Testosterone therapy for women: an Australian perspective

There is more to female sexual function than just circulating testosterone, and symptomatic women require a thorough clinical evaluation, according to the authors of a Perspective published online by the MJA. Commenting on the 2019 global consensus position statement on the use of testosterone therapy for women, Dr Christina Jang, an endocrinologist at Mater Health Services and senior lecturer at the University of Queensland, and colleagues wrote that the classification of female sexual disorders had been “a source of controversy and debate”. “In the Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition, hypoactive sexual dysfunction disorder (HSDD) and female sexual arousal disorder (FSAD) have been amalgamated and classified as a single entity: female sexual interest/arousal disorder. The writing group for the position statement regards HSDD and FSAD to be distinct conditions, a view shared by experts in the field,” wrote Jang and colleagues. “It is important to understand this clinical distinction as the position statement does not consider FSAD to be an indication for testosterone therapy.” Sexual dysfunction is common among Australian women. The prevalence of low sexual desire and HSDD was 69.3% and 32.2%, respectively, among a sample of community-based women aged 40–65 years in one study. In older women, the prevalence of HSDD was reported to be one in seven women in a population of women aged 65–79 years living in the community. “Clinicians in many countries including Australia have been prescribing testosterone off-label primarily for low sexual desire in women for several years,” Jang and colleagues wrote. “Clinicians managing these patients will require education in practical terms about assessing such patients for HSDD and safely prescribing and monitoring testosterone therapy when indicated.” The authors recommended further research to “address the safety of long term use of testosterone in women, particularly with respect to cardiovascular disease and breast cancer”.

Multiscreening may muddle your memory

Engaging with multiple forms of digital media simultaneously, known as media multitasking, may have a negative effect on memory performance in young adults, reports a study published in Nature. The findings suggest that heavy media multitasking, such as prolonged television watching while texting and surfing the internet, is associated with an increase in attention lapses and forgetting. In a group of 80 young adults (aged 18–26 years), researchers from Stanford University examined whether media multitasking related to spontaneous attention lapses, and whether attention lapses negatively related to remembering. Participants were briefly presented with images of objects on a computer screen. After a delay period of 10 minutes, they were presented with a second round of images and had to identify whether they were bigger or smaller, more pleasant or unpleasant, or if they had seen the image before or not compared with the previous set. Attention lapses were assessed by measuring changes in brainwave activity and pupil diameter. Participants also answered questionnaires that measured their weekly media multitasking engagement, symptoms of attention deficit/hyperactivity disorder (ADHD), impulsivity, video game usage, attention and mind wandering tendencies. The results suggested that lapses of attention in the moment prior to remembering were related to a reduction in the neural signals of memory, along with forgetting. The authors proposed that heavier media multitasking may be associated with a tendency to suffer more frequent attention lapses, which contributes to worse episodic memory.

Baby girls who do not live with both parents may be at higher risk of early puberty

Girls who do not live with both parents from birth to age 2 years may be at higher risk of starting puberty at a younger age than girls living with both parents, according to research published in BMC Pediatrics. The findings support the hypothesis that stress in early life may influence puberty onset. The risk of early puberty onset could potentially be mitigated by interventions aiming to improve child wellbeing. A team of US researchers found that girls who did not live with both parents from birth to age 2 years were 38% more likely to begin their period before the age of 12 years, compared with girls who lived with both parents. Girls who did not live with both parents between the ages of 2 and 6 years were 18% more likely than girls whose parents lived together to begin their period before the age of 12 years. They also found that girls who did not live with both parents from birth to age 2 years were 29% more likely to begin developing breasts earlier and 21% more likely to start the growth of pubic hair earlier, compared with girls who lived with both parents. Girls who did not live with both parents between the ages of 2 and 6 years were 13% more likely to start developing breasts and 15% more likely to start developing pubic hair earlier than girls who lived with both parents. The researchers used electronic health record data of girls born between 2003 and 2010 within the Kaiser Permanente Northern California health care system. Out of the 26 044 girls included in the study, 2034 (8%) lived with one parent before the age of 2 years and 2186 (8%) lived with one parent between the ages of 2 and 6 years. The researchers suggested that infant attachment insecurity – the lack of a positive bond that develops between infant and caregiver – may be one mechanism by which girls living in single-parent households before age 2 years are experiencing earlier pubertal onset.

People with higher vitamin A, E and D intake may have fewer respiratory complaints

High vitamin A, E and D intake may be linked to fewer respiratory complaints in adults, according to UK research published in BMJ Nutrition, Prevention and Health. The study surveyed 6115 adult participants in the 2008–2016 National Diet and Nutrition Survey Rolling Programme who had completed 3 or more days of diet diaries over 8 years about their diet, and also asked them about respiratory conditions such as colds and asthma. It found 33 cases of respiratory complaints and that vitamin A and E intake from both diet and supplements were associated with a lower prevalence of respiratory complaints. Vitamin D intake from supplements, but not from diet, was associated with fewer respiratory complaints, prompting the researchers to suggest that the findings add to the current scientific debate on the value of vitamin D supplementation. This was an observational study, and as such, can’t establish cause, added to which the number of respiratory complaints was small, meaning that no inferences can be made in respect to the coronavirus disease 2019 (COVID-19) pandemic, cautioned the researchers.


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