Skip to main content

Androgen Replacement in Women

  • Chapter
Hormone Replacement Therapy

Part of the book series: Contemporary Endocrinology ((COE,volume 13))

Abstract

There is increasing awareness of the significant and varied actions of endogenous androgens in women and acknowledgment that women may experience symptoms secondary to androgen deficiency. There is also substantial evidence that prudent testosterone replacement is effective in relieving both the physical and psychological symptoms of androgen insufficiency and is indicated for clinically affected women. Testosterone replacement for women is now available in a variety of formulations. It appears to be safe, with the caveat that doses should be restricted to the “therapeutic window” for androgen replacement in women in which the beneficial effects on well-being and quality of life can be achieved without incurring undesirable virilizing side effects.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Judd HL. Hormonal dynamics associated with the menopause. Clin Obstet Gynecol 1976; 19: 775–788.

    Article  PubMed  CAS  Google Scholar 

  2. Kirschner MAA, Bardin CW. Androgen production and metabolism in normal and virilized women. Metabolism 1972; 21: 667–688.

    Article  PubMed  CAS  Google Scholar 

  3. Judd HL, Yen, S. S. C. Serum androstenedione and testosterone levels during the menstrual cycle. J Clin Endocrinol Metab 1973; 36 (475): 481.

    Google Scholar 

  4. Vierhapper H, Nowotny P, Waldhausl W. Determination of testosterone production rates in men and women using stable isotope dilution and mass spectromety. J Clin Endocrinol Metab 1997; 82: 1492–1496.

    Article  PubMed  CAS  Google Scholar 

  5. Mushayandebvu T, Castracane DV, Gimpel T, Adel T, Santoro N. Evidence for diminished midcycle ovarian androgen production in older reproductive aged women. Fertil Steril 1996; 65: 721–723.

    PubMed  CAS  Google Scholar 

  6. Dunn JF, Nisula BC, Rodboard D. Transport of steroid hormones. Binding of 21 endogenous steroids to both testosterone-binding globulin and cortico-steroid-binding globulin in human plasma. J Clin Endocrinol Metab 1981; 53: 58–68.

    Article  PubMed  CAS  Google Scholar 

  7. Longcope C, Franz C, Morello C, Baker K, Johnston CC, Jr. Steroid and gonadotropin levels in women during the peri-menopausal years. Maturitas 1986; 8: 189–196.

    Article  PubMed  CAS  Google Scholar 

  8. Burger HG, Dudley EC, Hopper JL, et al. The endocrinology of the menopausal transition: a cross-sectional study of a population-based sample. J Clin Endocrinol Metab 1995; 80: 3537–3545.

    Article  PubMed  CAS  Google Scholar 

  9. Zumoff B, Strain GW, Miller LK, Rosner W. Twenty-four hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995; 80: 1429–1430.

    Article  PubMed  CAS  Google Scholar 

  10. Rannevik G, Jeppsson S, Johnell O. A longitudinal study of the perimenopausal transition: altered profiles of steroid and pituitary hormones, SHBG and bone mineral density. Matuitas 1986; 8: 189–196.

    Google Scholar 

  11. Zumoff B, Rosenfeld RS, Strain GW. Sex differences in the 24 hour mean plasma concentrations of dehydroisoandrosterone (DHA) and dehydroisoandrosterone sulfate (DHAS) and the DHA to DHAS ratio in normal adults. J Clin Endocrinol Metab 1980; 51: 330–334.

    Article  PubMed  CAS  Google Scholar 

  12. Meldrum, Dr. Changes in circulating steroids with aging in post menopausal women. Obstet Gynecol 1997; 57: 624–628.

    Google Scholar 

  13. Bancroft J., Cawood EHH. Androgens and the menopause: a study of 40–60 year old women. Clin Endocrinol 1996; 45: 577–587.

    Article  CAS  Google Scholar 

  14. Tazuke S, Khaw K-T, Chir MBB, and Barrett-Connor E. Exogenous estrogen and endogenous sex hormones. Medicine 1992; 71: 44–51.

    PubMed  CAS  Google Scholar 

  15. Mathur RS, Landgreve SC, Moody LO, Semmens JP, Williamson HO. The effect of estrogen treatment on plasma concentrations of steroid hormones, gonadotropins, prolactin and sex hormone-binding globulin in post-menopausal women. Maturitas 1985; 7: 129–133.

    Article  PubMed  CAS  Google Scholar 

  16. Krug R, Psych D, Pietrowsky R, Fehm HL, Born J. Selective influence of menstrual cycle on perception of stimuli with reproductive significance. Psychosom Med 1994; 56: 410–417.

