Female androgen insufficiency and potential risks of therapeutic replacement

Abstract

Women in their fourth decade and older experience a decrease in androgen serum levels. This may lead to the clinical syndrome of female androgen insufficiency expressed by insidious tiredness, diminished sense of well-being and libido, alterations in body composition and bone loss. If there is a past history of bilateral oophorectomy, hypopituitarism, androgen adrenal suppression and/or free testosterone serum levels are low, it is probable that these signs and symptoms could be relieved by a discerning androgen administration, which has been largely accepted. When current recommended doses are used, it appears that the benefits regarding bone mass, sexuality and well-being may be achieved without important signs of masculinizing. Nonetheless, it is necessary to conduct well-controlled, long-term studies, in order to validate the hypothesis that therapeutic administration of androgens to women does not lead to an increased incidence of breast cancer or metabolic complications.