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Hormonal Changes in Cardiac Syndrome X – Role of Testosterone

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Chest Pain with Normal Coronary Arteries

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Abstract

Cardiac Syndrome X occurs predominately in peri- or post-menopausal women. The onset of the chest pain associated with Cardiac Syndrome X coincides with the menopause or hysterectomy and the related decrease in circulating ovarian hormones. As well as estrogens and progestogens, testosterone is synthesized in the ovaries and adrenal glands of women, and has important physiological actions in women, either directly via androgen receptors or as precursors of estrogen production. Testosterone replacement can be given to menopausal women, with or without estrogen, to increase libido, relieve menopausal symptoms, increase bone density and improve quality of life. As well as chest pain, common symptoms of Cardiac Syndrome X include tiredness and lethargy, and it is feasible that reduced androgen concentrations may be involved in the pathophysiology of the syndrome. Relatively few studies have investigated the effects of testosterone replacement in women, and even fewer in women with Cardiac Syndrome X. Further studies are needed to better understand the role of testosterone in the pathophysiology and treatment of Cardiac Syndrome X.

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Author information

Authors and Affiliations

  1. Clinical Cardiology and Physiology, NHLI, Imperial College London, and Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK

    Carolyn M. Webb PhD

  2. Clinical Cardiology and Physiology, NHLI, Imperial College London, and Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, UK

    Peter Collins MA, MD (Cantab) FRCP

Authors
  1. Carolyn M. Webb PhD
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  2. Peter Collins MA, MD (Cantab) FRCP
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Correspondence to Carolyn M. Webb PhD .

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Editors and Affiliations

  1. Medical School, Coronary Artery Disease, Research Group, St George's Hospital, Cranmer Terrace, London, SW17 0RE, United Kingdom

    Juan Carlos Kaski

  2. University of Sydney, Discipline of Surgery, The Whiteley-Martin Research Centre, Parker Street, Sydney, 2747, New South Wales, Australia

    Guy D. Eslick

  3. , Women's Heart Center, Cedars-Sinai Heart Institute, S. San Vicente Blvd 444, Los Angeles, 90048, USA

    C. Noel Bairey Merz

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Webb, C.M., Collins, P. (2013). Hormonal Changes in Cardiac Syndrome X – Role of Testosterone. In: Kaski, J., Eslick, G., Bairey Merz, C. (eds) Chest Pain with Normal Coronary Arteries. Springer, London. https://doi.org/10.1007/978-1-4471-4838-8_28

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  • DOI: https://doi.org/10.1007/978-1-4471-4838-8_28

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4837-1

  • Online ISBN: 978-1-4471-4838-8

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