Effects of testosterone treatment on clitoral haemodynamics in women with sexual dysfunction.

S Cipriani, E Maseroli, V Di Stasi, I Scavello, T Todisco, G Rastrelli, M Fambrini, F Sorbi, F Petraglia, E A Jannini, M Maggi, L Vignozzi

Journal: Journal of endocrinological investigation 2022;44(12):2765-2776

PMID: 34118018

Abstract

PURPOSE

To explore the effects of 6-month systemic testosterone (T) administration on clitoral color Doppler ultrasound (CDU) parameters in women with female sexual dysfunction (FSD).

METHODS

81 women with FSD were retrospectively recruited. Data on CDU parameters at baseline and after 6 months with four different treatments were available and thus further longitudinally analyzed: local non-hormonal moisturizers (NH group), n = 37; transdermal 2% T gel 300 mcg/day (T group), n = 23; local estrogens (E group), n = 12; combined therapy (T + E group), n = 9. Patients underwent physical, laboratory, and genital CDU examinations at both visits and completed different validated questionnaires, including the Female Sexual Function Index (FSFI).

RESULTS

At 6-month visit, T therapy significantly increased clitoral artery peak systolic velocity (PSV) when compared to both NH (p < 0.0001) and E (p < 0.0001) groups. A similar increase was found in the T + E group (p = 0.039 vs. E). In addition, T treatment was associated with significantly higher FSFI desire, pain, arousal, lubrication, orgasm, and total scores at 6-month visit vs. baseline. Similar findings were observed in the T + E group. No significant differences in the variations of total and high-density lipoprotein-cholesterol, triglycerides, fasting glycemia, insulin and glycated hemoglobin levels were found among the four groups. No adverse events were observed.

CONCLUSION

In women complaining for FSD, systemic T administration, either alone or combined with local estrogens, was associated with a positive effect on clitoral blood flow and a clinical improvement in sexual function, showing a good safety profile.

TRIAL REGISTRATION NUMBER

NCT04336891; date of registration: April 7, 2020.

© 2021. The Author(s).

Address: Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Gaetano Pieraccini 6, 50139, Florence, Italy.; Department of Experimental, Clinical and Biomedical Sciences "Mario Serio", Gynecology Unit, University of Florence, Florence, Italy.; Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.; Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.; I.N.B.B. (Istituto Nazionale Biostrutture E Biosistemi), Rome, Italy.; Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Gaetano Pieraccini 6, 50139, Florence, Italy. [email protected].; I.N.B.B. (Istituto Nazionale Biostrutture E Biosistemi), Rome, Italy. [email protected].
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