    PubMed  CAS  Google Scholar 

  17. Ushiroyama T, Sugimoto O. Endocrine function of the peri-and postmenopausal ovary. Horm Res 1995; 44: 64–68.

    Article  PubMed  CAS  Google Scholar 

  18. Castlo-Branco C, Martinez de Osaba MJ, Fortuny A, Iglesias X, Gonzalez-Merlo J. Circulating hormone levels in menopausal women receiving different hormone replacement therapy regimens. A comparison. J Reprod Med 1995; 40: 556–560.

    Google Scholar 

  19. Goodman-Gruen D, Barrett-Connor E. Total but not bioavailable testosterone is a predictor of central adiposity in postmenopausal women. Int J Obes 1995; 19: 293–298.

    CAS  Google Scholar 

  20. Hallstrom, T. Sexuality in the climacteric. Clin Obstet Gynecol 1977; 4: 227–239.

    CAS  Google Scholar 

  21. McCoy NL, Davidson 1M. A longitudinal study of the effects of menopause on sexuality. Maturitas 1985; 7: 203–210.

    Article  PubMed  CAS  Google Scholar 

  22. Dennerstein L, Smith, AMA, Morse, Burger H. Sexuality and the menopause. J Psychsom Obstet Gynecol 1994; 15: 56–59.

    Google Scholar 

  23. Frock J, Money J. Sexuality and the menopause. Psychother Psychosom 1992; 57: 29–33.

    Article  PubMed  CAS  Google Scholar 

  24. Bachmann GA. Leiblum SR. Sexuality in sexagenarian women. Maturitas 1991; 13: 45–50.

    Article  Google Scholar 

  25. Utian WH. The true clinical features of postmenopausal oophorectomy and their response to estrogen replacement therapy. S Afr Med J 1972; 46: 732–737.

    PubMed  CAS  Google Scholar 

  26. Campbell S, Whitehead,M. Oestrogen therapy and the menopausal syndrome. Clin Obstet Gynecol 1977; 4: 31–47.

    CAS  Google Scholar 

  27. Studd JWW, Chakravarti S, Oram D. The climacteric. Clin Obstet Gynecol 1977; 4: 3–29.

    CAS  Google Scholar 

  28. Sherwin BN, Gelfand MM, Brender W. Androgen enhances sexual motivation in females: a prespective, crossover study of sex steroid administration in surgical menopause. Psychosom Med 1997; 47: 339–351.

    Google Scholar 

  29. Bixo M, Backstrom T, Winblad B, Andersson A. Estradiol and testosterone in specific regions of the human female brain in different endocrine states. J Steroid Biochem Mol Biol 1995; 55: 297–303.

    Article  PubMed  CAS  Google Scholar 

  30. Roselli CE, Resko JA. Aromatase activity in the rat brain: hormone regulation and sex differences. J Steroid Biochem Mol Biol 1993; 44: 499–508.

    Article  PubMed  CAS  Google Scholar 

  31. Van Goozen, SHM, Cohen-Kettensis PT, Gooren LIG., Frijda NH, Van de Poll NE. Gender differences in behaviour: activating effects of cross-sex hormones. Psychoneuroendocrinology 1995; 20: 343–363.

    Article  PubMed  Google Scholar 

  32. Studd JWW, Colins WP, Chakravarti S. Estradiol and testosterone implants in the treatment of psychosexual problems in postmenopausal women. Br J Obstet Gynaecol 1977; 84: 314–315.

    Google Scholar 

  33. Burger HG, Hailes J, Menelaus M. The management of persistent symptoms with estradiol-testosterone implants: clinical, lipid and hormonal results. Maturitas 1984; 6: 351–358.

    Article  PubMed  CAS  Google Scholar 

  34. Burger HG, Hailes J, Nelson J, Menelaus M. Effect of combined implants of estradiol and testosterone on libido in postmenopausal women. Br Med J 1987; 294: 936–937.

    Article  CAS  Google Scholar 

  35. Davis SR, McCloud PI, Strauss BJG, Burger HG. Testosterone enhances estradiol’s effects on postmenopausal bone density and sexuality. Maturitas 1995; 21: 227–236.

    Article  PubMed  CAS  Google Scholar 

  36. Dow MGT, Hart DM, Forrest CA. Hormonal treatments of sexual unresponsiveness in postmenopausal women: a comparative study. Br J Obstet Gynaecol 1983; 90: 361–366.

    Article  PubMed  CAS  Google Scholar 

  37. Colvard DS, Eriksen EF, Keeting PE. Identification of androgen receptors in normal human osteoblastlike cells. Proc Natl Acad Sci USA 1989; 86: 854–857.

    Article  PubMed  CAS  Google Scholar 

  38. Kasperk CH, Wergedal JE, Farley JR, Llinkhart TA, Turner RT, Baylink DG. Androgens directly stimulate proliferation of bone cells in vitro. Endocrinology 1989; 124: 1576–1578.

