{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T06:05:20Z","timestamp":1793858720825,"version":"4.6.1"},"reference-count":43,"publisher":"The Endocrine Society","issue":"11","funder":[{"DOI":"10.13039\/501100001026","name":"National Breast Cancer Foundation","doi-asserted-by":"publisher","award":["NT-16-006"],"award-info":[{"award-number":["NT-16-006"]}],"id":[{"id":"10.13039\/501100001026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1135843"],"award-info":[{"award-number":["1135843"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Intravaginal testosterone (IVT) is a potential treatment of vulvovaginal atrophy (VVA) associated with aromatase inhibitor (AI) use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the effects of IVT on sexual satisfaction, vaginal symptoms, and urinary incontinence (UI) associated with AI use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Double-blind, randomized, placebo-controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic clinical research center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Postmenopausal women taking an AI with VVA symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>IVT cream (300 \u03bcg per dose) or identical placebo, self-administered daily for 2 weeks and then thrice weekly for 24 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was the change in the sexual satisfaction score on the Female Sexual Function Index (FSFI). Secondary outcomes included vaginal symptoms and responses to the Profile of Female Sexual Function, the Female Sexual Distress Scale\u2013Revised (FSDS-R), and the Questionnaire for UI Diagnosis. Serum sex steroids were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 44 women were randomly assigned and 37 provided evaluable data, (mean age 56.4 years, SD 8.8 years). At 26 weeks, the mean between-group difference in the baseline-adjusted change in FSFI satisfaction scores was significantly greater for the IVT group than the placebo group (mean difference 0.73 units; 95% CI, 0.02 to 1.43; P = 0.043). IVT cream resulted in significant improvements, compared with placebo, in FSDS-R scores (P = 0.02), sexual concerns (P &amp;lt; 0.001), sexual responsiveness (P &amp;lt; 0.001), vaginal dryness (P = 0.009), and dyspareunia (P = 0.014). Serum sex steroid levels did not change. Few women had UI symptoms, with no treatment effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IVT significantly improved sexual satisfaction and reduced dyspareunia in postmenopausal women on AI therapy. The low reporting of UI among women on AI therapy merits further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2018-01345","type":"journal-article","created":{"date-parts":[[2018,9,16]],"date-time":"2018-09-16T05:05:25Z","timestamp":1537074325000},"page":"4146-4154","source":"Crossref","is-referenced-by-count":61,"title":["Intravaginal Testosterone Improves Sexual Satisfaction and Vaginal Symptoms Associated With Aromatase Inhibitors"],"prefix":"10.1210","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2955-0415","authenticated-orcid":false,"given":"Susan R","family":"Davis","sequence":"first","affiliation":[{"name":"Women\u2019s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penelope J","family":"Robinson","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Jane","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"White","sequence":"additional","affiliation":[{"name":"Olivia Newton-John Cancer Centre, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"White","sequence":"additional","affiliation":[{"name":"Cabrini Medical Centre, Malvern, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin J","family":"Bell","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2018,9,14]]},"reference":[{"issue":"5","key":"2020071623234118800_B1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1200\/JOP.000082","article-title":"American society of clinical oncology clinical practice guideline update on adjuvant endocrine therapy for women with hormone receptor\u2013positive breast cancer","volume":"6","author":"Burstein","year":"2010","journal-title":"J Oncol Pract"},{"key":"2020071623234118800_B2","doi-asserted-by":"crossref","first-page":"vi12","DOI":"10.1093\/annonc\/mdr371","article-title":"Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"22","author":"Aebi","year":"2011","journal-title":"Ann Oncol"},{"issue":"21","key":"2020071623234118800_B3","doi-asserted-by":"crossref","first-page":"4261","DOI":"10.1200\/JCO.2004.08.029","article-title":"Quality of life of postmenopausal women in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Adjuvant Breast Cancer