Author(s): Sonja Sokolovska, Moira J Finlay, George A Varigos and Susan R Davis
A 64 year old Caucasian lady living with Behçet's disease since 1984 presented with recurrent oral and genital ulceration refractory to colchicine, nicotinamide, and topical corticosteroids. The patient reported in the early years of her disease, that her ulcers worsened premenstrually and tended to heal around the middle of her menstrual cycle. She was commenced on testosterone therapy for the management of loss of libido, administered as a 50 mg subcutaneous implant (Organon, Netherlands) every 6 months, in combination with an estradiol patch releasing 75 mcg/day. Incidentally, the patient found marked improvement in the distribution and severity of her oral ulcers within weeks of the insertion of each testosterone implant, with concomitant resolution of all genital ulcers and a marked improvement in her overall quality of life. The treatment of Behcet's disease remains largely anecdotal at present. The use of subcutaneous testosterone implants could thus potentially serve as a safe and effective treatment option to improve oral and genital ulceration in females who suffer from this debilitating inflammatory condition. However, further investigation regarding the use of subcutaneous testosterone in the management of autoimmune diseases in women could be the subject of future research.
