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Mosleh Jabari Department of Endocrinology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi ArabiaCorrespondence: Mosleh Jabari, Department of Endocrinology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia, Email dr.mosleh.jabari@gmail.comBackground: Challenges in selecting the right formulation of testosterone (TE) for young males with delayed puberty (DP) arise from the fact that there is limited evidence based guidelines in recommending the most efficient and safe formulation of TE.Objective: To evaluate the existing evidence and systematically review the interventional effects of transdermal TE to other modes of TE administration for the treatment of DP among young and adolescent males.Methods: All types of methodologies published in English were searched from the data sources including MEDLINE, Embase, Cochrane Reviews, Web of Science, AMED and Scopus from 2015 till 2022. Boolean operators with keywords “types of TE”, “modes of TE administration”, “DP”, “transdermal TE”, “constitutional delay of growth and puberty, (CDGP)” “adolescent boys” and “hypogonadism” to optimize the search results. The main outcomes of concern were optimal serum TE level, body mass index, height velocity, testicular volume, pubertal stage (Tanner), The secondary outcomes included in this study were adverse events and patient satisfaction.Results: After screening 126 articles, 39 full texts were reviewed. Only five studies could be included after careful screening and rigid quality assessments. Most studies were at high or unclear risk of bias with short duration and follow up periods. Only one study was a clinical trial covering all the outcomes of interests.Conclusion: This study points out the favorable effects of transdermal TE treatment for DP in boys, while the existence of the vast gap in research needs to be acknowledged. Despite the utmost demand in an appropriate TE treatment for young males with DP, scarce efforts and trials are being undertaken to provide clear clinical guidance of treatment. Quality of life, cardiac events, metabolic parameters, coagulation profiles are important aspects of the treatment are overlooked and under evaluated in most studies.Systematic Review Registration: PROSPERO CRD 42022369699.Keywords: delayed puberty, transdermal testosterone, testosterone treatment, hypogonadism, constitutional delay of growth, DP, TT

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Person-to-person transmission of transdermal testosterone – termed secondary exposure – is a rare but important cause of precocious puberty. A 3.5-year-old male was evaluated for precocious puberty based on a 6 month history of penile growth, development of secondary sexual characteristics, and growth spurt. Total testosterone level was significantly elevated at 1,460 ng/dL with normal prepubertal gonadotropin levels. Further history revealed that the father had been using transdermal testosterone for about 1 year. Within 2 months of discontinuation, total testosterone level was 20 ng/dL. Given the recent increase in transdermal testosterone prescriptions, clinicians must consider exogenous hormonal exposure as an etiology for precocious puberty. Prescribers should counsel their patients about the significant risk of secondary exposure. [ABSTRACT FROM AUTHOR]

Objective: Studies are needed to examine the effects of testosterone replacement therapy on ambulatory blood pressure (BP) parameters. This study assessed a testosterone transdermal system (TTS) using 24-hour ambulatory BP monitoring., Methods: In a single-arm, noninferiority trial conducted at 41 US sites, 168 men (mean age: 56.2 years) with hypogonadism not receiving testosterone replacement therapy in the past 6 months were enrolled and received ≥1 study drug dose. Nightly TTS treatment was administered for 16 weeks (starting dose: 4 mg/d; min, max dose: 2, 6 mg/d) to achieve testosterone concentration of 400-930 ng/dL. The primary endpoint was mean change from baseline to week 16 in 24-hour systolic BP (SBP). Noninferiority was determined based on the upper bound of the 2-sided 95% CI <3.0 mmHg., Results: Sixty-two men had ≥85% study drug compliance and a valid week 16 ambulatory BP monitoring session. Mean change from baseline to week 16 in 24-hour average SBP was 3.5 mmHg (95% CI, 1.2-5.8 mmHg; n = 62). Since the upper limit of the CI was >3 mmHg, an effect of TTS could not be ruled out. Mean changes were larger at daytime vs nighttime and in subgroups of men with vs without hypertension. Cardiovascular adverse events were rare (<2%) and nonserious; no major cardiovascular adverse events were reported., Conclusion: A meaningful effect of 16-week TTS treatment on 24-hour average SBP among men with hypogonadism could not be ruled out based on the study's noninferiority criterion. The magnitude of mean changes observed may not be clinically meaningful regarding cardiovascular events., Competing Interests: Disclosure Financial support for the study was provided by AbbVie, Inc (North Chicago, IL). AbbVie, Inc, participated in study design, research, data collection, analysis, and interpretation of data, and writing, reviewing, and approving the publication. All authors contributed to the development of the manuscript and maintained control over the final content. No authors received payment or other compensation related to the development of the manuscript. Anna Chan and James W. Thomas are employees of AbbVie, Inc, and own AbbVie, Inc stock or stock options. Mitchell D. Efros, Jed C. Kaminetsky, and Neil D. Sherman have no relevant disclosures., (Copyright © 2024 AACE. Published by Elsevier Inc. All rights reserved.)

