to 0.41, p<0.001) Satisfaction with sex and relationship (SMD 0.83, 95% CI 0.28 to 1.37, p=0.003) Less concerns about sexual function impairment (SMD 0.24, 95% CI 0.03 to 0.44, p=0.23) Authors’ conclusion: the improvement in sexual function associated with Testosterone use in postmenopausal women, long-term safety “Despite data are lacking.” Somboonporn et al (2005)6, testosterone with MHT 35 RCTs Peri menopausal Testosterone (all Menopause Menopausal Testosterone plus (1)Yes. Included a (N=4768) women and formulations) plus hormone symptoms; menopause hormone comprehensive women who had menopause therapy alone Sexual therapy versus database search as entered a hormone therapy (1.25mg/day) function; menopause hormone well as a search for naturally or (CEE 0.625 Unexplained therapy sexual unpublished data. – mg/day fatigue; function (2)Yes. Quality -CEE 1.25 mg/day Breast cancer; Number of satisfying assessed by two menopause and (high dose) sexual events (SMD independent were using -CEE 0.625 mg 0.29, 95% CI 0.20 to assessors. hormone therapy. plus mT 1.25 0.38) (3)Yes. Results Participants with mg/day Total number of sexual expressed as odds breast cancer -CEE 1.25 mg plus events (SMD 0.25, 95% ratio or weighted were included mT 2.5 mg/day CI 0.17 to 0.34) mean difference. (high dose) or Number of orgasms (4)Yes. Statistical and Oestrogen plus (SMD 0.30, 95% CI 0.21 clinical Testosterone 300 to 0.39) heterogeneity was microgram/day Degree of libido or explored. or EE 0.625 desire (SMD 0.35, 95% CI SR risk of bias: Low mg/day 0.26 to 0.43) EB risk of bias: -EE 1.25 mg/day Moderate
to 0.41, p<0.001) Satisfaction with sex and relationship (SMD 0.83, 95% CI 0.28 to 1.37, p=0.003) Less concerns about sexual function impairment (SMD 0.24, 95% CI 0.03 to 0.44, p=0.23) Authors’ conclusion: “Despite the improvement in sexual function associated with Testosterone use in postmenopausal women, long-term safety data are lacking.” Somboonporn et al (2005)6, testosterone with MHT 35 RCTs (N=4768) Peri menopausal women and women who had entered a naturally or menopause and were using hormone therapy. Participants with breast cancer were included Testosterone (all formulations) plus menopause hormone therapy (CEE 0.625 mg/day -CEE 1.25 mg/day (high dose) -CEE 0.625 mg plus mT 1.25 mg/day -CEE 1.25 mg plus mT 2.5 mg/day (high dose) or Oestrogen plus Testosterone 300 microgram/day or EE 0.625 mg/day -EE 1.25 mg/day Menopause hormone therapy alone (1.25mg/day) Menopausal symptoms; Sexual function; Unexplained fatigue; Breast cancer; Testosterone plus menopause hormone therapy versus menopause hormone therapy – sexual function Number of satisfying sexual events (SMD 0.29, 95% CI 0.20 to 0.38) Total number of sexual events (SMD 0.25, 95% CI 0.17 to 0.34) Number of orgasms (SMD 0.30, 95% CI 0.21 to 0.39) Degree of libido or desire (SMD 0.35, 95% CI 0.26 to 0.43) (1)Yes. Included a comprehensive database search as well as a search for unpublished data. (2)Yes. Quality assessed by two independent assessors. (3)Yes. Results expressed as odds ratio or weighted mean difference. (4)Yes. Statistical and clinical heterogeneity was explored. SR risk of bias: Low EB risk of bias: Moderate