Effects of androgen supplementation of hormone replacement therapy on the vascular reactivity of cerebral arteries

Objective: To determine the effect of the androgen supplementation of hormo ne replacement therapy (HRT) on the vascular reactivity of cerebral arterie s. Design: Open randomized study. Setting: Healthy volunteers in an academic research environment. Patient(s): Forty postmenopausal women who were treated with sequential HRT (transdermal E-2 50 mug/d + medroxyprogesterone acetate 10 mg/d for 12 day s every other month) for greater than or equal to1 year and less than or eq ual to5 years. Intervention(s): Testosterone undecanoate (40 mg/d, p.o.) was randomly admi nistered to 20 patients during ongoing HRT; the other 20 served as controls . Doppler evaluations of the internal carotid and middle cerebral arteries were performed together with lipid levels assessments. A visual analogue sc ale (VAS) was used to evaluate various parameters relating to sexual life a nd well-being. Main Outcome Measure(s): Pulsatility index (PI) of the arteries, VAS assess ment of psychophysical well-being. Result(s): The administration of testosterone undecanoate during HRT induce d an increase in the PI of the middle cerebral artery and a reduction of hi gh-density lipoprotein cholesterol. Sexual desire and satisfaction were gre atly improved. Conclusion(s): In postmenopausal women, androgen supplementation during HRT can partially counteract the beneficial effects of estrogens on cerebral v ascular reactivity and lipid profiles, but sexual desire and satisfaction a re greatly improved. (C) 2001 by American Society for Reproductive Medicine .