human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The efficacy and safety of testosterone treatment for hypoactive sexual desire disorder in postmenopausal women not receiving estrogen therapy  are unknown . METHODS We conducted a double-blind , placebo-controlled , 52-week trial in which 814 women with hypoactive sexual desire disorder were r and omly assigned to receive a patch delivering 150 or 300 microg of testosterone per day or placebo .  Efficacy was measured to week 24 ; safety was evaluated over a period of 52 weeks , with a subgroup of participants followed for an additional year . The primary end point was the change from baseline to week 24 in the 4-week frequency of satisfying sexual episodes . RESULTS At 24 weeks , the increase in the 4-week frequency of satisfying sexual episodes was significantly greater in the group receiving 300 microg of testosterone per day than in the placebo group ( an increase of 2.1 episodes vs. 0.7 , P<0.001 ) but not in the group receiving 150 microg per day ( 1.2 episodes , P=0.11 ) . As compared with placebo , both doses of testosterone were associated with significant increases in desire ( 300 microg per day , P<0.001 ; 150 microg per day , P=0.04 ) and decreases in distress ( 300 microg per day , P<0.001 ; 150 microg per day , P=0.04 ) . The rate of and rogenic adverse events - primarily unwanted hair growth - was higher in the group receiving 300 microg of testosterone per day than in the placebo group ( 30.0 % vs. 23.1 % ) . Breast cancer was diagnosed in four women who received testosterone ( as compared with none who received placebo ) ; one of the four received the diagnosis in the first 4 months of the study period , and one , in retrospect , had symptoms before undergoing r and omization . CONCLUSIONS In postmenopausal women not receiving estrogen therapy  , treatment with a patch delivering 300 microg of testosterone per day result ed in a modest but meaningful improvement in sexual function . The long-term effects of testosterone , including effects on the breast , remain uncertain . ( Clinical Trials.gov number , NCT00131495 . OBJECTIFS : Le role physiologique de la dehydro-epi and rosterone ( DHEA ) chez l'etre humain reste incertain . L'insuffisance surrenale entraine un deficit en DHEA . L'administration de DHEA a des sujets âges en bonne sante entraine une augmentation de la densite osseuse , de la force musculaire , de la sensation de bien-etre et des concentrations du facteur de croissance « insuline-like » ( IGF-I ) . Mais ces etudes n'ont pas utilise de question naires valides de bien-etre et la plupart etaient ouvertes sans comparaison au placebo . L'objectif de l'essai est d'evaluer les effets de la supplementation en DHEA chez des patientes ayant une insuffisance surrenale sur le bien-etre et la sexualite . METHOD ES : Vingt quatre femmes ayant une insuffisance surrenale , ont ete incluses dans un essai croise , en double insu , et ont recu 50 mg de DHEA per os chaque matin pendant 4 mois et le placebo chaque matin pendant 4 mois , l'ordre des traitements etant attribue par la r and omisation . Une periode de 1 mois sans traitement separait les 2 periodes de traitement . Ont ete mesures les hormones steroides seriques , l'IGF-I , les lipides et l'hormone « sex-binding globulin » ( SBG ) . Ont egalement ete evaluees la sensation de bien-etre et la sexualite , a l'aide de question naires psychologiques valides et d'echelles visuelles analogiques . Les femmes ont ete evaluees avant le debut du traitement , apres 1 mois et 4 mois de traitement par DHEA , apres 1 mois et 4 mois de traitement par placebo , et 1 mois apres la fin de la deuxieme periode de traitement . PATIENTS : L'âge moyen des 24 femmes est de 42 ± 9 ans , l'anciennete de l'insuffisance surrenale est de 9 ± 2 ans . L'insuffisance surrenale est primitive pour 14 femmes et secondaire pour 10 femmes . Toutes les femmes prenaient une dose reguliere de glucocorticoides et 14 prenaient egalement des mineralocorticoides .  