testosterone, and dehydroepiandrosterone [DHEA]-S) than laboratory reference ranges. He also presented uncontrolled clinical trial data that found improvement in libido when women were given DHEA oral treatment. While these data are interesting and worthy of further study, there is a need for caution. There are methodologic problems in assay techniques, much of the data in the literature is cross-sectional, and there is a lack of population-based samples to construct reference ranges and to determine whether women with sexual dysfunction do have significantly different androgen levels compared with age-matched and menopause status-matched controls.

A recent analysis of longitudinal data from the Melbourne Women's Midlife Health Project[34] found no significant change in total testosterone levels with menopausal status during the years of study. Sex hormone binding globulin fell significantly with the menopausal transition so that there was a significant increase in free or bioavailable testosterone. DHEA-S did not change significantly with the menopausal transition but did fall significantly with aging.


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