Use of transdermal testosterone to treat menopausal symptoms in women with a history of breast cancer: a small, retrospective, open-label study

Objectives: To determine whether use of transdermal testosterone therapy is associated with improvement in menopausal symptoms for women with a history of breast cancer. Methods: A UK-based, open-label, retrospective cohort study. The Menopause Symptom Questionnaire (MSQ) was used to measure the prevalence and severity of menopausal symptoms in perimenopausal and postmenopausal breast cancer survivors before and after treatment with transdermal testosterone. Results: Forty-seven women were included (mean age 48.1 ± 8.6 y; mean time since breast cancer diagnosis 6.0 ± 5.7 y). At baseline the menopausal symptom burden was high. Fatigue, cognitive symptoms, and reduced libido were the most prevalent symptoms (98%, 96%, and 96% of women, respectively). Treatment with testosterone for 3.7 ± 1.8 months was associated with significant reductions in the prevalence of: night sweats (78.7% vs. 55.3%, P =0.03), anxiety/panic (78.7% vs. 51.1%, P =0.01), unhappy/depressed (80.9% vs. 51.1%, P =0.005), anhedonia (80.9% vs. 59.6%, P =0.04), and palpitations (59.6% vs. 31.9%, P =0.013). The mean MSQ score decreased from 30.81 (± 8.12) to 20.47 (± 8.00) ( P <0.001). After excluding libido, the mean MSQ score decreased from 28.36 (± 8.04) to 18.43 (± 7.77) ( P ≤0.001). Significant reductions in symptom severity were observed for 20 of 24 symptoms. Conclusions: Testosterone therapy was associated with significant improvement in menopause symptoms in women with a history of breast cancer. Placebo-controlled randomised clinical trials are needed to assess the impact of testosterone on menopausal symptoms beyond reduced libido and establish long-term safety in women with a history of breast cancer.