    Article  PubMed  CAS  Google Scholar 

  39. Nilas L, Christiansen C. Bone mass and its relationship to age and the menopause. J Clin Endocrinol Metab 1987; 65: 697–699.

    Article  PubMed  CAS  Google Scholar 

  40. Slemenda C, Longcope C, Peacock M, Hui S, Johnston CC. Sex steroids, bone mass, and bone loss. A propspective study of pre-, peri-and postmenopausal women. J Clin Invest 1996; 97: 14–21.

    Article  PubMed  CAS  Google Scholar 

  41. Simberg N, Titinen A, Silfrast A, Viinikka L, Ylikorkala O. High bone density in hyperandrogenic women: effect of gonadotropin-releasing hormone agonist alone or in conjunction with estrogen-progestin replacement. J Clin Endocrinol Metab 1995; 81: 646–651.

    Article  Google Scholar 

  42. Heiss CJ, Sanborn CF, Nichols DL. Associations of body fat distribution, circulating sex hormones and bone density in postmenopausal women. J Clin Endocrinol Metab 1995; 80: 1591–1596.

    Article  PubMed  CAS  Google Scholar 

  43. Jassal SK, Barrett-Connor E, Edelstein S. Low bioavailable testosterone levels predict future height loss in postmenopausal women. J Bone Min Res 1995; 10 (4): 650–653.

    Article  CAS  Google Scholar 

  44. Davidson BJ, Ross RK, Paganni Hill A, et al. Total free estrogens and androgens in post menopausal women with hip fractures. J Clin Endocrinol Metab 1982; 54: 115–120.

    Article  PubMed  CAS  Google Scholar 

  45. Raisz LG, Wiita B, Artis A, et al. Comparison of the effects of estrogen alone and estrogen plus androgen on biochemical markers of bone formation and resoprtion in postmenopausal women. J Clin Endocrinol Metab 1995; 81: 37–43.

    Article  Google Scholar 

  46. Watts NB, Notelovitz M, Timmons MC. Comparison of oral estrogens and estrogens plus androgen on bone mineral density, menopausal symptoms and lipid-lipoprotein profiles in surgical menopause. Obstet Gynecol 1995; 85: 529–537.

    Article  PubMed  CAS  Google Scholar 

  47. Savvas M, Studd JWW, Fogelman I, Dooley M, Montgomery J, Murby B. Skeletal effects of oral estrogen compared with subcutaneous oestrogen and testosterone in postmenopausal women. Br Med J 1988; 297: 331–333.

    Article  CAS  Google Scholar 

  48. Savvas M, Studd JWW, Norman S, Leather AT, Garnett, TJ. Increase in bone mass after one year of percutaneous oestradiol and testosterone implants in post menopausal women who have previously received long-term oral oestrogens. Br J Obstet Gynaecol 1992; 99: 757–760.

    Article  PubMed  CAS  Google Scholar 

  49. Morishima A, Grumbach MM, Simpson ER. Aromatase deficiency in male and female siblings caused by a novel mutuation and the physiological role of estrogens. J Clin Endocrinol Metab 1995; 80: 3689–3698.

    Article  PubMed  CAS  Google Scholar 

  50. Smith EP, Boyd J, Frank GR, et al. Estrogen resistance caused by a mutation in the oestrogen-receptor gene in a man. N Engl J Med 1994; 331: 1056–1061.

    Article  PubMed  CAS  Google Scholar 

  51. Kasra M. Grynpas MD. The effects of androgens on the mechanical properties of primate bone. Bone 1995; 17: 265–270.

    Article  PubMed  CAS  Google Scholar 

  52. Nawata H. Tariaka S. Aromatase in bone cell: association with osteoporosis in post menopausal women. J Steroid Biochem Molec Biol 1995; 53: 165–174.

    Article  PubMed  CAS  Google Scholar 

  53. Taelman P, Kayman JM, Janssens X, Vermeulen A. Persistence of increased bone resorption and possible role of dehydroepiandrosterone as a bone metabolism determinant in osteoporotic women in late menopause. Maturitas 1989; 11: 65–73.

    Article  PubMed  CAS  Google Scholar 

  54. Nordin BEC, Robertson A, Seamark RF, et al. The relation between calcium absorption serum DHEA and vertebral mineral density in postmenopausal women. J Clin Endocrinol Metab 1985; 60: 651–657.

    Article  PubMed  CAS  Google Scholar 

  55. Morales AJ, Nolan JJ, Nelson JC, Yen SSC. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab 1994; 78: 1360–1367.

    Article  PubMed  CAS  Google Scholar 

  56. Abraham GE. Ovarian and adrenal contribution to peripheral androgens during the menstrual cycle. J Clin Endocrinol Metab 1974; 39: 340–346.