Trial","volume":"22","author":"Fallowfield","year":"2004","journal-title":"J Clin Oncol"},{"issue":"6","key":"2020071623234118800_B4","doi-asserted-by":"crossref","first-page":"674","DOI":"10.3109\/13697137.2014.926322","article-title":"Women\u2019s expectations and experiences of hormone treatment for sexual dysfunction","volume":"17","author":"Fooladi","year":"2014","journal-title":"Climacteric"},{"issue":"1","key":"2020071623234118800_B5","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/j.1743-6109.2010.02034.x","article-title":"Sexual function after breast cancer","volume":"8","author":"Panjari","year":"2011","journal-title":"J Sex Med"},{"issue":"1","key":"2020071623234118800_B6","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/gme.0b013e3182610cab","article-title":"Understanding discontinuation of oral adjuvant endocrine therapy by women with hormone receptor\u2013positive invasive breast cancer nearly 4 years from diagnosis","volume":"20","author":"Bell","year":"2013","journal-title":"Menopause"},{"issue":"10","key":"2020071623234118800_B7","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1097\/GME.0000000000000329","article-title":"Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women\u2019s Sexual Health and the North American Menopause Society","volume":"21","author":"Portman","year":"2014","journal-title":"Menopause"},{"issue":"3","key":"2020071623234118800_B8","doi-asserted-by":"crossref","first-page":"267","DOI":"10.3109\/13697137.2012.657589","article-title":"The use of hormone therapy for the maintenance of urogynecological and sexual health post WHI","volume":"15","author":"Nappi","year":"2012","journal-title":"Climacteric"},{"issue":"3","key":"2020071623234118800_B9","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1200\/JOP.2011.000352","article-title":"Effects of vaginal estrogens on serum estradiol levels in postmenopausal breast cancer survivors and women at risk of breast cancer taking an aromatase inhibitor or a selective estrogen receptor modulator","volume":"8","author":"Wills","year":"2012","journal-title":"J Oncol Pract"},{"issue":"10","key":"2020071623234118800_B10","doi-asserted-by":"crossref","first-page":"3647","DOI":"10.1210\/jc.2017-01138","article-title":"Managing menopausal symptoms and associated clinical issues in breast cancer survivors","volume":"102","author":"Santen","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2020071623234118800_B11","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1001\/jamaoncol.2016.3904","article-title":"Vaginal testosterone cream vs estradiol vaginal ring for vaginal dryness or decreased libido in women receiving aromatase inhibitors for early-stage breast cancer: a randomized clinical trial","volume":"3","author":"Melisko","year":"2017","journal-title":"JAMA Oncol"},{"issue":"4","key":"2020071623234118800_B12","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1634\/theoncologist.2010-0435","article-title":"Topical testosterone for breast cancer patients with vaginal atrophy related to aromatase inhibitors: a phase I\/II study","volume":"16","author":"Witherby","year":"2011","journal-title":"Oncologist"},{"issue":"3","key":"2020071623234118800_B13","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1111\/j.1743-6109.2006.00212.x","article-title":"Vaginal application of testosterone: a study on pharmacokinetics and the sexual response in healthy volunteers","volume":"3","author":"Apperloo","year":"2006","journal-title":"J Sex Med"},{"issue":"1","key":"2020071623234118800_B14","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/sm2.22","article-title":"Breast cancer, aromatase inhibitor therapy, and sexual functioning: a pilot study of the effects of vaginal testosterone therapy","volume":"2","author":"Dahir","year":"2014","journal-title":"Sex Med"},{"issue":"2","key":"2020071623234118800_B15","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/009262300278597","article-title":"The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function","volume":"26","author":"Rosen","year":"2000","journal-title":"J Sex Marital Ther"},{"issue":"5","key":"2020071623234118800_B16","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1097\/gme.0b013e31819e8e2d","article-title":"Intravaginal dehydroepiandrosterone (prasterone), a physiological and highly efficient treatment of vaginal atrophy","volume":"16","author":"Labrie","year":"2009","journal-title":"Menopause"},{"issue":"5","key":"2020071623234118800_B17","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1097\/GME.0000000000000787","article-title":"Prevalence and correlates of vaginal estrogenization in postmenopausal