Sept femmes etaient menopausees , 3 avaient un hypogonadisme primitif et 7 un hypogonadisme secondaire . Parmi ces 17 femmes , 13 recevaient un traitement hormonal substitutif par estroprogestatifs . RESULT ATS : Le traitement par DHEA augmente les taux seriques initiaux bas de sulfate de DHEA , d ' and rostenedione et de testosterone jusqu'a des taux normaux . Les concentrations seriques de SBG , de cholesterol total , de lipoproteines de haute densite diminuent significativement . La DHEA ameliore significativement le score global de bien-etre , de meme que les scores de depression et d'anxiete . Ainsi , le score global s'ameliore de -0,18 ± 0,29 par rapport au debut du traitement dans le groupe DHEA , contre 0,03 ± 0,29 dans le groupe placebo ( p = 0,02 ) . Comparee au placebo , la DHEA augmente significativement la frequence des pensees sexuelles ( p = 0,006 ) , de l'interet sexuel ( p = 0,002 ) et la satisfaction avec la sexualite ( p = 0,02 ) . CONCLUSION : La DHEA ameliore le bien-etre et la sexualite chez des femmes ayant une insuffisance surrenale Aging in women and men is characterized by a progressive decline of circulating dehydroepi and rosterone ( DHEA ) levels and its sulfate ester ( DHEAS ) . The improvement of wellbeing described in postmenopausal women treated with DHEA  suggests that this steroid may exert specific actions on the central nervous system ( CNS ) . The postmenopausal period is associated with several neuroendocrine modifications . The decrease of circulating levels of beta-endorphin is considered a hormonal marker of those changes . The aim of the present study was to investigate neuroendocrine and behavioral effects of three months of DHEAS supplementation in postmenopausal women . Postmenopausal women ( n = 22 ) were divided in three groups : the first group was treated with oral DHEAS ( n = 8) ( 50 mg/day ) , the second treated with the same dose of oral DHEAS + transdermal estradiol ( n = 8) ( DHEAS ) 50 mg/day , estradiol 50 micrograms/patch ) and the third with transdermal estradiol alone ( n = 6 ) ( 50 micrograms/day ) . Before and after 1 , 2 and 3 months of therapy , the following circulating steroid and protein hormone levels were evaluated : DHEA , DHEAS , and rostenedione , testosterone , estrone , estradiol , 17-hydroxyprogesterone , sex hormone-binding globulin ( SHBG ) , follicle-stimulating hormone ( FSH ) , luteinizing hormone ( LH ) , beta-endorphin , growth hormone ( GH ) and cortisol , and a Kupperman score was performed . Before and after treatments , plasma beta-endorphin levels were evaluated in response to three neuroendocrine tests : ( a ) clonidine , an alpha 2-presynaptic adrenergic agonist ( 1.25 mg i.v . ) ( b ) naloxone , an opioid receptor antagonist ( 4 mg i.v . ) and ( c ) fluoxetine , a serotonin selective reuptake inhibitor ( 30 mg p.o . ) . In both groups of women treated with  DHEAS  , mean basal serum DHEA , DHEAS , and rostenedione , and testosterone levels significantly increased after treatment , while no changes were shown in the group receiving estradiol alone . Serum estradiol , estrone , GH and plasma beta-endorphin levels significantly increased progressively for the three months of treatment , with higher levels for estrone and estradiol in subjects receiving estradiol alone or plus DHEAS . Serum SHBG , cortisol , and 17-hydroxyprogesterone did not show significant variations under any treatment . Serum LH and FSH levels showed a significant decrease in groups treated with estradiol alone or plus DHEAS at the second and third months . The Kupperman score showed that all treatments were associated with similar and progressive improvement . Before therapy clonidine , naloxone and fluoxetine stimuli failed to modify circulating beta-endorphin levels . After each of the treatments , the beta-endorphin response was completely restored and was similar , independent of the kind of therapy . Restoration of the beta-endorphin response to specific stimuli suggests that DHEAS and /or its active metabolites modulates the neuroendocrine control of pituitary beta-endorphin secretion , which may support the therapeutic efficacy of the DHEAS on behavioral symptoms Menopause is associated with decreased lean body mass and increased fat due to aging and declining hormone secretion . Estrogens or estrogen-progestins have been used to alleviate vasomotor symptoms . However , estrogen- and rogen ( E/A ) therapy is also used for vasomotor symptom relief and has been shown to increase lean body mass while decreasing fat mass . The objective of this 16-wk , double-blind , r and omized , parallel group clinical trial was to compare esterified estrogen plus methyltestosterone ( 1.25 mg estrogen + 2.5 mg methyltestosterone/d ; E/A group ) vs. esterified estrogen alone ( 1.25 mg/d ; E group ) on body composition . Forty postmenopausal women ( mean age , 57 yr ) participated . Compared with estrogen treatment alone , women in the E/A group increased their total lean body mass and reduced their percentage fat for all body parts ( P < 0.05 ) . After E/A treatment , there were statistically significant increases in lean body mass by 1.232 kg [ 0.181 + /- 0.004 , 0.81 + /- 0.057 , and 0.24 + /- 0.009 kg in the upper body ( P = 0.021 ) , trunk ( P = 0.001 ) , and lower body ( P = 0.047 ) , respectively ] . In the E group , the increase was 0.31 + /- 0.004 , 