<b>Androgens and the menopause; a study of 40–60‐year‐old women </b>

Bancroft, John; Cawood, Elizabeth

doi:10.1046/j.1365-2265.1996.00846.x

Cited by 93 publications

(59 citation statements)

References 33 publications

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“…The lower SHBG levels in the PMO group compared to the PM group are in accordance with some studies 23,26,29 , but not with others 28,30,31 . BMI and WHR were negatively correlated to SHBG and the regression analysis showed that the SHBG levels could partly be explained by the BMI and WHR.…”

Section: Discussionsupporting

confidence: 78%

“…However, two smaller studies, one prospective and one cross-sectional, found a fall or a difference in total T over the menopausal transition 26,30 .…”

Section: Discussionmentioning

confidence: 99%

“…A significant amount of T is also loosely bound to albumin, leaving only a small fraction of free circulating T. The effects of estradiol on SHBG levels have been studied during the climacteric period, where higher estrogen levels have been associated with higher SHBG levels 23 . Investigations on when and how much total T, free T and SHBG change due to the menopausal transition have shown different results [23][24][25][26][27][28][29][30][31] . Androstendione (A), which is derived from the adrenal gland and the ovaries, needs to be converted to T to have potent androgenic effects 32 .…”

Section: Introductionmentioning

confidence: 99%

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Symptoms in peri- and postmenopausal women in relation to testosterone concentrations: data from The Women's Health in the Lund Area (WHILA) study

Götmar

Hammar

Fredrikson³

et al. 2008

Climacteric

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Objectives: The aim of this study was to investigate possible associations between androgen concentrations in perimenopausal women and symptoms that may be associated with low androgen concentrations in the blood. Results: 6908 women participated. The women on HRT had lower T and FTI and were less satisfied with mood and energy (p<0.05). Women with hot flushes had higher T and FTI and women reporting coldness had lower concentrations (p<0.05). Sexual well-being were not correlated to T or FTI (p>0.05).Conclusions: Lower T concentrations were associated with lower quality of life in perimenopausal women but not to sexual well-being. There must be other factors than 3 decrements in sex hormones that contribute to the emergence of some perimenopausal symptoms.

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Section: Discussionsupporting

confidence: 78%

“…However, two smaller studies, one prospective and one cross-sectional, found a fall or a difference in total T over the menopausal transition 26,30 .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Symptoms in peri- and postmenopausal women in relation to testosterone concentrations: data from The Women's Health in the Lund Area (WHILA) study

Götmar

Hammar

Fredrikson³

et al. 2008

Climacteric

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“…19 Rannevik also showed a clearcut fall in SHBG concentration related to the menopause, 20 while Bancroft showed no significant change in SHBG levels in comparing pre-, peri-, and postmenopausal women. 21 It should be noted that this study may have some empirical limitations. The small sample size does not allow the creation of Gaussian curves for each decade, with ranges expressed as 72 standard deviations of mean androgen values.…”

Section: Discussionmentioning

confidence: 99%

Serum androgen levels in healthy premenopausal women with and without sexual dysfunction: Part A. Serum androgen levels in women aged 20–49 years with no complaints of sexual dysfunction

et al. 2004

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Androgen insufficiency is a recognized cause of sexual dysfunction in men and women. Age-related decrements in adrenal and gonadal androgen levels also occur naturally in both sexes. At present, it is unclear if a woman's low serum androgen level is a reflection of the expected normal age-related decline or indicative of an underlying androgen-deficient state. We studied premenopausal women with no complaints of sexual dysfunction to help define a normal female androgen profile. In all, 60 healthy, normally menstruating women, ages 20-49 y, were studied. The Abbreviated Sexual Function Questionnaire was administered along with a detailed interview. Radioimmunoassay measurements of morning serum testosterone (T), free testosterone (fT), dehydroepiandrosteronesulfate (DHEAS), sex hormone-binding globulin (SHBG), and free androgen index (FAI) were measured during days 8-15 of the menstrual cycle. In women 20-49 y old without complaints of sexual dysfunction, serum androgen levels exhibit a progressive stepwise decline. Comparing values obtained in women age 20-29 y to those obtained in women 40-49 y, specific hormone decrements were DHEAS 195.6-140.4 lg/dl, serum T 51.5-33.7 ng/dl, fT 1.51-1.03 pg/ml. SHBG did not change significantly in women in this age group. The FAI reflected the age-related decrease in female androgen levels. The framework for the development of a female androgen profile in women with no complaints of sexual dysfunction has been established, and an age-related decrease in testosterone and its adrenal precursor, DHEAS, has been demonstrated. The FAI mirrors these decreases and its usefulness in clinical practice is confirmed. A precipitous decline in all androgens occurs after the decade of the 20s, yet SHBG does not show a significant change throughout the premenopausal years.

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“…Concurrent measurement of total testosterone and sex hormone-binding globulin (SHBG) concentrations may represent an alternative when no RIA for free testosterone is available. Testosterone and SHBG levels can be used to calculate the free androgen index (FAI), where FAI ¼ (testosterone nmol/l £ 100)/SHBG nmol/l (22). Importantly, estrogens increase SHBG concentrations, and thus decrease the FAI.…”

Section: Definition Of Female Androgen Deficiencymentioning

confidence: 99%

Androgen therapy in women

Arlt

2006

eur j endocrinol

105

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Androgens in women either derive from direct ovarian production or from peripheral conversion of the adrenal sex steroid precursor, dehydroepiandrosterone, towards active androgens. Therefore, loss of adrenal or ovarian function, caused by Addison's disease or consequent to bilateral oophorectomy, results in severe androgen deficiency, clinically often associated with a loss of libido and energy. Importantly, physiological menopause does not necessarily lead to androgen deficiency, as androgen synthesis in the ovaries may persist despite the decline in estrogen production. However, the definition of female androgen deficiency, as recently provided by the Princeton consensus statement, is not precise enough and may lead to over-diagnosis due to the high prevalence of its diagnostic criteria: androgen levels below or within the lower quartile of the normal range and concurrent sexual dysfunction. Importantly, physiological menopause is not necessarily associated with androgen deficiency and therefore does not routinely require androgen therapy. Current replacement options include transdermal testosterone administration or dehydroepiandrosterone treatment, both of which have been shown to result in significant improvements, in particular in libido and mood, while effects on body composition and muscular function are not well documented. It is important to keep in mind that the number of randomized controlled trials is still limited and that currently none of the available preparations is officially approved for use in women. Currently, androgen replacement should be reserved for women with severe androgen deficiency due to an established cause and matching clinical signs and symptoms.

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Androgens and the menopause; a study of 40–60‐year‐old women

Cited by 93 publications

References 33 publications

Symptoms in peri- and postmenopausal women in relation to testosterone concentrations: data from The Women's Health in the Lund Area (WHILA) study

Symptoms in peri- and postmenopausal women in relation to testosterone concentrations: data from The Women's Health in the Lund Area (WHILA) study

Serum androgen levels in healthy premenopausal women with and without sexual dysfunction: Part A. Serum androgen levels in women aged 20–49 years with no complaints of sexual dysfunction

Androgen therapy in women

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