Androgens & Testosterone
Bone Loss From Menopause
Loss of Sexual Interest
Psychological Well Being
Increased Skin Changes
Facial Hair Growth
to menopause androgens,
mostly testosterone, are produced by the ovaries and adrenal glands. Androgens
are important for maintaining bone density and sex drive. After menopause the
ovaries stop making androgens, the adrenals continue, but the total amount
produced by the body is greatly diminished. Androgens are available combined
with estrogen, for replacement therapy. The only combination drugs is ESTRATEST®,.
This is prescribed as second line therapy. For women who have not achieved good
relief from hot flashes, or who are complaining of loss of sex drive, on
Bone Loss From Menopause:
After menopause bones loose significant
amounts of calcium. In 25% of women this bone loss can result in osteoporosis
with the resultant high risk of broken bones. Taking estrogen stops the loss of
any more calcium but does not replace the calcium already lost. Taking calcium
supplements and vitamin D will not replace the lost calcium either. There is now
evidence that taking a estrogen-androgen combination can promote new bone
of Sexual Interest:
Loss of interest in sex is a common
complaint of postmenopausal women. Androgens have been shown, in several
studies, to improve libido ( sex drive ) in postmenopausal women. One study of
136 postmenopausal women complaining of sexual dysfunction were treated
initially with estrogen alone. The estrogen therapy relieved vaginal pain
associated with vaginal dryness, but did little for the loss of sex drive. The
women were not depressed and were in stable marital relationships. When they
were given estrogen-androgen combination therapy 80% reported improved libido.
Between 30% - 70% of postmenopausal women
complain of psychological symptoms such as moodiness, anxiety and irritability.
Higher androgen levels have been associated with better energy levels and an
increased sense of well being.
Androgen-estrogen combination therapy has
been shown to increase skin thickness and suppleness. There may also be an
associated increase in oiliness and acne.
Women's Facial Hair Growth
Virilization is the appearance of
masculine sexual characteristics, such as acne, deepening of the voice, baldness
and increased muscle mass. Hirsuitism is the appearance of facial hair. Some
women on androgens do show some of these symptoms however, the symptoms are mild
and readily reversible by lowering the dose or stopping the medication. Some
studies have shown that these changes are LESS frequent in estrogen-androgen
users. There is no evidence for an increase in liver disease in women who use
estrogen-androgen therapy. However women with liver disease should not start
Androgen-estrogen therapy generally
decreases HDL ( good cholesterol ). Estrogen alone increases HDL and this is
considered the reason that estrogen protects from heart disease. Risk factors
for heart disease need to be taken into consideration before starting androgens.
Should you be on an estrogen-androgen
combination? Possibly, if 1. You are on estrogen and still experiencing hot
flashes. 2. You are at high risk for osteoporosis. 3. You are on estrogen and
still experiencing loss of sex drive. There are other questions you must answer
with your physician. What is your BMD ? What is your cholesterol HDL ratio?
There are still unanswered questions concerning androgens. How will androgens
impact on heart disease and breast cancer over the long term? More long range
studies are needed. For now take the information you have and discuss it with
your physician if you think you might be a candidate for androgen therapy.
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