Estrogen Cream No Match for Sun-Damaged Skin

(HealthDay News) -- The hormone cream estradiol can repair aging skin, but only if that skin has never been touched by the damaging UV rays of sunlight, new research finds.

Decades of sun damage on the face and arms and other exposed areas seem to undermine the power of the cream, according to a study in the September issue of the Archives of Dermatology.
"Despite commonly held beliefs, estrogen was not able to raise collagen when the skin was damaged by sunlight," said study author Laure Rittié, a research investigator in the department of dermatology at the University of Michigan Medical School in Ann Arbor. "Apparently, chronic exposure to sunlight breaks something in the way estrogen increases collagen, which makes damaged skin even harder to repair."

Unfortunately, these are the exact areas that are most in need of repair.

"There was a general belief that estrogen was good for the skin," Rittié explained.

But most, if not all, previous studies that had purported to show this looked at sun-protected areas of the skin, not sun-exposed areas.

"When we look for treatments for aging skin, we usually want to treat the face or hands or neck, in other words, sun-exposed areas," Rittié explained. "We decided to go ahead and carefully test these questions."

Researchers applied topical estradiol for two weeks to both sun-exposed areas on the forearm and non-exposed skin near the hip in 40 women and 30 men, average age 75.

A biopsy was taken from each volunteer 24 hours after the last treatment.

The cream stimulated collagen production in sun-protected skin areas but not in sun-damaged areas. The collagen-promoting effects were found in both men and women but were more pronounced in women volunteers.

Both types of skin, however, had similar levels of estrogen-receptor expression. Estradiol activity seemed to be the same, regardless of whether the skin had or had not been damaged by the sun.

The study was partially supported by Pfizer.

The authors acknowledge that treating volunteers for more than two weeks might have yielded different results in sun-exposed skin areas; additional studies would be needed to test this.

"What makes a hormone a hormone is that it is made in one place but works somewhere else in the body," said Dr. Doris Day, an attending physician in dermatology at Lenox Hill Hospital in New York City. "It's like a light switch, it's small but, when you turn it on, the whole room lights up. Estradiol cream is like a little switch, but we're only just beginning to understand the different parts of the body it affects and how it affects them. This is putting the science behind the anecdote."

More information
The American Academy of Dermatology has sun-safety tips.

Testosterone Spray Improves Sexual Satisfaction in Women

(HealthDay News) -- Testosterone spray slightly improved sexual satisfaction in premenopausal women, but a placebo had the same effect, a new study reports.

Researchers look at 261 women, aged 35 to 46, who were treated at six medical centers in Australia. The women, with self-reported low libido and low serum-free testosterone levels, were randomly assigned to receive one of three different doses of a testosterone spray or a placebo daily for 16 weeks.

At the end of that time, all the women reported increased frequency of sexually satisfying events. The difference between the testosterone spray and the placebo was statistically significant only for women who received the middle dose of testosterone.

The researchers found that 81 percent to 86 percent of women in the testosterone groups and 70 percent of the women in the placebo group reported adverse side effects. The most common was hair growth on the abdomen, where the testosterone was sprayed.

The study was published in the April 15 issue of the Annals of Internal Medicine.

In an accompanying editorial, Dr. Rosemary Bassone, of the University of British Columbia in Vancouver, wrote that women's testosterone levels and libidos may decline as they age, but that doesn't mean the lack of testosterone is linked with sexual dissatisfaction.

"We do not have a fully satisfactory rationale for testosterone therapy," and there is a "lack of long-term safety data," Bassone wrote.

Instead of prescribing testosterone for women with sexual dissatisfaction, doctors should examine health and relationship issues, sexual dysfunction in the partner, and treat problems using conventional methods such as cognitive behavioral therapy, sex therapy and psychotherapy, Bassone recommended.

More information
The American Academy of Family Physician has more about female sexual dysfunction.

Male Contraception: Progress Slow but Steady

(HealthDay News) -- For now, men who want to do their part for birth control have meager choices: A vasectomy -- meant to be permanent -- and condoms.

For years, experts have predicted that male contraception is under development and that more choices will be here soon.

But when? Experts agree it's still a ways off, but it's getting closer.

"It has been slow," said Dr. Ronald Swerdloff, a researcher in the quest to find feasible male contraceptive methods. But there are good reasons for that slow pace, added Swerdloff, an endocrinologist and chief of the division of endocrinology at Harbor-UCLA and professor of medicine at the Harbor-UCLA Medical Center in Los Angeles.

Pharmaceutical companies are reluctant to take on a new product quickly because of untested liability issues, he said. And "one of the biggest single issues has to do with the fact that contraception in general is a difficult area it would be used by large numbers of healthy individuals." The safety threshold, he noted, is high. Still, he added, more options are moving closer.

"If we really focus on studies, with funding, it could be four or five years" before more options might be available, said Elaine Lissner, director of the Male Contraception Information Project, a San Francisco-based organization.

The problem, she added, is that the research has been scattergun. "If we [continue to] do a study here, a study there, as we have for the last 20 years, it could take forever."

At a "Future of Male Contraception" conference, sponsored by the U.S. National Institutes of Health in Seattle, a variety of methods were reviewed, including:

• Hormonal therapy and testicular warming -- Swerdloff and his team found that giving men testosterone and another hormone with testicular warming helped suppress sperm. "The transient testicular warming [like sitting in a spa] causes the suppression to occur much earlier [than the hormones alone]," he said.
• Transdermal gels -- In another study by Swerdloff's team, 140 men applied either a progestin gel called Nestorone or a testosterone gel, or both. The researchers studied various doses and then drew blood samples to measure hormone levels. They reported on the 119 men who complied and finished the study, concluding that the combination worked better to suppress sperm.
• "Intra Vas Device," or IVD -- An alternative to a vasectomy, this method involves inserting silicone plugs into the vas deferens, the tube sperm move through and the same tube cut in a vasectomy. "The sperm can't get past the plugs," said Joe Hofmeister, president of Shepherd Medical Company in St. Paul, Minn., the IVD developer.
• "Preliminary six-month data show that 90 percent of 60 men [tracked to date] have zero motile sperm," he said. More study is needed to track the IVD for reversibility, Hofmeister said.
• Vitamin A blocker -- Columbia University researchers tested a drug abandoned by a pharmaceutical company because it interferes with vitamin A receptors in the testes, lowering fertility. It worked well in animal studies; whether it will do the same in human studies is not yet known.

These approaches, if successful, will take several more years to get market approval, all the researchers agreed.

More informationTo learn more about all available contraception methods, visit the U.S. National Library of Medicine.