0.021 + /- 0.03 , and 0.056 + /- 0.05 kg in the upper body , trunk , and lower body , respectively . In the E/A group , body fat was reduced by 0.90 kg ( P = 0.18 for the trunk only ) , and percentage body fat declined by 7.4 % ( P < or = 0.05 for all body parts ) . Lower body strength increased by 23.1 kg ( 51 lb ) in the E/A group vs. only 11 kg ( 24.25 lb ) in the E group ( P = 0.002 between groups ) . A statistically significant increase in weight ( 2.7 + /- 5.1 vs. 0.1 + /- 4.6 lb ; P < 0.05 ) was observed in the E/A group compared with the E group . When subjects were given self-reporting question naires , more improvement was noted in sexual functioning and quality of life in the  E/A  group when compared with patients receiving E alone . There were no noteworthy side effects . In conclusion , E/A replacement therapy can improve body composition , lower-body muscle strength , quality of life , and sexual functioning in postmenopausal women OBJECTIVES This single-dose study compares three dehydroepi and rosterone delivery methods  ( oral crystalline steroid , micronized steroid , and vaginal administration ) to ascertain whether physiologic levels of circulating dehydroepi and rosterone and dehydroepi and rosterone sulfate can be obtained while increases in testosterone are minimized . STUDY DESIGN Two r and omized , double-blind , placebo-controlled single-dose comparisons were made . For oral micronized versus crystalline dehydroepi and rosterone 300 mg doses of micronized or crystalline dehydroepi and rosterone were administered , followed by 6 hours of blood sampling ( n=7 ) . Serum dehydroepi and rosterone , dehydroepi and rosterone sulfate , and testosterone levels were measured ; areas under the curve and mean peak values were analyzed by Student-Newman-Keuls tests . For oral versus vaginal micronized dehydroepi and rosterone 150 mg oral or vaginal doses of micronized dehydroepi and rosterone were administered , followed by blood sampling over 12 hours ( n=5 ) . Data analysis was as described . RESULTS Oral micronized and unmicronized dehydroepi and rosterone result ed in increases in serum dehydroepi and rosterone , dehydroepi and rosterone sulfate , 
    Output:
    
agent
There is no evidence that DHEA  improves quality of life but there is some evidence that it is associated with and rogenic side effects .
There is uncertainty whether DHEA decreases menopausal symptoms , but DHEA may slightly improve sexual function compared with placebo
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The efficacy and safety of testosterone treatment for hypoactive sexual desire disorder in postmenopausal women not receiving estrogen therapy  are unknown . METHODS We conducted a double-blind , placebo-controlled , 52-week trial in which 814 women with hypoactive sexual desire disorder were r and omly assigned to receive a patch delivering 150 or 300 microg of testosterone per day or placebo .  Efficacy was measured to week 24 ; safety was evaluated over a period of 52 weeks , with a subgroup of participants followed for an additional year . The primary end point was the change from baseline to week 24 in the 4-week frequency of satisfying sexual episodes . RESULTS At 24 weeks , the increase in the 4-week frequency of satisfying sexual episodes was significantly greater in the group receiving 300 microg of testosterone per day than in the placebo group ( an increase of 2.1 episodes vs. 0.7 , P<0.001 ) but not in the group receiving 150 microg per day ( 1.2 episodes , P=0.11 ) . As compared with placebo , both doses of testosterone were associated with significant increases in desire ( 300 microg per day , P<0.001 ; 150 microg per day , P=0.04 ) and decreases in distress ( 300 microg per day , P<0.001 ; 150 microg per day , P=0.04 ) . The rate of and rogenic adverse events - primarily unwanted hair growth - was higher in the group receiving 300 microg of testosterone per day than in the placebo group ( 30.0 % vs. 23.1 % ) . Breast cancer was diagnosed in four women who received testosterone ( as compared with none who received placebo ) ; one of the four received the diagnosis in the first 4 months of the study period , and one , in retrospect , had symptoms before undergoing r and omization . CONCLUSIONS In postmenopausal women not receiving estrogen therapy  , treatment with a patch delivering 300 microg of testosterone per day result ed in a modest but meaningful improvement in sexual function . The long-term effects of testosterone , including effects on the breast , remain uncertain . ( Clinical Trials.gov number , NCT00131495 . OBJECTIFS : Le role physiologique de la dehydro-epi and rosterone ( DHEA ) chez l'etre humain