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Estrogen replacement therapy: effects on the endogenous androgen milieu
1George Washington University School of Medicine, Washington, D.C., USA. jasimon@whrc.net
Fertility and Sterility
|May 15, 2002
Summary
Estrogen replacement therapy (ERT) and aging reduce androgen levels and bioavailability in women. These hormonal changes may negatively impact susceptible individuals, highlighting the need for careful consideration of ERT.
Area of Science:
- Endocrinology
- Reproductive Health
- Gerontology
Background:
- Androgens play crucial roles in female physiology, influencing mood, cognition, and sexual function.
- Androgen production and bioavailability naturally decline with age, a process potentially accelerated by menopause.
Purpose of the Study:
- To examine how exogenous estrogen replacement therapy (ERT) affects the production, binding, and metabolism of androgens.
- To understand the interplay between aging, ERT, and androgen levels in postmenopausal women.
Main Methods:
- A comprehensive literature review was conducted using MEDLINE.
- Studies published from January 1966 to June 2001 were analyzed.
Main Results:
- Androgen production decreases gradually throughout adulthood, not abruptly at menopause.
- Estrogen replacement therapy, especially oral forms, significantly diminishes androgen bioavailability.
- The combined effects of aging and oral ERT markedly reduce the endogenous bioavailable androgen pool.
Conclusions:
- Aging and ERT, particularly oral ERT, substantially lower androgen bioavailability in postmenopausal women.
- These reductions in bioavailable androgens may have adverse clinical consequences for certain individuals.
- Further research is warranted to explore the clinical implications of diminished androgen milieu in aging women receiving ERT.