Poor ovarian response remains one of the major challenges of assisted reproductive technology. Over the years, various interventions have been proposed to improve reproductive outcomes in poor responders, yet few have been shown to be beneficial. Recent studies indicate that hormonal pretreatments might increase clinical pregnancy rate, live birth rate and the number of oocytes retrieved in women with poor ovarian response undergoing assisted reproductive technology. Areas covered: Following extensive research of the up to date literature, this review aims to cover current considerations and controversies regarding the use of hormonal supplements such as dehydroepiandrosterone, transdermal testosterone and growth hormone. Expert opinion: There is limited data for the validity of using growth hormone and androgens or androgen modulating agents during assisted reproductive technology cycles in women suffering from poor ovarian response. However, there is a need to support the available data with further randomized controlled trials seeking for live birth rate as the primary outcome. [ABSTRACT FROM AUTHOR]

Urine and blood samples are the primary matrices for the detection of exogenous substances in doping control and toxicology. Although these matrices are, in general, very suitable for a wide range of substances, they do show some issues in particular cases. Here, alternative matrices may provide an answer. In this work, a quantitative method for steroid profiling (5 endogenous steroids and their ratios) in oral fluid was developed and validated. In total, 826 saliva samples were analyzed, and inter-individual reference population thresholds for saliva steroid profile parameters were set up. Alterations of this steroid profile after administration of naturally occurring anabolic androgenic steroids (e.g. testosterone (T) or dehydroepiandrosterone (DHEA)) were investigated. In addition, intra-individual short and long-term natural fluctuations were investigated. For longitudinal monitoring in oral fluid, steroid profile ratios (e.g., T/DHEA) were superior to absolute concentrations due to lower susceptibility towards the diurnal pattern. For the detection of a transdermal application of T, the salivary parameter T/DHEA proved to have the highest sensitivity. In contrast with the current screening procedures in urine, there is no need for an additional expensive and time-consuming isotope ratio mass spectrometry confirmation procedure to unequivocally attribute the elevated parameter to an exogenous origin. [ABSTRACT FROM AUTHOR]

Treatment to induce puberty in boys is indicated in those who do not undergo spontaneous development at a normal age. Stimulating development of the secondary sex characteristics is possible using gradually increasing doses of testosterone esters (TEs) via intramuscular (IM) administration, which is the most widely used method of testosterone (T) supplementation. When TEs are administered as monthly injection, serum T levels exhibit large fluctuations with supraphysiologic levels seen immediately after the injection followed by a decrease into the low range. Transdermal T (TT) has also been used for replacement therapy in adult males with hypogonadism and this provides steadier serum T levels. We report three adolescent boys with delayed puberty who were treated with TT gel for pubertal induction/continuation. This route was chosen as an alternative therapy due to their hepatic dysfunction, as is known that TT avoids the hepatic first-pass metabolism. [ABSTRACT FROM AUTHOR]

We compared a novel 5% testosterone (T) cream (AndroForte 5, Lawley Pharmaceuticals, Australia) with a 1% T gel (Testogel, Besins Healthcare, Australia). Using an open-label crossover design, subjects were randomized to one of two treatment sequences using either the T gel or T cream first in a 1 : 1 ratio. Each treatment period was 30 days with a 7-14 days washout period between them. On Days 1 and 30 of each treatment period blood was sampled at −15, −5 min, 0, 2, 4, 5, 6, 7, 8, 9, 10, 12 and 16 h post study drug administration. Sixteen men with established androgen deficiency aged between 29 and 73 years, who had undertaken a washout from prior testosterone therapy participated in the study. One subject failed to complete both arms and another was excluded post-completion because of a major protocol violation. Bioequivalence was established based on key pharmacokinetic ( PK) variables: AUC, Cavg, Cmax, Tmax, % fluctuation (with and without baseline correction) for the two formulations of testosterone on Day 1 and Day 30. The ratio and 90% CI of AUC 0.99 (0.86-1.14), Cmax 1.02 (0.84-1.24) and Cavg 0.99 (0.86-1.14) for T cream/T gel were within the predetermined bio-equivalence criteria of 80% to 125% at Day 30. There were no statistically significant differences between secondary biochemical markers: serum dihydrotestosterone ( DHT), oestradiol (E2), sex hormone-binding globulin ( SHBG), luteinizing hormone ( LH) and ( FSH). The two testosterone formulations were shown to be bioequivalent. [ABSTRACT FROM AUTHOR]

