Changes in Androgen Levels in Menopausal Women

During the menopausal period, women experience a relative increase in androgen levels due to a significant decrease in estrogens and an increase in sex hormone-binding globulin (SHBG). This hormonal shift can lead to symptoms of both hyperandrogenemia, such as facial hair growth and scalp hair loss, and androgen deficiency. The latter may manifest as hypoactive sexual desire dysfunction (HSDD), which is the only evidence-based indication for testosterone treatment in women. However, the response of tissues to androgens depends on their ability to regulate androgen availability. Additionally, the aging of ovarian and adrenal glands contributes to a decline in androgen levels, potentially affecting the quality of life. It is important to rule out other diseases before treating HSDD to ensure it is a direct result of androgen deficiency.