Testosterone Patch - Woman's Viagra
Decreasing libido is a common complaint among many women, especially those who are in the menopausal phase. Women who are on HRT during their menopausal and post-menopausal phase may not face this problem. Testosterone is a male sex hormone, though women produce small quantities of it too. It is crucial in maintaining their sex drive. HSDD (Hypoactive sexual desire disorder) is noticed in women, due to a variety of reasons. Menopause, surgical removal of ovaries, marital problems or other causes can result in low sex drive. Antidepressants are also known to reduce sexual desire. Reduced testosterone levels are a common reason.
The testosterone patch has shown a significant increase in sex drive among the women who participated in a study. There was considerable improvement in various areas of sexual functions such as arousal, responsiveness and orgasm. The women reported increased sexual activity and improved overall psychological well-being on usage of the testosterone patch. But the testosterone patch works on women who have lowered levels of testosterone which can be determined by blood tests. Decreased sex drive on account of other issues may need other forms of treatment.
Side Effects of testosterone patch: Testosterone patch side effects range from increased body hair and irritation on the patch site to URI.
Dosage of Testosterone patch:The thin transparent testosterone patch is worn on the stomach for two weeks at a time. Intrinsa - the testosterone patch that is being tested and developed is considered to be a wonder treatment for women who have suffered from lowered sex drive on account of lower testosterone levels. A slow-release testosterone patch is also on the anvil.
Andropause in men is similar to the menopause in women. Andropause is also referred to as male menopause. It is characterized by reduced production of testosterone and dehydroepiandrosterone. Symptoms experienced by middle-aged men during andropause are - fatigue, memory loss, erectile dysfunction, prostate problems, osteoporosis, weight around the belly and lowered sex drive.
The decreased concentration of the testosterone levels does not follow a gradual time span and hence there is no affirmative evidence of the abrupt drop in the testosterone levels. Some studies describe the drop in testosterone levels by symptoms such as decreased sexual activity, increase in body fat, decrease in the muscularity and also cognitive impairment. However the decrease in testosterone levels may also result in lesser bone mass, lack of energy, lethargy, mood swings and irritability. The decreased bone mass due to the andropause may also result in hip fractures in older men.
Symptoms of Andropause
Prolonged refractory period
Lack of enthusiasm
Decrease in muscle strength, mass and endurance
Decreased bone mass
The physiological factors that lead to andropause are poor hypothalamic activity, hormonal deficiencies, hypertension and obesity. Testosterone levels vary from person to person. An average value of serum testosterone levels are taken to facilitate the treatment. The average value of testosterone is greater than 200ng/dl. Any value less than the average are considered as low serum testosterone level. Analog free testosterone method is used for the diagnosis. In order to obtain accurate values of serum testosterone levels, the diagnostic blood tests should be done before 10 am in the morning.
Testosterone replacement therapy
It is employed for andropause which is proven to be the most effective treatment. The objective of this treatment methodology is to improve the libido, erectile function, muscle and bone mass restoration and also improving mental health of the individual. The apparent methods include oral sustained release medications, injections and also through transdermal patches. The advantages of testosterone replacement therapy is that it is gradual, effective and also increases the testosterone levels in a significant manner such high during the morning and gradual decrease during the course of the day.
Disadvantages of testosterone replacement therapy include conditions such as hypertension, pedal edema, liver toxicity, sleep apnea, breast enlargement in older men etc. In addition to these negative effects, inducing testosterone in to the body from external source may hinder the natural spermatogenesis process of the testes.
Gonadotropin-releasing hormone (GnRH) is a neurohormone consisting of ten amino acids which is produced by the arcuate nuclei of the hypothalamus. It is integral for starting the reproductive hormone cascade.
GnRH is secreted in the hypothalamus which is part of the brain. The hypothalamus is part of the 'Hypothalamus - Pituitary - Gonad' axis which regulates the reproductive system in men and women. Secretion of GnRH by the hypothalamus is delivered through a direct pathway between the hypothalamus and pituitary. GnRH stimulates the synthesis and secretion of two gonadotrophins namely, lutenizing hormone (LH) and follicle stimulating hormone (FSH) by the anterior pituitary gland. Controlled by internal and external factors, GnRH acts in a negative feedback loop. For instance, if there is excess FSH, LH or testosterone, then these hormones will inhibit GnRH production.
Lifestyles can also affect GnRH secretion. Lack of exercise, poor diet, opiad drugs and excessive stress can negatively affect GnRH production. What is so striking in GnRH is that under normal circumstances, GnRH is released at intervals of 90 to 120 minutes. Hence, in patients with GnRH deficiency, the releasing hormone should be administered in pulses. Constant administration of GnRH also suppresses gonadotropin secretion especially in children in puberty stage and in men with prostate cancer.
Why is GnRH treatment used?
This hormone is produced by the hypothalamus and it stimulates the pituitary gland to produce LH and FSH. Lack of GnRH in the hypothalamus can halt testosterone production in the testicles of men. In women, abnormal GnRH levels can be responsible for ovulatory disorders.
This is commonly used when Clomid treatment has not stimulated egg follicles to develop on the ovaries. GnRH works effectively to replace the natural GnRH in women and men who do not produce enough of it. Failure of release of GnRH can result in deficiency that can be partial or complete.
In a woman who is not ovulating because of lack of stimulation from hypothalamus.
In a man who is not producing sperm because his hypothalamus is not stimulating the hormones that trigger sperm production.
The use of GnRH can result in multiple pregnancies.
Some studies report that the pregnancy rate after treatment with GnRH is about 20%.
Some side effects include:
The small pump that is used for GnRH may bother some people and treatment requires daily monitoring by a doctor.
Although clinicians and scientists have observed the findings of olfactory disturbances and reproductive dysfunction, the syndrome comprising complete GnRH deficiency and lack of olfactory senses is named Kallmann Syndrome after the American geneticist Kallmann who identified this disorder in 1944.
The choice of therapy depends upon the patient's desire to achieve one or more of the following options:
In males, treatment is decided to provide androgen replacement. The patient's age, potential adverse effects of therapy, patient's desire for fertility are considered. In the prepubertal male, GnRH stimulates penile growth, body and facial hair growth, bone and muscle development and voice changes. Androgens also stimulate growth hormone production, contributing to the adolescent growth spurt. Male androgen deficiency can result in social ridicule and therefore starting androgen therapy around age 14-15 is prudent.
Oral, injectable and transdermal and implantable pellets formulation are available for treatment of males with Kallmann syndrome. Oral androgen preparations should not be used due to their toxic effects on the liver and adverse effects on lipids. Injectable long-acting testosterone are low-cost, relatively safe and effective. The disadvantages include intramuscular injection and non physiologic pattern of testosterone over the dosing interval. There could be wide swings in libido in some men.
Transdermal patches and gel preparation of testosterone are currently available - adverse effect with these formulations include skin reactions at the application. In females as in males, treatment depends upon age and fertility desires. Estrogen replacement is a must to prevent osteoporosis.
Oral preparations, transdermal patches, vaginal cream and rings are available for standard hormone replacement therapy. Transdermally administered 17 beta estradiol has been shown as an effective regimen for preventing bone loss in normal menopausal women.
Women with intact uterus receive a cyclical progestin to accompany estradiol treatment. Optimal hormone therapy depends upon whether the patient has primary or secondary amenorrhea. Gradual dose escalation results in optimal breast development and allows time for young woman to adjust psychologically to her physical maturation.
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Bibliography / Reference
Collection of Pages - Last revised Date: February 9, 2023