Objective: To evaluate to the efficacy of testosterone, dehydroepiandrosterone (DHEA) and growth hormone (GH) supplementations in patients with diminished ovarian reserve (DOR) in assisted reproductive technology (ART) cycles. Materials and Methods: A retrospective cohort including 33 women with 81 ART cycles were aged and ovarian reserve matched 52 women with 102 conventional in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) protocol. Administration of DHEA for 12 weeks and transdermal testosterone for 4 weeks as pretreatment adjuvant and luteal start GH in DOR patient treatment arm compared to conventional IVF/ICSI cycles. Results: The number of follicles >14 mm, number of oocytes, number of metaphase 2 oocytes and fertilisation rate were significantly higher in ISIK protocol (IP). The clinical pregnancy rate (CPR) per embryo transfer of the IP was 38.2% (13/34). The cancellation rate of cycles decreased significantly from 54.5 % (24/44) to 8.1% (3/37) with the IP, while the OPR was 35.3% (12/34). Conclusions: Our study has shown that even the poorest responders could achieve clinical pregnancy after inducing ovarian folliculogenesis with a combination of transdermal testosterone, DHEA and GH. [ABSTRACT FROM AUTHOR]

Objectives To determine the pharmacodynamic profile of serum total testosterone and luteinizing hormone ( LH) levels in men with secondary hypogonadism after initial and chronic daily oral doses of enclomiphene citrate vs transdermal testosterone., To determine the effects of daily oral doses of enclomiphene citrate in comparison with transdermal testosterone on other hormones and markers in men with secondary hypogonadism., Patients and Methods This was a randomized, single-blind, two-centre, phase II study to evaluate the effects of three different doses of enclomiphene citrate (6.25, 12.5 and 25 mg) vs transdermal testosterone on 24-h LH and total testosterone in otherwise normal healthy men with secondary hypogonadism., Forty-eight men were enrolled in the trial (the intent-to-treat population), but four men had testosterone levels >350 ng/dL at baseline. Forty-four men completed the study per protocol. All subjects enrolled in this trial had serum total testosterone in the low range (<350 ng/dL) and had low to normal LH (<12 IU/L) on at least two occasions., Total testosterone and LH levels were assessed each hour for 24 h to examine the effects at each of three treatment doses of enclomiphene citrate vs a standard dose (5 g) of transdermal testosterone. In the initial profile, total testosterone and LH were determined in a naïve population after a single initial oral or transdermal treatment (day 1). This was contrasted to that seen after 6 weeks of continuous daily oral or transdermal treatment (day 42)., The pharmacokinetics of enclomiphene citrate were assessed in a select subpopulation., Serum samples were obtained over the course of the study to determine the levels of various hormones and lipids., Results After 6 weeks of continuous use, the mean ( sd) concentration of total testosterone at day 42 was 604 (160) ng/dL for men taking the highest dose of enclomiphene citrate (enclomiphene citrate, 25 mg daily) and 500 (278) ng in those men treated with transdermal testosterone. These values were higher than day 1 values but not different from each other ( P = 0.23, t-test)., All three doses of enclomiphene citrate increased the testosterone concentration at time 0 of each 24-h sampling period, and the mean, maximum, minimum and range of testosterone concentrations over the 24-h sampling period. Transdermal testosterone also raised total testosterone, albeit with more variability, and with suppressed LH levels., The patterns of total testosterone over the 24-h period after 6 weeks of dosing could be fit to a nonlinear function with morning elevations, mid-day troughs, and rising night-time levels., Enclomiphene citrate and transdermal testosterone increased levels of total testosterone within 2 weeks, but they had opposite effects on FSH and LH., Treatment with enclomiphene citrate did not significantly affect levels of thyroid-stimulating hormone, adenocorticotropic hormone, cortisol, lipids or bone markers. Both transdermal testosterone and enclomiphene citrate decreased insulin-like growth factor-1 levels ( P < 0.05) but suppression was greater in the enclomiphene citrate groups., Conclusions Enclomiphene citrate increased serum LH and total testosterone; however, there was not a temporal association between the peak drug levels and the maximum concentration levels of LH or total testosterone., Enclomiphene citrate consistently increased serum total testosterone into the normal range and increased LH and FSH above the normal range. The effects on LH and total testosterone persisted for at least 1 week after stopping treatment. [ABSTRACT FROM AUTHOR]

