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Testosterone and Ovarian Failure

Study to test whether male hormone helps women with premature ovarian failure

SATURDAY, May 19, 2001 (HealthDayNews) -- Hormone-replacement therapy typically includes the two hormones most commonly associated with women -- estrogen and progestin.

But researchers say women who suffer from a condition known as premature ovarian failure may also need replacement of a hormone more commonly associated with men -- testosterone.

To find out just how important the inclusion of testosterone is in the hormone treatment that helps prevent osteoporosis in such women, researchers at the National Institute of Child Health and Human Development (NICHHD) are conducting a study on testosterone.

Women who suffer from premature ovarian failure are currently being recruited by the institute to take part in the three-year study. It will compare patients who receive testosterone in addition to estrogen and progestin with those who receive only estrogen and progestin.

Premature ovarian failure (POF) occurs when a woman's ovaries stop functioning before she turns 40. The causes for the condition are unknown, but various factors are suspected.

"In addition to genetics and chromosome abnormalities, other causes looked at include autoimmune conditions such as Addison's disease, myasthenia gravis, diabetes mellitus and hypothyroidism," says Dr. Andrew Shelling, a POF researcher at the National Women's Hospital in Auckland, New Zealand.

"Other possible causes of ovarian failure include infections, such as mumps. But no one, to the best of my knowledge, has been able to link an environmental factor," he says.

While the hormone-replacement therapy of estrogen and progestin usually offered such women is much the same as that offered to women with menopause, POF is considered a condition quite different from menopause, says the study's lead researcher, Dr. Lawrence Nelson, head of the NICHHD's Unit on Gynecologic Endocrinology.

"For one thing, the normal menopausal ovary continues to make testosterone, while there are these deficiencies in women with POF. So, considering the effect of testosterone on normally menopausal women is a different issue that we're not looking at here," Nelson says.

The combination of high levels of bone-density loss and the lower-than-average testosterone levels among women with POF prompted Nelson and his colleagues to conduct the study.

"Testosterone just hasn't been seen as one of the hormones that the ovary makes that women with POF need to replace. But that may need to change because the normal ovary indeed makes a small amount of testosterone that's an important part of women's hormonal equation," Nelson says.

The study will be divided into three groups, each with 55 women. The first group of women with premature ovarian failure will wear an experimental skin patch that delivers the amount of testosterone normally produced by the ovary in healthy young women.

These women will be compared to a second group of women with premature ovarian failure who will wear a placebo patch -- a patch that delivers no hormone.

Women in both groups will also wear a patch that delivers estrogen and take tablets containing progestin.

These two groups will be compared with a third group of women who have normal ovarian function.

All women in the study will receive periodic scans to measure bone density, as well as tests of cognition, mood, well being, and sexual function, among others.

Many experts believe that, in addition to playing a key role in maintaining a woman's sexual desire and other aspects of sexual function, testosterone may contribute to women's bone and muscle mass, strength, energy level, memory and a positive sense of well being.

What To Do

For information on how to participate in the NICHHD study, potential volunteers with premature ovarian failure -- as well as women with normally functioning ovaries -- who are between the ages of 18 and 42 should contact Vien Vanderhoof by calling toll free, 877-206-0911.

Visit the POF Support Group for more information about premature ovarian failure.

Or read more about premature ovarian failure in this HealthScout story.

If you're interested in clinical trials on reproductive conditions, check out this information from Veritas.

SOURCES: Interviews with Lawrence Nelson, M.D., lead researcher and head of the National Institute of Child Health and Human Development's Unit on Gynecologic Endocrinology, Bethesda, Md.; Andrew Shelling, M.D., premature ovarian failure researcher, National Women's Hospital, Auckland, New Zealand; NICHHD press release
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