Beneficial effects of testosterone therapy in women measured by the validated Menopause Rating Scale (MRS)

  • Rebecca Glaser
    Corresponding author at: Millennium Wellness Center, 228 E. Spring Valley Road, Dayton, OH 45458, USA. Tel.: +1 937 436 9821; fax: +1 937 436 9827; mobile: +1 937 545 1177.
    Millennium Wellness Center, 228 E. Spring Valley Road, Dayton, OH 45458, USA

    Wright State University Boonshoft School of Medicine, Department of Surgery, 3460 Colonel Glenn Highway, Dayton, OH 45435, USA
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  • Anne E. York
    York Data Analysis, 6018 Sycamore Ave NW, Seattle, WA 98107, USA
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  • Constantine Dimitrakakis
    1st Department of Ob/Gyn, Athens University Medical School, 80 Vas. Sophias Street, 11528 Athens, Greece

    National Institutes of Health, NICHD, Bldg 10, 10 Center Drive, Bethesda, MD 20892-1103, USA
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      This study was designed to measure the beneficial effects of continuous testosterone therapy, delivered by subcutaneous implant, in the relief of somatic, psychological and urogenital symptoms in both pre- and post-menopausal patients, utilizing the validated Health Related Quality of Life (HRQOL), Menopause Rating Scale (MRS).

      Study design

      300 pre- and post-menopausal women with symptoms of relative androgen deficiency, were asked to self-administer the 11-item MRS, at baseline and 3 months after their first insertion of the subcutaneous testosterone implant. Baseline hormone measurements, menopausal status and BMI, were assessed to determine correlation with symptoms and clinical outcome.

      Main outcome measurements

      Changes related to therapy were determined. Total MRS scores as well as psychological, somatic and urogenital subscale scores were compared prior to therapy and following testosterone implant therapy.


      Pre-menopausal and post-menopausal females reported similar hormone deficiency symptoms. Both groups demonstrated similar improvement in total score, as well as psychological, somatic and urogenital subscale scores with testosterone therapy. Better effect was noted in women with more severe complaints. Higher doses of testosterone correlated with greater improvement in symptoms.


      Continuous testosterone alone, delivered by subcutaneous implant, was effective for the relief of hormone deficiency symptoms in both pre- and post-menopausal patients. The validated, HRQOL questionnaire, Menopause Rating Scale (MRS), proved a valuable tool in the measurement of the beneficial effects of testosterone therapy in both cohorts.


      HRQOL (Health Related Quality of Life), MRS (Menopause Rating Scale), IRB (Institutional Review Board), BMI (body mass index)