Clitoromegaly is the abnormal enlargement of the clitoris. Its etiology is often divided into congenital and acquired causes, leading to a differential diagnosis that is quite broad. Workup often includes serum hormone testing, imaging studies, and sometimes an investigation into genetic and nonhormonal causes, which can be obtained from a detailed patient history. Exposure to exogenous or endogenous androgens can directly stimulate and enlarge the clitoris, resulting in early virilization. Transdermal testosterone gel can be transferred from the skin of an adult to the skin of a child. Topical testosterone gel is an approved therapy for the treatment of hypoandrogenism in males. While it offers a convenient means of treatment, there is a concern about unintentional exposure to females and children from skin contact with the application site. Here, we report a case of an infant who presented to a pediatric endocrinology clinic for clitoromegaly that was possibly due to exogenous exposure to testosterone., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Deskins et al.)

A systematic review and meta-analysis was performed to evaluate the effect of transdermal testosterone preceding ovarian stimulation in women with poor ovarian response undergoing IVF. Studies comparing pretreatment with transdermal testosterone versus standard ovarian stimulation among poor responders were included. The main outcome assessed was live birth. Three trials were included (113 women in the testosterone group, 112 in the control group). Testosterone-treated women achieved significantly higher live birth rate (risk ratio, RR, 1.91, 95% CI 1.01 to 3.63), clinical pregnancy rate (RR 2.07, 95% CI 1.13 to 3.78) and required significantly lower doses of FSH (RR -461.96, 95% CI -611.82 to -312.09). However, differences observed in clinical pregnancy per embryo transferred were not statistically significant (RR 1.72, 95% CI 0.91 to 3.26). No differences were observed regarding number and quality of the oocytes retrieved. In conclusion, transdermal testosterone significantly increases live birth and reduces the doses of FSH required. These findings support the theoretical synergistic role of androgens and FSH on folliculogenesis. The present data should be interpreted with caution because of the small number of trials and clinical heterogeneity. The identification of poor responders that could especially benefit from testosterone treatment should be addressed in further studies. [ABSTRACT FROM AUTHOR]

Male hypogonadism occurs in up to 40% of men, with a large proportion that may be undiagnosed and untreated, particularly those with late-onset hypogonadism. The condition is associated with suboptimal sexual, physical and psychological functioning. Testosterone-replacement therapy has been shown to prevent or reverse these secondary health complications, leading to an improvement in quality of life. This paper reviews the pharmacokinetics, clinical efficacy and tolerability of a 1% transdermal testosterone gel (Testogel®/AndroGel®: 5 g gel contains 50 mg testosterone as the active ingredient) to evaluate its clinical benefits and adverse effects in the treatment of male hypogonadism. Administration of this transdermal preparation of 50-100 mg of testosterone in 5-10 g gel daily appears to provide an optimal dose to most subjects in achieving testosterone concentrations within the male reference range and provides associated health benefits. [ABSTRACT FROM AUTHOR]