    Article  PubMed  CAS  Google Scholar 

  57. Engelson ES, Goggin KJ, Rabkin JG, Kotler DP. Nutrition and testosterone status of HIV positive women. Proceedings of the XI Inter Conf on AIDS Vancouver 1996;332:Po.Tu.B. 2382.

    Google Scholar 

  58. Engelson ES, Rabkin JG, Rabkin R, Kotler DP. Effects of testosterone upon body composition [Letter]. J Acquir Immune Defic Syndr Hum Retrovirol 1996; 11: 510–511.

    Article  PubMed  CAS  Google Scholar 

  59. Darling GM, Johns JA, McCloud PI, Davis SR. A comparison of combined estrogen and progestin therapy with simvastatin on serum lipids in hypercholesterolemic postmenopausal women. N Engl J Med 1997; 337: 595–601.

    Article  PubMed  CAS  Google Scholar 

  60. Wakatsuki A, Sagara Y. Lipoprotein metabolism in postmenopausal and oophorestomized women. Obstet Gynecol 1995; 85: 523–528.

    Article  PubMed  CAS  Google Scholar 

  61. Hickok LR, Toomey C, Speroff LA comparison of esterified estrogens with and without methyltestosterone: Effects on endometrial histology and serum lipoproteins in postmenopausal women. Obstet Gynecol 1993; 82: 919–924.

    PubMed  CAS  Google Scholar 

  62. Wagner JD, Zhang L, Williams JK, Register TC, Ackerman DM, Wiita B, Clarkson TB, Adams MR. Esterified estrogens with and without methyltesterone decrease arterial LDL metabolism in Cynomolgus monkeys. Arterioscler Thromb Vasc Biol 1996; 16: 1473–1479.

    Article  PubMed  CAS  Google Scholar 

  63. Barrett-Connor E, Goodman-Gruen D. Prospective study of endogenous sex hormones and fatal cardiovascular disease in postmenopausal women. BMJ 1995; 311: 1193–1196.

    Article  PubMed  CAS  Google Scholar 

  64. Barrett-Connor E, Goodman-Gruen D. Dehydroepiandrosterone sulfate does not predict cardiovascular death in postmenopausal women. The Rancho Bernardo Study. Circulation 1995; 91: 1757–1760.

    Article  PubMed  CAS  Google Scholar 

  65. Chou TM, Sudhir K, Hutchison SJ, Ko E, Amidon TM, Collins P, Chatterjee K. Testosterone induces dilation of canine coronary conductance and resitstance arteries in vivo. Circulation 1996; 94: 2614–2619.

    Article  PubMed  CAS  Google Scholar 

  66. Honore EK, Williams JK, Adams MR, Ackerman DM, Wagner JD. Methyltestosterone does not diminish the beneficial effects of estrogen replacement therapy on coronary arter reactivity in cynomolgus monkeys. Menopause: J North Am Menopause Soc 1996; 3: 20–26.

    Article  Google Scholar 

  67. Secreto G, Toniolo P, Pisani P, et al. Androgens and breast cancer in premenopausal women. Cancer Res 1989; 49: 471–476.

    PubMed  CAS  Google Scholar 

  68. Secreto G, Toniolo P, Berrino E, et al. Serum and urinary androgens and risk of breast cancer in postmenopausal women. Cancer Res 1991; 51: 2572–2576.

    PubMed  CAS  Google Scholar 

  69. Berrino F, Muti P, Michelli A, Bolelli G, Krogh V, Sciajno R, Pisani P, Panico S, Secreto G. Serum sex hormone levels after menopause and subsequent breast cancer. J Natl Cancer Inst 1996; 88: 291–296.

    Article  PubMed  CAS  Google Scholar 

  70. Recchione C, Venturelli E, Manzari A, Cavalteri A, Martinetti A, Secreto G. Testosterone, dihydrotestosterone and oestradiol levels in postmenopausal breast cancer tissues. J Steroid Biochem Mol Biol 1995; 52: 541–546.

    Article  PubMed  CAS  Google Scholar 

  71. Bryan RM, Mercer RJ, Rennie GC, Lie TH, Morgan FJ. Androgen receptors in breast cancer. Cancer 1984; 54: 2436–2440.

    Article  PubMed  CAS  Google Scholar 

  72. Barrett-Connor E, Timmons MC, Young R, Wiita B, Estratest Working Group. Interim safety analysis of a two-year study comparing oral estrogen-androgen and congugated estrogens in surgically menopausal women. J Women’s Health 1996; 5: 593–602.

    Article  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Davis, S.R., Burger, H.G. (1999). Androgen Replacement in Women. In: Meikle, A.W. (eds) Hormone Replacement Therapy. Contemporary Endocrinology, vol 13. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-700-0_22

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-700-0_22

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-092-2

  • Online ISBN: 978-1-59259-700-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics