Androgen Excess and Post-Reproductive Health

    April 2018 in “ Maturitas ”
    Stavroula A. Paschou, Panagiotis Anagnostis, Dimitrios G. Goulis, Irene Lambrinoudaki
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    TLDR Excess male hormones in postmenopausal women can cause health issues and increase the risk of heart disease and diabetes; treatment depends on the cause.
    The 2018 article addressed the problem of androgen excess in postmenopausal women, which can cause symptoms like hirsutism, alopecia, and acne. It stressed the importance of identifying the cause of hyperandrogenism, which may be non-tumorous, such as Polycystic Ovary Syndrome (PCOS) or Congenital Adrenal Hyperplasia (CAH), or tumorous, originating from the ovaries or adrenals. PCOS, the most common cause in reproductive-aged women, is linked to metabolic issues and an elevated risk of cardiovascular disease (CVD), which persists after menopause. A systematic review involving over 14,000 women with PCOS and over 60,000 controls indicated a 4-fold increase in diabetes risk, regardless of obesity. Treatment should target the specific cause and may include lifestyle changes, medications, and surgery for tumors. Lifestyle changes can lower androgen levels and increase Sex Hormone Binding Globulin (SHBG), while metformin can decrease insulin and testosterone levels. The article called for more research to clarify if the link between hyperandrogenism and CVD is direct or through associated obesity and diabetes.
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