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Mechanism of action/effects of androgens on lipid metabolism

M D Gillmer1

  • 1John Radcliffe Maternity Hospital, Oxford, England.

International Journal of Fertility
|January 1, 1992
PubMed

Insights

Androgens lower beneficial HDL cholesterol and raise harmful LDL cholesterol, increasing cardiovascular disease risk in women. Estrogens offer protection, but this is lost after menopause, impacting heart disease incidence.

Area of Science:

  • Cardiovascular endocrinology
  • Lipoprotein metabolism
  • Women's cardiovascular health

Background:

  • Cardiovascular disease (CVD) risk factors in women include diabetes, hypertension, smoking, and hypertriglyceridemia.
  • Hormonal differences between sexes influence lipoprotein profiles, affecting CVD risk.
  • Estrogens are believed to be protective against CVD in premenopausal women, while androgens may increase risk.

Purpose of the Study:

  • To review the effects of androgens on lipoprotein metabolism in both men and women.
  • To examine the relevance of androgen effects on lipoproteins to oral contraceptive progestogen selection.
  • To understand the hormonal basis for sex differences in cardiovascular disease incidence.

Main Methods:

  • Literature review of studies on endogenous and exogenous androgens.
  • Analysis of the impact of androgens and estrogens on High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL) levels.
  • Consideration of menopausal status and its effect on hormone levels and CVD risk.

Main Results:

  • Androgens decrease HDL (especially HDL-2) and increase LDL concentrations.
  • Estrogens increase HDL (especially HDL-2) and decrease LDL concentrations.
  • The loss of estrogen's protective effect post-menopause contributes to increased CVD incidence in women.

Conclusions:

  • Androgen activity significantly influences lipoprotein metabolism and cardiovascular risk.
  • Understanding these hormonal effects is crucial for selecting appropriate progestogens in oral contraceptives.
  • Hormonal therapy and oral contraceptives require careful consideration regarding their impact on cardiovascular health in women.

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