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Low Libido Treatment

Intrinsa - NOT RECOMMENDED

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Low Libido Treatment (women only)

Testosterone Patch (Intrinsa) - NOT RECOMMENDED

Anytime Doctor is aware that some online agencies supply Intrinsa for women with low libido. Following a review of the evaluated published evidence, Anytime Doctor does NOT offer a Low Libido Consulation service for the following reasons:

1. It has not been established that androgen production in the ovaries decreases significantly during the natural menopause and there is poor correlation between androgen levels and symptoms of female sexual dysfunction.

2. It is also extremely difficult to measure testosterone levels.

3. The effect on sexual desire when compared to placebo was small and many patients did not respond to treatment.

4. The place in therapy is difficult to determine because of the limited evidence of efficacy and lack of long-term safety data.

The Drug

Intrinsa is a transdermal preparation licensed for use in women with hypoactive sexual desire disorder (HSDD). The license restricts its use to the treatment of HSDD in bilaterally oophorectomised and hysterectomised women on concomitant oestrogen.

1. Diagnosis of hypoactive sexual desire disorder (HSDD) can only be made after many months of surgery once the patients’ normal activities are resumed. HSDD is complex. Diagnosis requires a full psychological and medical assessment by a specialist.

2. Cognitive behavioural therapy and /or sex therapy may be most appropriate.

3. Testosterone implants (50 -100mg every 4-8 months) are used by some specialists.

Evidence of Effectiveness:

Efficacy for HSDD has been assessed in only two trials which were placebo controlled. Although there were improvements in the company developed efficacy tools, the clinical relevance of these results has been questioned as the effect was small. Many patients did not respond to treatment and there was also a large placebo response in these trials.

Evidence of Safety:

The most common adverse event in clinical trials was application site reactions. There was a higher rate of androgenic adverse effects with Intrinsa compared to placebo, mainly hirsutism and acne. Published data for Intrinsa are currently limited to trials of 24 weeks duration. Further data are needed to assess the long-term safety particularly with regard to cardiovascular effects, effects on breast tissue and endometrial safety (if used in non-hysterectomised women). In 2004 an FDA panel rejected a license application for Intrinsa for similar concerns.

This information is based on evidence at the time of publishing and will be reviewed when more evidence is available.

July 2009

References:

1. UK Medicines Information; New Medicines Profile: Testosterone Patch, April 2007.

2. Summary of Product Characteristics for Intrinsa (http://emc.medicines.org.uk/ – checked online July 2009)

3. Drug Tariff, July 2007.

Female sexual dysfunction

Video: Female sexual dysfunction

Denise Knowles a pyschosexual therapist discusses female sexual dysfunction

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