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        • Davison S.L.
        • Bell R.
        • Donath S.
        • Montalto J.G.
        • Davis S.R.
        Androgen levels in adult females: changes with age, menopause, and oophorectomy.
        Journal of Clinical Endocrinology & Metabolism. 2005; 90: 3847
        • Zumoff B.
        • Strain G.W.
        • Miller L.K.
        • Rosner W.
        Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women.
        Journal of Clinical Endocrinology & Metabolism. 1995; 80: 1429-1430
        • Lobo R.A.
        Androgens in postmenopausal women: production, possible role, and replacement options.
        Obstetrical and Gynecological Survey. 2001; 56: 361
        • Dennerstein L.
        • Dudley E.C.
        • Hopper J.L.
        • Guthrie J.R.
        • Burger H.G.
        A prospective population-based study of menopausal symptoms.
        Obstetrics & Gynecology. 2000; 96: 351
        • Burger H.G.
        • Hailes J.
        • Menelaus M.
        • Nelson J.
        • Hudson B.
        • Balazs N.
        The management of persistent menopausal symptoms with oestradiol-testosterone implants: clinical, lipid and hormonal results.
        Maturitas. 1984; 6: 351
        • Gambrell Jr., R.D.
        • Natrajan P.K.
        Moderate dosage estrogen-androgen therapy improves continuation rates in postmenopausal women: impact of the WHI reports.
        Climacteric. 2006; 9: 224-233
        • Garnett T.
        • Studd J.
        • Watson N.
        • Savvas M.
        A cross-sectional study of the effects of long-term percutaneous hormone replacement therapy on bone density.
        Obstetrics & Gynecology. 1991; 78: 1002
        • Thom M.H.
        • Collins W.P.
        • Studd J.W.W.
        Hormonal profiles in postmenopausal women after therapy with subcutaneous implants.
        British Journal of Obstetrics and Gynaecology. 1981; 88: 426-433
        • Dimitrakakis C.
        • Jones R.A.
        • Liu A.
        • Bondy C.A.
        Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy.
        Menopause. 2004; 11: 531
        • Segaloff
        Hormone therapy of breast cancer.
        Cancer Treatment Reviews. 1975; 2: 129-135
        • Glaser R.
        • Wurtzbacher D.
        • Dimitrakakis C.
        Efficacy of testosterone therapy delivered by pellet implant.
        Maturitas. 2009; 63: 283
        • Dewis P.
        • Newman M.
        • Ratcliffe W.A.
        • Anderson D.C.
        Does testosterone affect the normal menstrual cycle.
        Clinical Endocrinology (Oxford). 1986; 24: 515-521
        • Glaser R.
        • Newman M.
        • Parsons M.
        • Zava D.
        • Glaser-Garbrick D.
        Safety of maternal testosterone therapy during breast feeding.
        International Journal of Pharmaceutical Compounding. 2009; 13: 314-317
        • Traish A.M.
        • Gooren L.J.
        Safety of physiological testosterone therapy in women: lessons from female-to-male transsexuals (FMT) treated with pharmacological testosterone therapy.
        The Journal of Sexual Medicine. 2010; 7: 3758-3764
        • Heinemann L.A.J.
        • Potthoff P.
        • Schneider H.P.G.
        International versions of the menopause rating scale (MRS).
        Health and Quality of Life Outcomes. 2003; 1: 28
        • Heinemann K.
        • Ruebig A.
        • Potthoff P.
        • et al.
        The menopause rating scale (MRS) scale: a methodological review.
        Health and Quality of Life Outcomes. 2004; 2: 45
        • Heinemann L.A.J.
        • DoMinh T.
        • Strelow F.
        • Gerbsch S.
        • Schnitker J.
        • Schneider H.P.G.
        The menopause rating scale (MRS) as outcome measure for hormone treatment? A validation study.
        Health and Quality of Life Outcomes. 2004; 2: 67
        • Davis S.R.
        • Davison S.L.
        • Donath S.
        • Bell R.J.
        Circulating androgen levels and self-reported sexual function in women.
        JAMA. 2005; 294: 91
        • Davis S.R.
        • Moreau M.
        • Kroll R.
        • et al.
        Testosterone for low libido in postmenopausal women not taking estrogen.
        New England Journal of Medicine. 2008; 359: 2005
        • Braunstein G.D.
        • Sundwall D.A.
        • Katz M.
        • et al.
        Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: a randomized, placebo-controlled trial.
        Archives of Internal Medicine. 2005; 165: 1582
        • Choi H.H.
        • Gray P.B.
        • Storer T.W.
        • et al.
        Effects of testosterone replacement in human immunodeficiency virus-infected women with weight loss.
        Journal of Clinical Endocrinology & Metabolism. 2005; 90: 1531
        • Fargo K.N.
        • Foecking E.M.
        • Jones K.J.
        • Sengelaub D.R.
        Neuroprotective actions of androgens on motoneurons.
        Frontiers in Neuroendocrinology. 2009; 30: 130-141
        • Zang H.
        • Sahlin L.
        • Masironi B.
        • Eriksson E.
        • Linden Hirschberg A.
        Effects of testosterone treatment on endometrial proliferation in postmenopausal women.
        Journal of Clinical Endocrinology & Metabolism. 2007; 92: 2169
        • Perrone A.M.
        • Cerpolini S.
        • Salfi N.C.M.
        • et al.
        Effect of long-term testosterone administration on the endometrium of female-to-male (ftm) transsexuals.
        The Journal of Sexual Medicine. 2009;
        • Campagnoli C.
        • Clavel-Chapelon F.
        • Kaaks R.
        • Peris C.
        • Berrino F.
        Progestins and progesterone in hormone replacement therapy and the risk of breast cancer.
        Journal of Steroid Biochemistry and Molecular Biology. 2005; 96: 95-108
        • Sands R.
        • Studd J.
        • Seed M.
        • et al.
        The effects of exogenous testosterone on lipid metabolism & insulin resistance in postmenopausal women.
        Maturitas. 1997; 27: 50
        • Seed M.
        • Sands R.H.
        • McLaren M.
        • Kirk G.
        • Darko D.
        The effect of hormone replacement therapy and route of administration on selected cardiovascular risk factors in post-menopausal women.
        Family Practice. 2000; 17: 497
        • Dimitrakakis C.
        • Zava D.
        • Marinopoulos S.
        • Tsigginou A.
        • Antsaklis A.
        • Glaser R.
        Low salivary testosterone levels in patients with breast cancer.
        BMC Cancer. 2010; 10: 547
        • Labrie F.
        • Luu-The V.
        • Labrie C.
        • et al.
        Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone.
        Endocrine Reviews. 2003; 24: 152
        • Dimitrakakis C.
        • Bondy C.
        Androgens and the breast.
        Breast Cancer Research. 2009; 11: 212