reste incertain . L'insuffisance surrenale entraine un deficit en DHEA . L'administration de DHEA a des sujets âges en bonne sante entraine une augmentation de la densite osseuse , de la force musculaire , de la sensation de bien-etre et des concentrations du facteur de croissance « insuline-like » ( IGF-I ) . Mais ces etudes n'ont pas utilise de question naires valides de bien-etre et la plupart etaient ouvertes sans comparaison au placebo . L'objectif de l'essai est d'evaluer les effets de la supplementation en DHEA chez des patientes ayant une insuffisance surrenale sur le bien-etre et la sexualite . METHOD ES : Vingt quatre femmes ayant une insuffisance surrenale , ont ete incluses dans un essai croise , en double insu , et ont recu 50 mg de DHEA per os chaque matin pendant 4 mois et le placebo chaque matin pendant 4 mois , l'ordre des traitements etant attribue par la r and omisation . Une periode de 1 mois sans traitement separait les 2 periodes de traitement . Ont ete mesures les hormones steroides seriques , l'IGF-I , les lipides et l'hormone « sex-binding globulin » ( SBG ) . Ont egalement ete evaluees la sensation de bien-etre et la sexualite , a l'aide de question naires psychologiques valides et d'echelles visuelles analogiques . Les femmes ont ete evaluees avant le debut du traitement , apres 1 mois et 4 mois de traitement par DHEA , apres 1 mois et 4 mois de traitement par placebo , et 1 mois apres la fin de la deuxieme periode de traitement . PATIENTS : L'âge moyen des 24 femmes est de 42 ± 9 ans , l'anciennete de l'insuffisance surrenale est de 9 ± 2 ans . L'insuffisance surrenale est primitive pour 14 femmes et secondaire pour 10 femmes . Toutes les femmes prenaient une dose reguliere de glucocorticoides et 14 prenaient egalement des mineralocorticoides .  Sept femmes etaient menopausees , 3 avaient un hypogonadisme primitif et 7 un hypogonadisme secondaire . Parmi ces 17 femmes , 13 recevaient un traitement hormonal substitutif par estroprogestatifs . RESULT ATS : Le traitement par DHEA augmente les taux seriques initiaux bas de sulfate de DHEA , d ' and rostenedione et de testosterone jusqu'a des taux normaux . Les concentrations seriques de SBG , de cholesterol total , de lipoproteines de haute densite diminuent significativement . La DHEA ameliore significativement le score global de bien-etre , de meme que les scores de depression et d'anxiete . Ainsi , le score global s'ameliore de -0,18 ± 0,29 par rapport au debut du traitement dans le groupe DHEA , contre 0,03 ± 0,29 dans le groupe placebo ( p = 0,02 ) . Comparee au placebo , la DHEA augmente significativement la frequence des pensees sexuelles ( p = 0,006 ) , de l'interet sexuel ( p = 0,002 ) et la satisfaction avec la sexualite ( p = 0,02 ) . CONCLUSION : La DHEA ameliore le bien-etre et la sexualite chez des femmes ayant une insuffisance surrenale Aging in women and men is characterized by a progressive decline of circulating dehydroepi and rosterone ( DHEA ) levels and its sulfate ester ( DHEAS ) . The improvement of wellbeing described in postmenopausal women treated with DHEA  suggests that this steroid may exert specific actions on the central nervous system ( CNS ) . The postmenopausal period is associated with several neuroendocrine modifications . The decrease of circulating levels of beta-endorphin is considered a hormonal marker of those changes . The aim of the present study was to investigate neuroendocrine and behavioral effects of three months of DHEAS supplementation in postmenopausal women . Postmenopausal women ( n = 22 ) were divided in three groups : the first group was treated with oral DHEAS ( n = 8) ( 50 mg/day ) , the second treated with the same dose of oral DHEAS + transdermal estradiol ( n = 8) ( DHEAS ) 50 mg/day , estradiol 50 micrograms/patch ) and the third with transdermal estradiol alone ( n = 6 ) ( 50 micrograms/day ) . Before and after 1 , 2 and 3 months of therapy , the following circulating steroid and protein hormone levels were evaluated : DHEA , DHEAS , and rostenedione , testosterone , estrone , estradiol , 17-hydroxyprogesterone , sex hormone-binding globulin ( SHBG ) , follicle-stimulating hormone ( FSH ) , luteinizing hormone ( LH ) , beta-endorphin , growth hormone ( GH ) and cortisol , and a Kupperman score was performed . Before and after treatments , plasma beta-endorphin levels were evaluated in response to three neuroendocrine tests : ( a ) clonidine , an alpha 2-presynaptic adrenergic agonist ( 1.25 mg i.v . ) ( b ) naloxone , an opioid receptor antagonist ( 4 mg i.v . ) and ( c ) fluoxetine , a serotonin selective reuptake inhibitor ( 30 mg p.o . ) . In both groups of women treated with  DHEAS  , mean