Androgen replacement therapy in women

Abstract

Physiologically, androgens in women either derive from direct ovarian production or from the peripheral conversion of the adrenal sex steroid precursor dehydroepiandrosterone to the active androgens. Therefore, loss of adrenal or ovarian function, as in Addison's disease or after bilateral oophorectomy, usually results in severe androgen deficiency. Androgen replacement in these women may produce significant improvements, particularly in libido and mood. Physiological menopause is not necessarily associated with androgen deficiency and therefore does not routinely require androgen therapy. The number of randomized controlled trials of androgen use in women is still limited. Choosing both a convenient and efficient mode of androgen administration in women remains a challenge and currently none of the available preparations is officially approved for use in women.