Androgens in postmenopausal women

Balan V.E., Zaidieva Ya.Z., Tsarkova A.V.

Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russian Federation
The use of androgens in postmenopausal women is now being actively discussed. The review gives the latest data on hormonal profile changes in postmenopausal women, describes factors influencing the circulation of androgens, and evaluates the effect of low-dose androgens on the sexual function of postmenopausal women. It also presents clinical trials dealing with androgen therapy and discusses the potential risks of this therapy in the treatment of sexual dysfunction in postmenopausal women.

Keywords

androgens
testosterone
female sexual dysfunction
postmenopause

References

  1. Butenandt A. The chemical investigation of the sex hormone. Z. Angew. Chem. 1931; 44: 905-8.
  2. David K., Dingemanse E., Freud J., Laqueur E. Uber krystallinisches mannliches Hormon aus Hoden (Testosteron) wirksamer als aus harn oder aus Cholesterin bereitetes Androsteron. Hoppe Seylers Z. Physiol. Chem. 1935 233: 281.
  3. Davis S., Panjari M., Stanczyk F. Clinical review: DHEA replacement for postmenopausal women. J. Clin. Endocrinol. Metab. 2011; 96(6): 1642-53.
  4. Pretorius E., Africander D.J., Vlok M., Perkins M.S., Quanson J., Storbeck K.H. 11-Ketotestosterone and 11-ketodihydrotestosterone in castration resistant prostate cancer: potent androgens which can no longer be ignored. PLoS One. 2016; 11(7): e0159867.
  5. Pretorius E., Arlt W., Storbeck K.H. A new dawn for androgens: novel lessons from 11-oxygenated C19 steroids. Mol. Cell. Endocrinol. 2016; 44: 76-85.
  6. Haring R., Hannemann A., John U., Radke D., Nauck M., Wallaschofski H. et al. Age-specific reference ranges for serum testosterone and androstenedione concentrations in women measured by liquid chromatography-tandem mass spectrometry. J. Clin. Endocrinol. Metab. 2012; 97(2): 408-15.
  7. van der Stege J.G., Groen H., van Zadelhoff S.J., Lambalk C.B., Braat D.D., van Kasteren Y.M. et al. Decreased androgen concentrations and diminished general and sexual well-being in women with premature ovarian failure. Menopause. 2008; 15(1): 23-31.
  8. Pugeat M., Nader N., Hogeveen K., Raverot G., Dechaud H., Grenot C. Sex hormone-binding globulin gene expression in the liver: drugs and the metabolic syndrome. Mol. Cell. Endocrinol. 2010; 316: 53-9.
  9. Wåhlin-Jacobsen S., Pedersen A.T., Kristensen E., Laessøe N.C., Lundqvist M., Cohen A.S. et al. Is there a correlation between androgens and sexual desire in women? J. Sex. Med. 2015; 12(2): 358-73.
  10. Randolph J.F. Jr., Zheng H., Avis N.E., Greendale G.A., Harlow S.D. Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition. J. Clin. Endocrinol. Metab. 2015; 100(1): 258-66.
  11. Wierman M.E., Arlt W., Basson R., Davis S.R., Miller K.K., Murad M.H. et al. Androgen therapy in women: a reappraisal: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2014; 99(10):3489-510.
  12. Huang G., Basaria S., Travison T.G., Ho M.H., Davda M., Mazer N.A. et al. Testosterone dose-response relationships in hysterectomized women with or without oophorectomy: effects on sexual function, body composition, muscle performance and physical function in a randomized trial. Menopause. 2014; 21(6): 612-23.
  13. Spoletini I., Vitale C., Pelliccia F., Fossati C., Rosano G.M. Androgens and cardiovascular disease in postmenopausal women: a systematic review. Climacteric. 2014; 17(6): 625-34.
