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CLINICAL EXPERIENCES WITH TESTOSTERONE REPLACEMENT IN WOMEN
Dr. Adrian Zentner
Primary Care Physician and Medical Director of the Wellmen and Women
Too Programme, operating regular clinics in 5 capital cities across
Australia. zentner@netspace.net.au
Androgen deficiency in women is a poorly defined yet well recognized
condition characterized by otherwise unexplained fatigue, lethargy,
depression, cognitive changes and loss of libido. The causes and
significance of testosterone deficiency in women are reviewed and
two cases presented to illustrate the precautions required and the
benefits that may accrue when treating women with testosterone.
Case 1 is that of a 49 y.o. obese woman with classical symptoms
but a diagnosis of PCOS and case 2 that of a 51 y.o. with recently
treated carcinoma of the breast.
ANDROPAUSE - THE DISCONNECT
Clement E. Williams and John S Corey
Dundarave Medical Clinic, #115 - 2419 Bellevue Ave. West Vancouver,
B.C. V7V1E1, Canada.
Introduction
In most cases the treatment of the Andropause in men has neglected
their partners. The treatment of the menopause is currently in chaos
for women.
Using the current consensus and literature we have done a large
study in our Multi-Disciplinary Clinic on the premenopausal, menopausal
and post-menopausal women. The treatment involves primarily the
use of low dose estrogen and testosterone. Progesterone is used
only when indicated.
Model and methods
The management of the peri- and post-menopausal symptoms has been
under intense scrutiny for the last 2 years. The W.H.I. (Women's
Health Initiative) in the U.S.A. has created a media sensation in
the lay press. This has engendered an environment of fear regarding
hormone replacement therapy for women. The media presented some
highlights but did not express the issues. The W.H.I. study will
be summarized and has provided the focus for our research. We have
conducted our study with women between the ages of 50 and 79.
We have combined my 40 years experience treating the menopause with
the best current therapies. Patients were randomly selected out
of a large group. The history obtained includes family history,
B.M.I., lifestyle, National Survey, general habits tests, as well
as serum. estrogen, free testosterone, FSH and LH where indicated.
With breast cancer the #2 killer in women, we have increased our
mammography surveillance. We have employed the "Eve Questionnaire"
which is our female mirror image for the "Adam Questionnaire" in
men as part of our diagnostic arsenal. These questionnaires will
be taken both before and after treatment.
Conclusions
Experts agree and we have confirmed that the Hormone Therapy we
have employed remains safe and effective to help women cope with
the menopause years. Low dose Estrogen & 1/10thth the male dose
of Testosterone are prescribed. Symptoms improved significantly
and the benefits may even be anti-aging. More than 80% of the women
enjoyed improvements in vasomotor symptoms, a sense of wellness,
strength, improved mood, libido and orgasms.
This research has led us to believe that we should combine the study
of female and male medicine into a new specialty called Couples
Medicine. Those women whose Andropausal male partners are under
our care will be studied also.
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