Introduction. Postmenopausal women with hypoactive sexual desire disorder (HSDD) experienced statistically significant improvements in the frequency of satisfying sexual activity, sexual desire, and distress with testosterone treatment in phase III trials, but it was not known whether the magnitude of these effects was clinically meaningful. The clinical relevance study was designed to answer this question. Aim. To evaluate the clinical relevance of the treatment benefits. Methods. This study involved a representative sample of 132 surgically postmenopausal women with HSDD who were enrolled in two randomized, placebo-controlled trials (N = 1094) assessing the efficacy and safety of transdermal testosterone treatment (300 mcg/day) for 6 months. At the end of the studies, prior to unblinding, a sample of women (12%) was interviewed concerning their experiences with the treatment. Main Outcome Measures. Women were asked “Overall, would you say that you experienced a meaningful benefit from the study patches?” Changes in the efficacy end points in the double-blind studies were compared for the women who did and did not experience an overall meaningful benefit. Results. Overall, 33 of 64 women (52%) who received testosterone reported experiencing a meaningful treatment benefit, compared with 21 of 68 women (31%) who received placebo ( P = 0.025). Among the women who identified themselves as experiencing a meaningful benefit, the mean (SE) change from baseline in 4-week frequency of satisfying sexual activity was 4.4 (0.76), in desire score was 21.0 (2.78), moving from “seldom” to “sometimes” feeling sexual desire, and in distress score was −36.5 (3.96), moving from “often” to “seldom” being distressed. Among the women who identified themselves as not experiencing a meaningful benefit, the mean (SE) change from baseline in 4-week frequency of satisfying sexual activity was 0.5 (0.31), in desire score was 2.9 (1.42), and in distress score was −8.8 (2.23). Conclusions. Surgically menopausal women with HSDD in these studies received clinically meaningful benefits, including improvements in satisfying sexual activity, sexual desire, and personal distress. Kingsberg S, Shifren J, Wekselman K, Rodenberg C, Koochaki P, and DeRogatis L. Evaluation of the clinical relevance of benefits associated with transdermal testosterone treatment in postmenopausal women with hypoactive sexual desire disorder. J Sex Med 2007;4:1001–1008. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: There is evidence that suggests that androgen might play an important role in different tissues and in modulating sexual response. In women of reproductive age the most important source of androgens present in the blood is the ovary. Androgens complement the contribution of adrenal precursors, which in peripheral organs and target tissue can be transformed into bioactive androgens. The human brain is an important target organ of the sex hormones. The expression in the brain of men and women of estrogenic and/or androgenic receptors (AR) in the cerebral nucleus, especially the hypothalamus, whose important participation in the regulation of the secretion of gonadotrophins, sexual motivation and sexual response is well documented by experimental research on animals and is being verified by studies on functional neuroimaging in humans. Methods and results: The two pivotal studies that have served for acceptance of the testosterone patch as therapy for hypoactive sexual desire by the European Agency for the Evaluation of Medicinal Products (EMEA) have been The Intimate Study (SM1) and The Intimate Study (SM2). The data on the efficiency of these studies have therefore been clear and positive; the side effects have also been studied and were found in general to be the same as those of the placebo group. Conclusion: There are certain limitations in the studies that are currently being evaluated. Studies with androgens alone and androgens plus estrogens in the natural menopause are ongoing at present. [Copyright &y& Elsevier]

Male hypogonadism is a condition in which the body does not produce enough testosterone, resulting in symptoms such as depressed mood, decreased sex drive, decreased skeletal muscle, and increased fat mass. Male hypogonadism can be readily treated with many available treatments when clinically indicated. The advent of readily available testosterone therapy has increased the importance of finding the most efficacious and cost-efficient treatment modality to approach these patients. Testosterone is typically administered through intramuscular or subcutaneous injections, topical gels, and oral tablets. The efficacy of testosterone therapy on hypogonadal men has been widely studied. However, there has been little research done comparing each modality against each other. This paper seeks to compare the various modalities of testosterone replacement therapy using various parameters such as the beneficial effects on bone mineral density, skeletal muscle mass, fat mass, and libido while simultaneously weighing the distinct undesirable side effects of each form of administration. Our investigation analyzes the methodology and results of the existing research within this field. It aims to draw a nuanced conclusion about the current standard of care for testosterone replacement therapy. According to our research and statistical analyses, we have concluded that oral administration has shown to be as advantageous as other modalities for male hypogonadism. Currently, injectables are the modality of choice, but with the right improvements, oral administration can potentially overtake injectables and transdermal testosterone as the treatment of choice., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Ahmad et al.)

Two patients suffering from systemic sclerosis (SSc) were treated with the 25 μ/hr transdermal fentanyl patch for pain from either deltoid muscle tendinitis of the left arm or from ischemia of the left-hand thumb. When the medication was changed to either oral morphine or oral methadone, the effects did not correspond to the drug conversion table. These findings suggest that patients with SSc and other systemic skin diseases may be at risk for limited absorption of transdermal fentanyl. In contrast, no restriction of the absorption of transdermal testosterone was observed. [ABSTRACT FROM AUTHOR]