women in the United States","volume":"24","author":"Lindau","year":"2017","journal-title":"Menopause"},{"issue":"4","key":"2020071623234118800_B18","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1097\/01.GME.0000109316.11228.77","article-title":"Profile of female sexual function: a patient-based, international, psychometric instrument for the assessment of hypoactive sexual desire in oophorectomized women","volume":"11","author":"McHorney","year":"2004","journal-title":"Menopause"},{"issue":"2","key":"2020071623234118800_B19","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/j.1743-6109.2007.00672.x","article-title":"Validation of the Female Sexual Distress Scale\u2013Revised for assessing distress in women with hypoactive sexual desire disorder","volume":"5","author":"Derogatis","year":"2008","journal-title":"J Sex Med"},{"issue":"1\u20132","key":"2020071623234118800_B20","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.cca.2009.09.003","article-title":"Development and validation of a sensitive liquid chromatography\u2013tandem mass spectrometry assay to simultaneously measure androgens and estrogens in serum without derivatization","volume":"409","author":"Harwood","year":"2009","journal-title":"Clin Chim Acta"},{"issue":"5","key":"2020071623234118800_B21","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1111\/jsm.12473","article-title":"Efficacy of vaginally applied estrogen, testosterone, or polyacrylic acid on sexual function in postmenopausal women: a randomized controlled trial","volume":"11","author":"Fernandes","year":"2014","journal-title":"J Sex Med"},{"key":"2020071623234118800_B22","unstructured":"Davis SR. 2018 Supplementary data. Intra-vaginal testosterone improves sexual satisfaction and vaginal symptoms associated with aromatase inhibitors. figshare 2018. https:\/\/doi.org\/10.26180\/5b6517ab522f4. Accessed 4 August 2018."},{"issue":"1","key":"2020071623234118800_B23","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1038\/ijir.2012.25","article-title":"Androgen receptor expression in the human vagina under different physiological and treatment conditions","volume":"25","author":"Baldassarre","year":"2013","journal-title":"Int J Impot Res"},{"issue":"4","key":"2020071623234118800_B24","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1007\/s11255-011-9938-5","article-title":"The effect of testosterone treatment on urodynamic findings and histopathomorphology of pelvic floor muscles in female rats with experimentally induced stress urinary incontinence","volume":"43","author":"Mammadov","year":"2011","journal-title":"Int Urol Nephrol"},{"issue":"11","key":"2020071623234118800_B25","doi-asserted-by":"crossref","first-page":"4589","DOI":"10.1210\/endo.142.11.8547","article-title":"Minireview: aromatase and the regulation of estrogen biosynthesis--some new perspectives","volume":"142","author":"Simpson","year":"2001","journal-title":"Endocrinology"},{"issue":"3","key":"2020071623234118800_B26","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1530\/acta.0.0040265","article-title":"Proliferative effect of testosterone propionate on human vaginal epithelium","volume":"4","author":"Salinger","year":"1950","journal-title":"Acta Endocrinol (Copenh)"},{"issue":"1","key":"2020071623234118800_B27","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1001\/jama.1943.02840010019004","article-title":"Testosterone propionate pellet implantation in gynecic disorders","volume":"121","author":"Greenblatt","year":"1943","journal-title":"JAMA"},{"issue":"6","key":"2020071623234118800_B28","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1097\/GME.0000000000001052","article-title":"A systematic review of intravaginal testosterone for the treatment of vulvovaginal atrophy","volume":"25","author":"Bell","year":"2018","journal-title":"Menopause"},{"issue":"3","key":"2020071623234118800_B29","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1111\/j.1743-6109.2009.01667.x","article-title":"A comparative study of the effects of local estrogen with or without local testosterone on vulvovaginal and sexual dysfunction in postmenopausal women","volume":"7","author":"Raghunandan","year":"2010","journal-title":"J Sex Med"},{"issue":"5","key":"2020071623234118800_B30","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1097\/01.gme.0000227401.98933.0b","article-title":"A randomized comparative study of the effects of oral and topical estrogen therapy on the vaginal vascularization and sexual function in hysterectomized postmenopausal