MONDAY, April 14 (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  .

SATURDAY, April 12 (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 information

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

FRIDAY, April 11 (HealthDay News) -- Three-quarters of the 68 countries most in need of improving mother and child mortality rates have made little, if any, progress in meeting internationally set goals over the past three years, according to a series of new reports.

The Countdown to 2015 for Maternal, Newborn and Child Survival, an international group that monitors these goals, still holds hope that progress can be made quickly in these underachieving nations, according to reports this week in a special edition of The Lancet.

The medical journal looks at the group's efforts in 68 "priority" or "countdown" countries, where 97 percent of the maternal and child-under-5 deaths occur worldwide. The group has set goals to reduce child mortality rate by two-thirds and maternal deaths by three-quarters by 2015.

In a commentary, Lancet Editor Dr. Richard Horton calls the Countdown project's overall progress "strikingly inadequate" and concludes, "children and mothers are dying, because those who have the power to prevent their deaths choose not to act. This indifference -- by politicians, policy makers, donors, research funders and civil society -- is a betrayal of our collective hope for a stronger and more just society."

Of the priority countries, only 16 are on track to reach the goal of reducing the mortality rate in children. Three -- China, Haiti and Turkmenistan -- had made demonstrable progress to improve maternal, newborn and child survival since the countdown began in 2005. The others were either already on track when the countdown was launched or were added onto the list only recently.

Most of the countries that have made no progress, or even taken steps backward, are in sub-Saharan Africa.

Another report in The Lancet states that most of the countries being watched have made some progress since 1990 to reduce the coverage gap for four key interventions -- family planning, maternal and newborn care, immunization and treatment of sick children. Yet the study, by the Countdown 2008 Equity Analysis Group, said the pace needs to be more than doubled if they hope to meet goals for 2015.

While actual maternal mortality was still high or very high in 56 of 68 countries, one report suggests some key parts of the solution are in place. These include consensus on priority interventions (such as immunization and antenatal care), various health-care policies and funding increases.

For example, donor funding increases have nearly doubled funding per child in the 68 countries, according to one report in The Lancet. Child-related disbursements increased from a mean of $4 per child in 2003 to $7 in 2006. Those for maternal and neonatal health increased from $7 per live birth in 2003 to $12 per live birth in 2006.

However, the report noted that funding still dropped in several countries, stifling attempts for governments to make long-term commitments to health improvements.

"In the seven years until 2015, the next two years before the next Countdown Report will be the most crucial," the study's authors wrote. "With strategic decisions and investments, and a focus on partnerships for results, we have the opportunity to see unprecedented progress in these 68 countries. Or will the 2010 report show more of the same gaps and lives lost?"

Some of the other findings in the special edition include:

• Policy gaps in many of the countries are hindering their progress along with financing woes and human resources issues.
• Tanzania is one of the few African nations on track to meet the goal of reducing child mortality, showing a 24 percent decline from 2000 to 2004. The report credits good program funding and several initiatives such as insecticide-treated nets to prevent malaria, vitamin A supplementation, immunization and exclusive breast-feeding.
• South Africa is suffering major setbacks in meeting its goals because of pregnancy and childbirth complications, newborn illness, childhood illness, HIV and AIDS, and malnutrition. It is one of just 12 countries globally where the child mortality rate has risen since 1990.

More information

Here's more about Countdown to 2015  .

FRIDAY, April 11 (HealthDay News) -- A new HIV/AIDS vaccine designed to overcome the problem of preexisting immunity to common vaccine vectors is being tested in an early clinical trial at Brigham and Women's Hospital in Boston.

Preexisting immunity is believed to be a major problem in developing nations.

There will be 48 healthy volunteers taking part in the trial of the vaccine, which consists of a replication-incompetent, recombinant adenovirus serotype 26 (rAd26) vector encoding an HIV-1 envelope gene.

Each volunteer will receive either two or three immunizations, and then be monitored to assess the safety of the vaccine and its ability to trigger an immune response.

The rAd26 vaccine was developed by the Integrated Preclinical/Clinical AIDS Vaccine Development (IPCAVD) program, sponsored by the U.S. National Institute of Allergy and Infectious Diseases. The program brings together academic and industry researchers to accelerate development of promising HIV/AIDS vaccine candidates.

The vaccine, the first HIV-1 vaccine candidate to emerge from the IPCAVD program, is made by Dutch biotechnology company Crucell Holland B.V.

The approach used in developing the rAd26 vaccine enables researchers to circumvent preexisting immunity to serotype 5, the virus responsible for the common cold. This virus has recently shown limitations as an HIV-1 vaccine vector.

"The rAd26 vector does not regularly occur in the human population, and human antibodies to this vector are rare. The rAd26 vector therefore is efficacious in eliciting good T and B (immune) cell responses," Jaap Goudsmit, chief scientific officer at Crucell, said in a prepared statement.

About 33.2 million people worldwide are living with HIV/AIDS, and there were 2.7 million new infections reported in 2007.

More information

Currently, there is no vaccine to protect against HIV/AIDS. The American Academy of Family Physicians offers tips for preventing HIV infection  .