Objective: Follicular Output Rate (FORT) is an efficient quantitative and qualitative marker of ovarian responsiveness to gonadotropins. Transdermal testosterone (TT) has been used as adjuvant therapy to gonadotrophins in order to improve ovarian response in poor responders (PR). The aim of this study was to analyze whether TT can improve follicular sensitivity to gonadotropins using FORT., Methods: This retrospective study, held in a tertiary-care university hospital included 90 PR patients, according to the Bologna criteria. Patients in Group 1 (n = 46) received transdermal application of testosterone preceding gonadotrophin ovarian stimulation under pituitary suppression. In Group 2 (n = 44) ovarian stimulation was carried out with high-dose gonadotrophin in association with minidose GnRH agonist protocol. We analyzed ovarian stimulation parameters and IVF outcomes. We determined antral follicle count (AFC) (3-8 mm) before ovarian stimulation, pre-ovulatory follicle count (PFC) (16-22 mm) and the day of hCG administration. We calculated the FORT using the PFCx100/AFC ratio., Results: Baseline characteristics and ovarian reserve parameters were similar in both groups. FORT and oocytes retrieved were significantly higher in group 1 vs group 2. There were no significant differences in pregnancy rates. In group 1 there was a significant correlation between FORT and AFC., Conclusions: This study suggests that the potential beneficial mechanism of TT in poor responder patients may be based on increasing the antral follicle sensitivity to gonadotrophin. FORT is an excellent tool to demonstrate this.

Dose adjustment with transdermal testosterone preparations should recognize the variability of serum total testosterone levels between applications and over the course of 24 h. Dose adjustments are also made difficult by between-laboratory assay variability. Low SHBG with obesity and diabetes lowers the total testosterone level, and free or bioavailable testosterone may prove to be a better choice for monitoring the progress and dosing of testosterone-treated men with adult onset hypogonadism. [ABSTRACT FROM PUBLISHER]

Background/aim: Hypoactive sexual desire disorder (HSDD) is hypothesised to manifest in postmenopausal women at onset of menopause due to decreased oestrogen levels. Transdermal testosterone is a potential treatment option. This systematic review explores the relationship between the incidence of breast cancer and transdermal testosterone use., Materials and Methods: Searches were conducted on the PubMed and Ovid databases. In Ovid, the advanced search function was used: 'transdermal testosterone not male'. In PubMed, the following search terms were used: 'transdermal, testosterone, menopausal, women, breast cancer, women'. Abstracts that fitted our initial criteria were further investigated., Results: A total of 25 publications from PubMed and 192 publications from Ovid were initially assessed. Three randomised control trials were judged to have sufficiently met our inclusion criteria. However, these trials were too heterogeneous for a meta-analysis. A systematic review was deemed the most appropriate analysis of the data available., Conclusion: The publications examined in this systematic review suggest that the use of transdermal testosterone to treat HSDD in postmenopausal women does not increase breast cancer incidence. However, further research in the form of adequately powered randomised controlled trials with breast cancer incidence being the primary end point is required in order to confirm this., (Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Objective To systematically review and summarize the existing evidence related to the efficacy and safety of transdermal T in postmenopausal women for the treatment of hypoactive sexual desire disorder (HSDD). Design Systematic reviews and meta-analysis. Setting Not applicable. Patient(s) Seven randomized controlled trials enrolled 3,035 participants; 1,350 women were randomized to treatment with T patch, and 1,379 women were randomized to placebo. Intervention(s) None. Main Outcome Measure(s) Primary outcome: satisfying sexual episodes. Secondary outcomes: sexual activity, orgasm, Profile of Female Sexual Function domains (desire), personal distress score, adverse events, acne, increased hair growth, facial hair, alopecia, voice deepening, urinary symptoms, breast pain, headache, site reaction, total adverse events, serious adverse events, withdrawal from study, and follow-up rate. Result(s) The T group had significantly more satisfying sexual episodes, sexual activity, orgasms, desire, significant change in Personal Distress Scale score, androgenic adverse events, acne, and hair growth compared with the placebo group. There was no significant difference between the two groups in increase in facial hair, alopecia, voice deepening, urinary symptoms, breast pain, headache, site reaction to the patch, total adverse events, serious adverse events, reasons for withdrawal from the study, and the number of women who completed the study. Conclusion(s) The short-term efficacy in terms of improvement of sexual function and safety of transdermal T in naturally and surgically menopausal women affected by HSDD either on or not on estrogen progestin hormone therapy is evident from this systematic review. The use of transdermal T is associated with increase in androgenic adverse events such as acne but is not associated with any serious adverse events. [ABSTRACT FROM AUTHOR]

Presents a study which investigated the incidence of polycythemia as a complication of transdermal testosterone therapy. Medical history of a man who developed symptoms of polycythemia; Testosterone levels of the patient; Use of computerized tomography in the diagnosis.