Androgen Replacement Therapy in Women

The 2012 document reviews the use of androgen replacement therapy (ART) in women, particularly focusing on conditions like adrenal insufficiency and bilateral oophorectomy that cause severe androgen deficiency, leading to symptoms such as reduced libido, drive, and energy. It discusses the benefits of ART, including improvements in libido and mood, but also highlights the lack of long-term safety data, particularly regarding body composition, cardiovascular health, and cancer risk. The document reports on studies with varying numbers of participants, including a study by Shifren et al. with 75 women, larger trials with 1095 women, and the ADORE study with 272 women, which showed improvements in sexual function and well-being. However, it also notes a 30% incidence of androgenic skin effects and a 2.4% incidence of breast cancers in one study with 814 women. The document emphasizes that physiological menopause does not inherently require androgen therapy and that current guidelines recommend against the general use of testosterone in postmenopausal women. It also discusses the use of DHEA, which has been shown to improve well-being and sexual function in women with adrenal insufficiency when administered orally at 50 mg daily. The document concludes that further research is needed to better understand the role of androgens in women and to develop standardized serum androgen level data across a woman's lifespan.