The seventh publication of the Journal of Sexual Medicine’s methodology update series will be Dr. Tami Rowen’s “Methodological Challenges in Studying Testosterone Therapies for Hypoactive Sexual Desire Disorder in Women,” which was published in JSM’s April 2020 issue (https://doi.org/10.1016/j.jsxm.2019.12.013).
Tami S. Rowen, MD, MS, is an Assistant Professor of Obstetrics, Gynecology and Gynecologic Surgery at the University of California San Francisco, with research focusing on various areas including sexual health and gynecologic care for women with disabilities as well as cancer.
To get a more in-depth understanding of the thoughts behind her paper, we conducted a text interview with Dr. Rowen:
1. What can the reader learn from the paper?
“This paper highlights the methodological challenges in studying testosterone for HSDD in women. The reader can learn about who is studied, how they are studied, what the relevant outcomes are and what the confounders are. We also write about the challenges in bringing a testosterone product to market.”
2. What are the challenges when performing trials on the effect of testosterone for women?
“The population has overall been very homogeneous. This often is a byproduct of RCT design; we want to avoid confounders, but this leads to limitations in generalizability. We don't know how testosterone may affect women at the edges of age, those with medical comorbidities for example. We also don't have great scales to measure desired outcomes, there are a variety of patient reported outcomes, but we are still challenged to find one that is most relevant to HSDD.”
3. Which women are testosterone treatment for?
“In the context of this paper, we are focusing on postmenopausal women with hypoactive sexual desire disorder. There is limited data in premenopausal women and also on the use of topical testosterone for local vulvovaginal symptoms that contribute to sexual dysfunction.”
4. What are the advantages and pitfalls when treating women with testosterone?
“Testosterone is overall very safe and does have evidence to show efficacy. If used correctly, there are very few systemic side effects, and these are very different from the FDA approved treatments for HSDD (which focus on premenopausal women). The pitfalls are that there is no FDA approved product, thus providing women this treatment is a challenge. If taken in higher doses, there can be systemic side effects of hyperandrogenemia.”
5. What do you hope the future will bring?
“I hope that we will continue to study this as a potential treatment and look towards an FDA approved product. Ideally we can include heterogenous women in these studies and find an ideal patient reported outcome so that we can better understand who is best served by this treatment.”
About 60% of British couples are having sex less than once a week during the COVID-19 pandemic, according to a new Journal of Sexual Medicine study.
Researchers surveyed 868 adults in the United Kingdom who were social distancing due to the coronavirus.
Respondents were having sex an average of 1.75 times per week. Sexual frequency was higher for men than for women. Approximately 40% said they were sexually active at least once a week.
What are the implications of these findings? Find out here.