Breast cancer risk in postmenopausal women using testosterone in combination with hormone replacement therapy

Bitzer, Johannes; Kenemans, Peter; Mueck, Alfred O.; for the ’FSDeducation Group,

doi:10.1016/j.maturitas.2008.01.005

« Previous Next »Maturitas
Volume 59, Issue 3 , Pages 209-218, 20 March 2008

Breast cancer risk in postmenopausal women using testosterone in combination with hormone replacement therapy

Johannes Bitzer
- University-Women's Hospital Basel, Department of Gynecological Social Medicine and Psychosomatic, Spitalstrasse 21, 4031 Basel, Switzerland
- Corresponding author. Tel.: +41 61 2659043.
Peter Kenemans
- VU University Medical Center, Department of Obstetrics and Gynaecology, Amsterdam, The Netherlands
Alfred O. Mueck
- University-Women's Hospital Tuebingen, Department of Endocrinology and Menopause, Germany
for the ’FSDeducation Group
- Contributing members of the FSDeducation Group (Female Sexual Dysfunction): Farook Al-Azzawi, Leicester, UK; Johannes Bitzer, Basel, Switzerland; Alessandra Graziottin, Milan, Italy; Peter Kenemans, Amsterdam NL (Chair); Michèle Lachowsky, Paris, France; Sylvain Mimoun, Paris, France; Alfred O. Mueck (external expert); Rossella Nappi, Pavia, Italy; Santiago Palacios, Madrid, Spain; HP Zahradnik, Freiburg, Germany. Further information on www.FSDeducation.eu.

Received 29 October 2007; received in revised form 25 January 2008; accepted 28 January 2008. published online 17 March 2008.

Abstract

Objectives

Testosterone supplementation can be considered as a treatment option for surgically postmenopausal women with a distressful low sexual desire disorder, while on oestrogen therapy with or without progestagens.

The purpose of this study is to review the available clinical data on the impact of exogenous testosterone containing postmenopausal hormone therapy on breast cancer risk.

Methods

A literature search was done in MEDLINE (1969–July 2007) and in addition in EMBASE and Biosis (1990–July 2007) for original reports in English and French. Case reports and studies without a control group were excluded.

Results

No prospective randomized clinical trials were found. The five studies found (two case–control studies, two cohort studies and one retrospective observational study) showed inconsistent results. All studies had severe methodological limitations. Formulations and dosages used could be considered suboptimal.

Conclusion

At present, there are no valid randomized or observational clinical studies that provide evidence that the addition of testosterone to conventional postmenopausal hormone therapy influences breast cancer risk.

Keywords: Postmenopausal patients, Exogenous testosterone, Oestrogen/testosterone combination therapy, Breast cancer risk, Review