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Effect of postmenopausal estrogen replacement on circulating androgens
P R Casson1, K E Elkind-Hirsch, J E Buster
1Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA. pcasson@bcm.tmc.edu
Obstetrics and Gynecology
|December 16, 1997
Summary
Estrogen replacement therapy (ERT) significantly lowers serum androgen levels, including dehydroepiandrosterone-sulfate and testosterone, in postmenopausal women. This suggests ERT may cause androgen deficiency, warranting further investigation into androgen replacement.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Hormone Therapy
Background:
- Postmenopausal women often experience hormonal changes affecting androgen levels.
- Estrogen replacement therapy (ERT) is used to manage menopausal symptoms.
- The impact of ERT on serum androgens in postmenopausal women requires clarification.
Purpose of the Study:
- To investigate the effects of estrogen replacement therapy (ERT) on serum androgen levels in postmenopausal women.
- To quantify changes in dehydroepiandrosterone (DHEA), DHEA-sulfate, and testosterone following ERT.
Main Methods:
- A randomized, blinded, placebo-controlled crossover study.
- 28 postmenopausal women received 2 mg/day of oral micronized estradiol for 12 weeks with a 6-week washout period.
- Serum levels of androgens, estradiol, gonadotropins (LH, FSH), and sex hormone-binding globulin were measured.
Main Results:
- ERT significantly increased serum estradiol (E2) levels.
- Mean serum dehydroepiandrosterone-sulfate decreased by 23% and testosterone by 42% with ERT.
- Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels declined, while sex hormone-binding globulin increased by 160%.
Conclusions:
- Menopausal ERT leads to a significant decrease in serum androgen levels (DHEA-sulfate and testosterone).
- The reduction in testosterone may be linked to decreased LH-driven ovarian steroidogenesis.
- ERT may induce a relative ovarian and adrenal androgen deficiency, suggesting a potential need for concurrent androgen replacement.