Management and Treatment Options
The majority of patients with androgen insufficiency exhibit reduced sexual drive, altered mood and unexplained lethargy and fatigue.
Management requires a multidisciplinary, integrated approach.
- Specific medical conditions such as iron deficiency, abnormal bleeding, diabetes, depression and thyroid disease require addressing before considering hormonal therapies.
- Lifestyle changes such as exercise, smoking, alcohol intake and weight loss need to be reviewed.
- Vaginal lubricants provide symptomatic relief for vaginal dryness and dyspareunia. Localised estrogen pessaries, vaginal tablets, creams and gels can also assist.
- Pelvic floor physiotherapy will improve vaginal muscle tone and muscle associated with orgasm, and in managing incontinence.
- Alteration of prescribed medications which may interfere with sexual function if appropriate. Especially oral HRT, OC’s and antidepressants. See Table 1.
- Testosterone therapy.
As discussed earlier (Background of Testosterone use in females) injections of testosterone and testosterone implants have largely been superceded by products designed for delivering physiological doses of testosterone appropriate for use in women. These products are:
Andro-Feme® 1% testosterone cream (Lawley Pharmaceuticals, Australia)
Intrinsa® transdermal testosterone patch (Proctor and Gamble, USA)
Andro-Feme® 1% testosterone cream (Lawley Pharmaceuticals, Australia)
Andro-Feme® 1% testosterone cream has been available in Australia since 1998 and is currently the only available approved testosterone product available for delivering testosterone safely and effectively to women. Andro-Feme® is applied topically to the inner thighs, arms and lower abdomen once daily. The dose is titratable and the usual dose is 1-2cm (5-10mg testosterone) daily (measurer included).
For Andro-Feme® Product Information details click here.
For Andro-Feme® Consumer Medication Information click here.
For further information on Andro-Feme® testosterone cream click here. www.androfeme.com.
For Health Professional Online Ordering of Andro-Feme® click here.
Intrinsa® testosterone patch (Proctor and Gamble, USA)
The testosterone patch is yet to be approved by the USA Food and Drug Administration (FDA) or the Australian Therapeutic Goods Administration (TGA). Intrinsa® has been approved by the European Agency for the Evaluation of Medicinal Products (EMEA) but is yet to be released onto the market.
It is expected that this will occur in Europe toward the end of 2007. The cost of this treatment is as yet unknown.
For further information on Intrinsa® transdermal testosterone patch click here. www.intrinsa.com.