A new ratio: urinary etiocholanolone/androsterone as an indication of sexual interest in postmenopausal women

Abstract

Background: Although the role of testosterone in women’s interest in sex after menopause has been suggested, it appears not to be related to testosterone. Testosterone is converted to its active dihydrotestosterone by an enzyme 5α-reductase.Objective: To introduce a new ratio for detection of sexual interest in postmenopausal women.Methods: Thirty postmenopausal women experiencing a loss of interest in sex were studied for 5α-reductase activity through its urinary product etiocholanolone to 5α product. Androsterone of androstenedione and 30 women with no loss of sexual interest after menopause were used as controls; hormone replacement therapy was started (using prempack-C = 0.625 conjugated estrogen, 0.15 norgestrol).Results: A ratio of more than one indicates a higher loss of interest, and this ratio will be reversed after estrogen therapy and a rate <1. There is no loss of interest and less response to estrogen therapy. The urinary etiocholanolone/androsterone ratio has a positive predictive of 0.91 and a negative predictive value of 6.6 in determining which women will experience a loss of interest in sex following menopause and which will respond to estrogen therapy.Conclusions: A new ratio will now determine sexual response at menopause, and it can measure the effect of treatment.