Please select the eligibility criteria that correspond to the clinical trial below.
Title: Sex Steroids in Sjögren's Syndrome: Effect of Substitution Treatment on Fatigue
Brief Summary: Our research contributes to the understanding of some of the basic biology of the salivary glands. The etiology and many of the pathomechanisms of Sjögren's syndrome are unknown. In particular, reasons for the female dominance, late age of onset, fatigue and the prominent involvement of exocrine glands are unknown. We hypothesize, due to the disease characteristics, that the primary target hit by the disease process is the secretory acinar cell and that this cell is particularly damaged in women due to insufficient support, normally provided by dehydroepiandrosterone and its intracrine processing.


Options:
A: Inclusion Criteria:

* Woman participating in the research will be in the menopausal phase or after it (above a year in postmenopause)aged 65 and below. Man age range will be 18 - 65.

Exclusion Criteria:

* Individuals suffering from a significant systemic illness, hormonal illness, alcoholism, drug abuse, major depression, "Mano/matroagia" or hypogonadism. Additionally, individuals treated with androgens, antidepressant or any other medication which may cause a disorder in sexual desire.
* Man diagnosed as suffering from prostate carcinoma, BHP or will show PSA levels above 2.5 will not be included.
* Woman treated with HRT or suffering from any of the following diseases will not be included: breast carcinoma, ovarian or uterus cancer or with a first grade family history of one of the mentioned.
B: Inclusion Criteria:

1. Primary SS according to the American-European consensus criteria
2. General Fatigue ≥14 calculated from MFI-20 (Multiple fatigue inventory-20 questionnaire; the value was based on a pilot study of 239 members of the Finnish SS patient association)
3. subnormal serum S-DHEAS values (the reference values were calculated based on a pilot study of 81 healthy women and 57 healthy men).

Exclusion Criteria:

1. Age \<18 years or \>80 years
2. prisoner
3. individuals not able to give their informed consent
4. history of breast cancer
5. history of uterus cancer
6. history of prostatic cancer
7. history of stroke or prothrombotic coagulation disorders
8. pregnant or lactating women
9. fertile patients without adequate prevention
10. difficult acne
11. a significant liver disease
12. patients with changes in their systemic medication taken for SS during the previous three months 13) patients taking more than 10 mg prednisolone per day
C: Inclusion Criteria:

* Be a generally healthy surgically menopausal woman (12 months), 20 to 70 years of age, not receiving any systemic estrogen or estrogen progestin therapy
* Be a generally healthy naturally menopausal woman (2 years since last period), 40 to 70 years of age, not receiving any systemic estrogen or estrogen progestin therapy.
* Be, in their own judgment, in a stable monogamous sexual relationship for at least one year prior to study entry that is perceived to be secure and communicative with the same partner who is sexually functional and physically present at least 50% of the time.
* Answer affirmatively to ALL of the following questions:

  1. Was the patient's sex life before menopause good and satisfying in general?
  2. Since menopause, has a meaningful loss in the level of desire for sex occurred?
  3. Since menopause, has a significant decrease in sexual activity occurred?
  4. Is the current level of desire for or interest in sex bothering or concerning?
  5. Is an increase in the level of interest in or desire for sex and sexual activity desired?

Exclusion Criteria:

* Physical limitations that would interfere with normal sexual function;
* Estrogen use in the last 12 weeks (vaginal estriol or low dose vaginal estradiol accepted)
* Use of any of the following medications:

  * antiandrogen therapy or topical minoxidil (last 5 years),
  * androgen therapy (past 3 months/implantable past 7 months),
  * systemic corticosteroids,
  * selective serotonin reuptake inhibitors (SSRIs),
  * tricyclic anti-depressants,
  * anti-androgens,
  * systemic beta-blockers,
  * anti-adrenergics,
  * spironolactone,
  * apomorphine,
  * phosphodiesterase type 5 (PDE5) inhibitors (e.g., Viagra, tibolone or selective estrogen receptor modulators (SERMs), including tamoxifen (last 12 weeks))
* Be experiencing any chronic or acute life stress relating to any major life change that may significantly interfere with sexual function;
* Have significant psychiatric disorder (including mild depressive disorder - Beck Depression Inventory-II score of \> 14;
* Have current severe dermatological problems or a known suspected hypersensitivity or allergy to any adhesive or any of the constituents of the transdermal testosterone patch
* Have evidence of or history of malignancy (estrogen dependent or any gynecological cancer) within the last 5 years;
* Have diabetes mellitus, active gallbladder disease, unstable thyroid disease, history of cerebrovascular disease, thrombo-embolic disorders, myocardial infarction or angina within the last 5 years or other significant organic disease that would prevent the patient from completing the study, or otherwise affect the outcome of the study.
* Have significant abnormal pretreatment laboratory parameters.
D: Postmenopausal women ages 50 to 79.

Answer: B