TESTOSTERONE ENHANCES ESTRADIOLS EFFECTS ON POSTMENOPAUSAL BONE-DENSITY AND SEXUALITY
TESTOSTERONE ENHANCES ESTRADIOLS EFFECTS ON POSTMENOPAUSAL BONE-DENSITY AND SEXUALITY
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DOI：
10.1016/0378-5122(94)00898-h
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发表时间：
1995-04-01
期刊：
影响因子：
4.9
通讯作者：
BURGER, H
中科院分区：
文献类型：
--
作者：
DAVIS, SR;MCCLOUD, P;BURGER, H
为了研究雄激素在增加绝经后妇女骨密度和改善性欲低下方面的作用，我们在一项前瞻性、为期2年的单盲随机试验中研究了雌二醇和睾酮植入物对骨密度和性行为的长期影响。34名绝经后志愿者被随机分为两组，一组单独使用雌二醇50毫克(E)，另一组使用雌二醇50毫克加睾酮50毫克（EandT），每3个月服用一次，持续2年。子宫完整的女性服用周期性口服黄体酮。32名女性完成研究，两组患者全身、腰椎（L1-L4）和髋面积的骨密度（DEXA）均显著增加。睾酮治疗组在所有部位的骨密度增加更快，EandT组在全身（P < 0.008），椎体L1-L4 （P < 0.001）和转子（P < 0.005）测量的骨密度显著增加。两组的各项性指标（Sabbatsberg性自评量表）均有显著改善，睾酮组在性活动（P < 0.03）、满意度（P < 0.03）、愉悦感（P < 0.01）、性高潮（P < 0.035）和相关性（P < 0.05）方面的改善显著高于对照组，两组的总胆固醇和LL - l -胆固醇及体脂均有所下降。我们得出结论，在绝经后妇女中，联合使用雌二醇和睾酮植入物比单独使用雌二醇植入物更有效地增加了髋部和腰椎的骨矿物质密度，在性行为方面观察到更大的改善，验证了睾酮植入物对绝经后妇女性欲减退的治疗价值。在接受T治疗的妇女中，有利的雌激素对脂质的影响被保留下来，与身体成分的有益变化有关。
To investigate the role of androgens in increasing bone density and improving low libido in postmenopausal women, we have studied the long-term effects of estradiol and testosterone implants on bone mineral density and sexuality in a prospective, 2 year, single-blind randomised trial. Thirty-four postmenopausal volunteers were randomised to treatment with either estradiol implants 50 mg alone (E) or estradiol 50 mg plus testosterone 50 mg (EandT), administered 3-monthly for 2 years, Cyclical oral progestins were taken by those women with an intact uterus. Thirty-two women completed the study, BMD (DEXA) of total body, lumbar vertebrae (L1-L4) and hip area increased significantly in both treatment groups. BMD increased more rapidly in the testosterone treated group at all sites, A substantially greater increase in BMD occurred in the EandT group for total body (P < 0.008), vertebral L1-L4 (P < 0.001) and trochanteric (P < 0.005) measurements. All sexual parameters (Sabbatsberg sexual self-rating scale) improved significantly in both groups, Addition of testosterone resulted in a significantly greater improvement compared to E for sexual activity (P < 0.03), satisfaction (P < 0.03), pleasure (P < 0.01), orgasm (P < 0.035) and relevancy (P < 0.05), Total cholesterol and LL)L-cholesterol fell in both groups as did total body fat. Total body fat-free mass (DEXA, anthropometry, impedance) increased in the EandT group only, We concluded that in postmenopausal women, treatment with combined estradiol and testosterone implants was more effective in increasing bone mineral density in the hip and lumbar spine than estradiol implants alone, Significantly greater improvement in sexuality was observed with combined therapy, verifying the therapeutic value of testosterone implants for diminished libido in postmenopausal women. The favourable estrogenic effects on lipids were preserved in women treated with T, in association with beneficial changes in body composition.