Androgen therapy in women

Area of Science:

• Endocrinology
• Women's Health
• Reproductive Medicine

Background:

• Androgens in women originate from ovarian production or adrenal conversion of dehydroepiandrosterone (DHEA).
• Loss of adrenal or ovarian function (e.g., Addison's disease, oophorectomy) leads to androgen deficiency, impacting libido and energy.
• Physiological menopause does not consistently cause androgen deficiency due to persistent ovarian androgen synthesis.

Purpose of the Study:

• To critically evaluate the definition and diagnosis of female androgen deficiency.
• To review current androgen replacement therapies and their efficacy.
• To establish appropriate indications for androgen therapy in women.

Main Methods:

• Review of existing literature on female androgen production, deficiency, and treatment.
• Analysis of the Princeton consensus statement criteria for androgen deficiency.
• Evaluation of clinical trial data for testosterone and dehydroepiandrosterone (DHEA) replacement.

Main Results:

• The current definition of female androgen deficiency is imprecise, potentially leading to over-diagnosis.
• Androgen replacement therapies (transdermal testosterone, DHEA) show improvements in libido and mood.
• Limited randomized controlled trials exist, and no preparations are FDA-approved for women.

Conclusions:

• Androgen deficiency in women requires careful diagnosis, considering established causes beyond menopause.
• Androgen replacement therapy should be reserved for women with severe deficiency and clear clinical symptoms.
• Further research is needed to clarify the role of androgens and optimize treatment in women.