women","volume":"13","author":"Long","year":"2006","journal-title":"Menopause"},{"issue":"4","key":"2020071623234118800_B31","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/S0015-0282(02)04923-3","article-title":"Correlation of androgen receptors, aromatase, and 5-alpha reductase in the human vagina with menopausal status","volume":"79","author":"Berman","year":"2003","journal-title":"Fertil Steril"},{"issue":"1","key":"2020071623234118800_B32","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1210\/jcem.86.1.7103","article-title":"Parental testosterone improves endothelium-dependent and independent vasodilation in postmenopausal women already receiving estrogen","volume":"86","author":"Worboys","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2020071623234118800_B33","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/j.1743-6109.2006.00406.x","article-title":"Genital and subjective measurement of the time course effects of an acute dose of testosterone vs. placebo in postmenopausal women","volume":"4","author":"Heard-Davison","year":"2007","journal-title":"J Sex Med"},{"issue":"1","key":"2020071623234118800_B34","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/01.mca.0000236290.79306.d1","article-title":"Endogenous testosterone and endothelial function in postmenopausal women","volume":"18","author":"Montalcini","year":"2007","journal-title":"Coron Artery Dis"},{"issue":"2","key":"2020071623234118800_B35","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.maturitas.2008.12.017","article-title":"Age-specific prevalence of, and factors associated with, different types of urinary incontinence in community-dwelling Australian women assessed with a validated questionnaire","volume":"62","author":"Botlero","year":"2009","journal-title":"Maturitas"},{"issue":"12","key":"2020071623234118800_B36","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1016\/j.jsxm.2017.09.018","article-title":"Aromatase inhibitors are associated with low sexual desire causing distress and fecal incontinence in women: an observational study","volume":"14","author":"Robinson","year":"2017","journal-title":"J Sex Med"},{"key":"2020071623234118800_B37","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1016\/0378-5122(95)00958-2","article-title":"The prevalence of urogenital symptoms in postmenopausal women","volume":"22","author":"Stenberg","year":"1995","journal-title":"Maturitas"},{"key":"2020071623234118800_B38","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.lfs.2017.05.006","article-title":"Micturition dysfunction in four-month old ovariectomized rats: effects of testosterone replacement","volume":"179","author":"Bonilla-Becerra","year":"2017","journal-title":"Life Sci"},{"key":"2020071623234118800_B39","author":"Bonilla","year":"2018"},{"issue":"2","key":"2020071623234118800_B40","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.juro.2017.08.093","article-title":"The association of serum testosterone levels and urinary incontinence in women","volume":"199","author":"Kim","year":"2018","journal-title":"J Urol"},{"key":"2020071623234118800_B41","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.fertnstert.2016.10.028","article-title":"Efficacy and safety of transdermal testosterone in postmenopausal women with hypoactive sexual desire disorder: a systematic review and meta-analysis","volume":"107","author":"Achilli","year":".","journal-title":"Fertil Steril"},{"issue":"19","key":"2020071623234118800_B42","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1056\/NEJMoa0707302","article-title":"Testosterone for low libido in postmenopausal women not taking estrogen","volume":"359","author":"Davis","year":"2008","journal-title":"N Engl J Med"},{"issue":"5","key":"2020071623234118800_B43","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/01.GME.0000060256.03945.20","article-title":"Transdermal testosterone therapy improves well-being, mood, and sexual function in premenopausal women","volume":"10","author":"Goldstat","year":"2003","journal-title":"Menopause"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/103\/11\/4146\/26109433\/jc.2018-01345.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/103\/11\/4146\/26109433\/jc.2018-01345.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T08:16:32Z","timestamp":1594973792000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/103\/11\/4146\/5096789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,14]]},"references-count":43,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2018-01345","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.734054609.793551123","asserted-by":"object"}]},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2018,11]]},"published":{"date-parts":[[2018,9,14]]}}}