  14. Davis S.R., Wahlin-Jacobsen S. Testosterone in women: the clinical significance. Lancet Diabetes Endocrinol. 2015; 3(12): 980-92.
  15. Benn M., Voss S.S., Holmegard H.N., Jensen G.B., Tybjaerg-Hansen A., Nordestgaard B.G. Extreme concentrations of endogenous sex hormones, ischemic heart disease, and death in women. Arterioscler. Thromb. Vasc. Biol. 2015; 35(2): 471-7.
  16. Naessen T., Sjogren U., Bergquist J., Larsson M., Lind L., Kushnir M.M. Endogenous steroids measured by high-specificity liquid chromatographytandem mass spectrometry and prevalent cardiovascular disease in 70-yearold men and women. J. Clin. Endocrinol. Metab. 2010; 95(4):1889-97.
  17. Davis S.R., Robinson P.J., Moufarege A., Bell R.J. The contribution of SHBG to the variation in HOMA-IR is not dependent on endogenous oestrogen or androgen levels in postmenopausal women. Clin. Endocrinol. (Oxford). 2012; 77(4): 541-7.
  18. Ding E.L., Song Y., Manson J.E., Hunter D.J., Lee C.C., Rifai N. et al. Sex hormone-binding globulin and risk of type 2 diabetes in women and men. N. Engl. J. Med. 2009; 361(12): 1152-63.
  19. Pike C.J., Carroll J.C., Rosario E.R., Barron A.M. Protective actions of sex steroid hormones in Alzheimer’s disease. Front. Neuroendocrinol. 2009; 30(2): 239-58.
  20. Davis S.R., Davison S.L., Gavrilescu M., Searle K., Gogos A., Rossell S.L. et al. Effects of testosterone on visuospatial function and verbal fluency in postmenopausal women: results from a functional magnetic resonance imaging pilot study. Menopause. 2014; 21(4): 410-4.
  21. Davison S.L., Bell R.J., Gavrilescu M., Searle K., Maruff P., Gogos A. et al. Testosterone improves verbal learning and memory in postmenopausal women: results from a pilot study. Maturitas. 2011; 70(3): 307-11.
  22. Clarke B.L., Khosla S. Androgens and bone. Steroids. 2009; 74(3): 296-305.
  23. Rariy C.M., Ratcliffe S.J., Weinstein R., Bhasin S., Blackman M.R., Cauley J.A. et al. Higher serum free testosterone concentration in older women is associated with greater bone mineral density, lean body mass, and total fat mass: the cardiovascular health study. J. Clin. Endocrinol. Metab. 2011; 96(4): 989-96.
  24. Finigan J., Gossiel F., Glüer C.C., Felsenberg D., Reid D.M., Roux C., Eastell R. Endogenous estradiol and the risk of incident fracture in postmenopausal women: the OPUS study. Calcif. Tissue Int. 2012; 91(1): 59-68.
  25. Davis S.R., Moreau M., Kroll R., Bouchard C., Panay N., Gass M. Testosterone for low libido in postmenopausal women not taking estrogen. N. Engl. J. Med. 2008; 359(19): 2005-17.
  26. Huang G., Basaria S., Travison T.G., Ho M.H., Davda M., Mazer N.A. et al. Testosterone dose-response relationships in hysterectomized women with or without oophorectomy: effects on sexual function, body composition, muscle performance and physical function in a randomized trial. Menopause. 2014; 21(6): 612-23.
  27. Alkatib A.A., Cosma M., Elamin M.B., Erickson D., Swiglo B.A., Erwin P.J., Montori V.M. A systematic review and metaanalysis of randomized placebo-controlled trials of DHEA treatment effects on quality of life in women with adrenal insufficiency. J. Clin. Endocrinol. Metab. 2009; 94(10): 3676-81.