basal serum DHEA , DHEAS , and rostenedione , and testosterone levels significantly increased after treatment , while no changes were shown in the group receiving estradiol alone . Serum estradiol , estrone , GH and plasma beta-endorphin levels significantly increased progressively for the three months of treatment , with higher levels for estrone and estradiol in subjects receiving estradiol alone or plus DHEAS . Serum SHBG , cortisol , and 17-hydroxyprogesterone did not show significant variations under any treatment . Serum LH and FSH levels showed a significant decrease in groups treated with estradiol alone or plus DHEAS at the second and third months . The Kupperman score showed that all treatments were associated with similar and progressive improvement . Before therapy clonidine , naloxone and fluoxetine stimuli failed to modify circulating beta-endorphin levels . After each of the treatments , the beta-endorphin response was completely restored and was similar , independent of the kind of therapy . Restoration of the beta-endorphin response to specific stimuli suggests that DHEAS and /or its active metabolites modulates the neuroendocrine control of pituitary beta-endorphin secretion , which may support the therapeutic efficacy of the DHEAS on behavioral symptoms Menopause is associated with decreased lean body mass and increased fat due to aging and declining hormone secretion . Estrogens or estrogen-progestins have been used to alleviate vasomotor symptoms . However , estrogen- and rogen ( E/A ) therapy is also used for vasomotor symptom relief and has been shown to increase lean body mass while decreasing fat mass . The objective of this 16-wk , double-blind , r and omized , parallel group clinical trial was to compare esterified estrogen plus methyltestosterone ( 1.25 mg estrogen + 2.5 mg methyltestosterone/d ; E/A group ) vs. esterified estrogen alone ( 1.25 mg/d ; E group ) on body composition . Forty postmenopausal women ( mean age , 57 yr ) participated . Compared with estrogen treatment alone , women in the E/A group increased their total lean body mass and reduced their percentage fat for all body parts ( P < 0.05 ) . After E/A treatment , there were statistically significant increases in lean body mass by 1.232 kg [ 0.181 + /- 0.004 , 0.81 + /- 0.057 , and 0.24 + /- 0.009 kg in the upper body ( P = 0.021 ) , trunk ( P = 0.001 ) , and lower body ( P = 0.047 ) , respectively ] . In the E group , the increase was 0.31 + /- 0.004 , 0.021 + /- 0.03 , and 0.056 + /- 0.05 kg in the upper body , trunk , and lower body , respectively . In the E/A group , body fat was reduced by 0.90 kg ( P = 0.18 for the trunk only ) , and percentage body fat declined by 7.4 % ( P < or = 0.05 for all body parts ) . Lower body strength increased by 23.1 kg ( 51 lb ) in the E/A group vs. only 11 kg ( 24.25 lb ) in the E group ( P = 0.002 between groups ) . A statistically significant increase in weight ( 2.7 + /- 5.1 vs. 0.1 + /- 4.6 lb ; P < 0.05 ) was observed in the E/A group compared with the E group . When subjects were given self-reporting question naires , more improvement was noted in sexual functioning and quality of life in the  E/A  group when compared with patients receiving E alone . There were no noteworthy side effects . In conclusion , E/A replacement therapy can improve body composition , lower-body muscle strength , quality of life , and sexual functioning in postmenopausal women OBJECTIVES This single-dose study compares three dehydroepi and rosterone delivery methods  ( oral crystalline steroid , micronized steroid , and vaginal administration ) to ascertain whether physiologic levels of circulating dehydroepi and rosterone and dehydroepi and rosterone sulfate can be obtained while increases in testosterone are minimized . STUDY DESIGN Two r and omized , double-blind , placebo-controlled single-dose comparisons were made . For oral micronized versus crystalline dehydroepi and rosterone 300 mg doses of micronized or crystalline dehydroepi and rosterone were administered , followed by 6 hours of blood sampling ( n=7 ) . Serum dehydroepi and rosterone , dehydroepi and rosterone sulfate , and testosterone levels were measured ; areas under the curve and mean peak values were analyzed by Student-Newman-Keuls tests . For oral versus vaginal micronized dehydroepi and rosterone 150 mg oral or vaginal doses of micronized dehydroepi and rosterone were administered , followed by blood sampling over 12 hours ( n=5 ) . Data analysis was as described . RESULTS Oral micronized and unmicronized dehydroepi and rosterone result ed in increases in serum dehydroepi and rosterone , dehydroepi and rosterone sulfate , 
    Output:
    