Androgen Insufficiency in Women: Diagnostic and Therapeutic Implications

    September 2004 in “ Human Reproduction Update
    Livia Rivera-Woll, Mary-Anne Papalia, Susan Ruth Davis, Henry G. Burger
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    TLDR Testosterone replacement can help women with low libido and mood, but they need to have enough estrogen first to avoid side effects.
    The 2004 document discussed Female Androgen Insufficiency Syndrome (FAIS), a condition characterized by reduced libido, diminished well-being, and lowered mood, along with low serum free testosterone levels. The diagnosis of FAIS was complex due to the lack of a reliable, inexpensive assay for measuring free testosterone levels in women. Despite these challenges, testosterone replacement was reported to effectively alleviate FAIS symptoms. The document also highlighted the need for testosterone therapy formulations specifically designed for women, along with clear guidelines regarding optimal therapeutic doses and long-term safety data. It also discussed the physiological roles of androgens in women, the levels of circulating androgens in relation to age and menopause, and the variability of androgen production in postmenopausal women. The document concluded that while testosterone therapy can have beneficial effects, it is essential that women be well-estrogenized prior to androgen replacement to avoid unwanted side effects.
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