The Role of Androgens in Hormone Replacement Therapy
September 2005
in “
Expert Opinion on Pharmacotherapy
”
androgens hormone replacement therapy testosterone dihydrotestosterone DHT androgen therapy serum testosterone levels testosterone transdermal patch estrogen androgen bioavailability androgen replacement therapy low-dose androgen therapy androgen insufficiency sexual function bone density muscle strength breast cancer risk HRT testosterone patch
TLDR Androgen therapy can help with symptoms like low libido in women, but more research is needed to understand its long-term safety and effects on health.
The document from 2005 explores the significance of androgens in hormone replacement therapy (HRT) for women, particularly focusing on sexual health, androgen insufficiency, and the potential benefits and risks associated with androgen therapy. It emphasizes that androgens like testosterone and dihydrotestosterone (DHT) are crucial for female sexual function and that symptoms such as fatigue, low libido, and diminished well-being may be improved with androgen therapy. The paper discusses the decline of androgen levels with age, the biosynthesis pathways of androgens, and the complexity of female sexual arousal. It also addresses the challenges in measuring serum testosterone levels in women and the need for sensitive assays. A 24-week randomized, double-blind, Phase III trial involving 562 surgically menopausal women showed significant improvements in sexual activity and desire with a testosterone transdermal patch. The document also reviews the history of androgen use in women, the impact of chronic illness and medications on androgen production, and the role of estrogen in androgen bioavailability. It calls for long-term, large-scale clinical trials to evaluate the safety and efficacy of androgen therapy and notes that while some studies have shown benefits of combined estrogen and testosterone therapy on libido and sexual enjoyment, the FDA has not approved androgen replacement therapy for sexual dysfunction in women. The safety profile of low-dose androgen therapy appears favorable, but further research is needed to determine appropriate dosing and long-term safety. The relationship between androgens and breast cancer is unclear, with both positive and negative associations reported, but androgens may have a role in breast cancer treatment. Regarding cardiovascular health, recent research suggests androgens may have beneficial or neutral effects, not negatively affecting lipid profiles or endothelial function in women. The document concludes that androgen therapy can alleviate symptoms of androgen insufficiency and that future studies will help define the role of androgens in health aspects such as sexual function, bone density, muscle strength, and breast cancer risk.
