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What Should Women Know About Testosterone Therapy?

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What Should Women Know About Testosterone Therapy?Some postmenopausal women with low libido might benefit from testosterone therapy, according to recently-issued guidelines.

The “Global Consensus Position Statement on the Use of Testosterone Therapy in Women” was developed by a panel of experts to guide healthcare providers who prescribe hormonal therapy to women. The statement was endorsed by 11 medical organizations, including the International Society for Sexual Medicine (ISSM) (The Sexual Medicine Society of North America, which produces SexHealthMatters.org, is affiliated with the ISSM.)

While the news may be a step forward for women’s sexual health, the panel was very specific in its recommendations, which covered how testosterone should be measured, prescribed, and monitored.

Here are some key points from the statement:

Testosterone therapy may be recommended for women with hypoactive sexual desire disorder (HSDD), but not for women with other types of sexual problems.

HSDD is a persistent lack of sexual desire that has no apparent cause. For example, it’s not a medication side effect, and it’s not a result of other health conditions associated with low libido. Another component of HSDD is distress. Women who have HSDD are bothered by their low sex drive. It might cause stress in their relationship, or they might miss the intimacy they once shared with a partner.

Testosterone therapy may be recommended for postmenopausal women, but not premenopausal women.

The menopause distinction is important. Currently, scientists don’t have enough information to recommend the use of testosterone in women who have not gone through menopause.

During menopause, a woman’s estrogen levels decline, and she stops having menstrual periods. Testosterone levels decline, too.

Women are considered to be postmenopausal (finished with menopause) when they have gone 12 months without a menstrual period. Before this benchmark, periods may be irregular, and many women think they have finished menopause when in fact they haven’t. Women who are unsure of their menopausal status should talk to their gynecologist.

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Birth Control Pills for Men are Possible, Studies Suggest

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Birth Control Pills for Men are Possible, Studies SuggestBirth control pills may eventually be available for men, scientists say.

A final product may still be years in the making, but researchers have deemed the medications safe and tolerable for healthy men.

The results of one study were presented at the annual meeting of the Endocrine Society in March 2019.

The drug, 11-beta-MNTDC, may reduce the production of sperm without decreasing a man’s libido. The drug behaves like testosterone, the hormone that drives sexual desire and gives men some of their masculine characteristics. But it does not trigger sperm production in the testes.

Forty healthy men participated in the 28-day study. Each day, 14 men took 200 mg of the 11-beta-MNTDC drug, and 16 men took 400 mg. The remaining 10 men took a placebo pill.

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Peyronie’s Disease: More Men Receiving CCH Injections

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Peyronie’s Disease: More Men Receiving CCH Injections Nowadays, more men with Peyronie’s disease are being treated with injections of collagenase clostridium histolyticum (CCH) than surgery, according to recent research.

Peyronie’s disease is characterized by plaques of hardened scar tissue that form on the penis, just below the skin’s surface. The plaques make the penis lose some of its flexibility. As a result, the penis starts to bend. Sometimes, the curve is so severe that intercourse is difficult. Men with Peyronie’s disease may also experience pain and erectile dysfunction (ED).

Surgery to correct the curve is a common treatment. CCH injections, which are targeted directly at the plaques, were approved in 2014.

The study findings are based on insurance claims data for 36,156 men who were first diagnosed with Peyronie’s disease between 2011 and 2017. Diagnosis rates did not change much during that period.

In 2014, the treatment rate with either CCH or surgery was 9.8%, but the rate rose to 15.5% by 2017, reflecting an increase in men undergoing CCH injections. After CCH injections were approved, their use as a first-line treatment increased an average of 1.6% per year.

The ratio of CCH to surgery as a first-line treatment increased from 1:1 in 2014 to about 2:1 by 2017.

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Low Testosterone Common in Germ Cell Tumor Survivors

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Low Testosterone Common in Germ Cell Tumor SurvivorsIn a recent study of germ cell tumor survivors, roughly half had hypogonadism – low testosterone – regardless of whether they were treated with surgery alone or surgery with platinum-based chemotherapy, scientists report in the journal Supportive Care in Cancer.

However, patients who had chemotherapy added to their surgical treatment were more likely to have male aging symptoms.

Germ cells are reproductive cells: egg cells in females and sperm cells in males. Tumors form when these cells grow and accumulate in an abnormal way. Some germ cell tumors are cancerous. When they are, they usually develop into ovarian cancer or testicular cancer.

The study included 199 germ cell tumor survivors between the ages of 18 and 50. Each participant completed a quality of life questionnaire at the start of the study and again three and six months later.

About 48% of the entire group had low testosterone. (For this study, hypogonadism was diagnosed if a man’s testosterone levels were below 300 ng/dL.)

Next, the researchers looked at testosterone levels based on type of treatment. Among patients who had had both surgery and chemotherapy, the low testosterone rate was 51%. For those who had surgery alone, the rate was 45%.

Patients who had low testosterone levels were more likely to have reported fatigue, poor sleep quality, and worse general health at the start of the study.

When the scientists compared quality of life assessment scores for the two groups, they found no statistically significant differences. However, those who had had both surgery and chemotherapy “exhibited more symptoms related to male aging.”

Resources

Mayo Clinic

“Germ cell tumors”

(May 25, 2019)

https://www.mayoclinic.org/diseases-conditions/germ-cell-tumors/symptoms-causes/syc-20352493

Oncology Learning Network

Porcelli, Hina

“Surgery With or Without Chemo Yields Low Testosterone in GCT Survivors”

https://www.oncnet.com/news/surgery-or-without-chemo-yields-low-testosterone-gct-survivors

Ovarian Cancer Research Alliance

“Chemotherapy”

https://ocrahope.org/patients/about-ovarian-cancer/treatment/chemotherapy/

Supportive Care in Cancer

Khanal, N., et al.

“The effects of hypogonadism on quality of life in survivors of germ cell tumors treated with surgery alone versus surgery plus platinum-based chemotherapy”

(Abstract. Published: November 9, 2019)

https://link.springer.com/article/10.1007/s00520-019-05117-0

WebMD

“What Are Germ Cell Tumors?”

(Reviewed: October 12, 2019)

https://www.webmd.com/cancer/germ-cell-tumors#1

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