The Role of Androgen Therapy

In 2003, the document discussed the role of androgens, a group of 19-carbon steroid hormones associated with maleness, in both men and women. Androgens, which include dehydroepiandrosterone sulphate (DHEAS), DHEA, A, T and dihydrotestosterone (DHT), were found to act directly by binding to a specific androgen receptor and initiating biological responses in the target tissue. They could also act after conversion to oestrogens in peripheral tissues and then via the oestrogen receptors. Symptoms of androgen insufficiency in women included a diminished sense of well-being, dysphoric mood, and others. Testosterone therapy was indicated for women presenting classical clinical symptoms, with the diagnosis being substantiated by a free T concentration in the lowest quartile of the relevant female reference range. However, contraindications to T therapy included pregnancy and lactation, androgen-dependent neoplasia, severe acne and/or hirsutism, androgenic alopecia, and situations where increased libido was undesirable.