Psychosexual functioning in women with complete testicular feminization: Is androgen replacement therapy preferable to estrogen?

Abstract

Effects of oral testosterone undecanoate (Andriol) on blood hormone levels, moods, sociosexual functioning and self-image of the body were studied in four gonadectomized patients with complete testicular feminization. In a double-blind cross-over experiment, patients were treated with oral testosterone undecanoate (120 mglday) or placebo for four weeks. Peripheral blood was taken for hormone assays at the end of each four-week period. Psychosexual functioning was reported once weekly, mood scales twice weekly. In three patients testosterone treatment resulted in adult male blood levels of testosterone and estradiol. One patient did not show increased steroid levels, possibly because ofhyperth-yroxinaemia. No systematic effects were found on coitus, masturbation, sexual thoughts, scores on desire for bodily contact, and on attention for physical appearance. In one patient there was a marked and sustained rise in the positive moods and a fall in negative moods during androgen treatment. These results do not demonstrate that androgen therapy is preferable to estrogen in gonadectomized women with complete testicular feminization with regard to psychosexual functioning.