Could a patch boost female sex drive?

A patch to boost the female libido is being labelled Viagra for women. Rachel Liddle reports

What is the story?
A sex patch for women that went on sale in the UK last week will ‘boost raunchy thoughts’ and could ‘change love lives forever’, according to media reports.

Hailed as the Viagra for women, Intrinsa (testosterone) hit the headlines as a wonder cure for flagging female libidos.

The Intrinsa patch is applied to the stomach or the buttocks and works by releasing the male sex hormone testosterone into the blood stream.

Women who have trialled the patch were reported to think about sex and want it more often.

Initially, the drug will only be available on prescription to women with sexual problems. But the papers predict the patch will follow a similar path to Viagra (sildenafil) and become a ‘lifestyle’ drug for healthy adults to spice up their sex lives.

What is the research?
Intrinsa manufacturers Procter & Gamble officially launched the product in the UK this month, but it was licensed by the European Medicines Agency last July.

The testosterone patch is indicated for hyposexual desire disorder (HSDD) in women who have undergone bilateral oophorectomy or hysterectomy and are taking concomitant oestrogen therapy.

HSDD is a low libido that causes a woman distress and was recognised by the American Psychiatric Association in 1994.

In women who have undergone a surgical menopause, 29 per cent of those aged 20–49 and 46 per cent of those 50–70 years have low sexual desire, according to drug company marketing data.

The science behind Intrinsa testosterone patches is that to relieve HSDD, women need a testosterone boost.

Research has suggested that after a bilateral oophorectomy, a woman’s circulating testosterone levels typically fall by 50 per cent.

Giving a patient oral oestrogen after surgery may ameliorate vasomotor symptoms, such as vaginal dryness. But it does not necessarily boost libido.

Prescribing testosterone along with oestrogen may therefore increase sexual desire. It was decided that delivering testosterone through a transdermal patch would have the advantage of avoiding early metabolism of testosterone and provide consistent levels over time.

In research published in the Journal of Clinical Endocrinology and Metabolism in 2005, US researchers, including those at a Procter & Gamble laboratory, assessed testosterone patches in women with HSDD.

The study involved women aged 26 to 70 years who had been diagnosed with HSDD more than six months after bilateral oophorectomy and hysterectomy. To be eligible for inclusion, women had to report having a satisfying sex life before surgery and a meaningful loss of sexual desire and decrease in sexual activity after surgery.

They also had to express that they were bothered or concerned about their low desire. All women had a low testosterone level at baseline, with a median measurement of 0.8pg/ml.

For the 24-week trial, 221 women were given testosterone patches and 230 placebo.

At the end of the study, an in-crease of two episodes of ‘total satisfying sexual activity’ every four weeks was reported in the testosterone group. An increase of almost one episode every four weeks was recorded in those taking placebo.

Free testosterone levels were recorded as a median of 4pg/ml in the testosterone group and 0.7pg/ml in the placebo group.

What the researchers say?
Nick Panay, consultant gynaecologist at Queen Charlotte’s and Chelsea and Westminster Hospitals in London, has been carrying out research into the value of Intrinsa after a natural menopause.

The official launch of Intrinsa in the UK was to be accompanied by a press briefing to outline the licensed uses of Intrinsa.

But the story broke early in the Sunday Times, and Intrinsa was labelled as the female Viagra in the national press.

Gynaecologists have been giving testosterone to women with HSDD for decades, but this has been delivered as implants that each last six months, are difficult to remove and require a surgical procedure, he added.

‘There appears to be a 75 per cent increase in satisfactory sexual activity, but some women have a bigger effect, others a smaller effect. In those women for who it works, it works very well,’ said Mr Panay, who added that it should be given with oestrogen.

‘It’s important to think of it as complete package.’

Although GPs can prescribe Intrinsa, only GPSIs in women’s health may feel comfortable to do so, he said.

What do other experts say?
Peter Bowen-Simpkins, a consultant gynaecologist at Sancta Maria Hospital in Swansea and spokesman for the Royal College of Obstetricians and Gynaecologists, said it was important to recognise that Intrinsa does not work in the same way as Viagra and will not have instant effects.

But Intrinsa is a useful alternative to testosterone implants, which have been used for the past 50 years, he said.

‘Implants have only been given in specialist care, but this can be used in primary care.

‘This is a small market but it has a definite place,’ he added.

‘What it underlies is that people these days are much more prepared to talk about these things.’

GPs should tackle the question of HSDD in women who have been through the sexual menopause, said Mr Bowen-Simpkins.

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