  28. Elraiyah T., Sonbol M.B., Wang Z., Khairalseed T., Asi N., Undavalli C. et al. Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. J. Clin. Endocrinol. Metab. 2014; 99(10): 3536-42.
  29. Labrie F., Archer D.F., Koltun W., Vachon A., Young D., Frenette L. et al. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause. 2016; 23(3): 243-56.
  30. Baldassarre M., Perrone A.M., Giannone F.A., Armillotta F., Battaglia C., Costantino A. et al. Androgen receptor expression in the human vagina under different physiological and treatment conditions. Int. J. Impot. Res. 2013; 25(1): 7-11.
  31. Fernandes T., Costa-Paiva L.H., Pedro A.O., Baccaro L.F., Pinto-Neto A.M. Efficacy of vaginally applied estrogen, testosterone, or polyacrylic acid on vaginal atrophy: a randomized controlled trial. Menopause. 2016; 23(7): 792-8.
  32. Witherby S., Johnson J., Demers L., Mount S., Littenberg B., Maclean C.D. et al. Topical testosterone for breast cancer patients with vaginal atrophy related to aromatase inhibitors: a phase I/II study. Oncologist. 2011; 16(4): 424-31.
  33. Wierman M.E., Arlt W., Basson R., Davis S.R., Miller K.K., Murad M.H. et al. Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 2014; 99(10): 3489-510.
  34. Huang G., Pencina K.M., Coady J.A., Beleva Y.M., Bhasin S., Basaria S. Functional voice testing detects early changes in vocal pitch in women during testosterone administration. J. Clin. Endocrinol. Metab. 2015; 100(6): 2254-60.
  35. Manson J.E., Chlebowski R.T., Stefanick M.L., Aragaki A.K., Rossouw J.E., Prentice R.L. et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013; 310(13): 1353-68.
  36. Fooladi E., Reuter S.E., Bell R.J., Robinson P.J., Davis S.R. Pharmacokinetics of a transdermal testosterone cream in healthy postmenopausal women. Menopause. 2015; 22: 44-9.
  37. Ali A., Berens P., Siddiqui G., Ali V. Nipple and areolar hyperpigmentation secondary to the use of estradiol spray on the ipsilateral forearm skin: a report of two cases. J. Womens Health (Larchmt). 2012; 21(3): 363-5.
  38. Elraiyah T., Sonbol M.B., Wang Z., Khairalseed T., Asi N., Undavalli C. et al. Clinical review:The benefits and harms of systemic testosterone therapy in postmenopausalwomen with normal adrenal function: a systematic review and meta-analysis. J. Clin. Endocrinol. Metab. 2014; 99(10): 3543-50.
  39. Davis S., Papalia M., Norman R., O’Neill S., Redelman M., Williamson M. et al. Safety and efficacy of a testosterone metered-dose transdermal spray for treating decreased sexual satisfaction in premenopausal women. Ann. Intern. Med. 2008; 148(8): 569-77.
  40. Goldstat R., Briganti E., Tran J., Wolfe R., Davis S. Transdermal testosterone therapy improves well-being, mood and sexual function in premenopausal women. Menopause. 2009; 10(5): 390-8.
  41. Zeleke B.M., Bell R.J., Billah B., Davis S.R. Hypoactive sexual desire dysfunction in community-dwelling older women. Menopause. 2017; 24(4): 391-9.
  42. Shifren J.L., Davis S.R. Androgens in postmenopausal women. Menopause. 2017; 24(8): 970-9.
  43. Сухих Г.Т., Сметник В.П., Андреева Е.Н., Балан В.Е., Гависова А.А., Григорян О.Р., Ермакова Е.И., Зайдиева Я.З., Ильина Л.М., Касян В.Н., Марченко Л.А., ПодзолковаН.М., Роговская С.И., Сметник А.А., Чернуха Г.Е., Юренева С.В. Менопаузальная гормонотерапия и сохранение здоровья женщин в зрелом возрасте. Клинические рекомендации (протокол лечения). М.; 2015. 54с. [ Sukhikh G.T., Smetnik V.P., Andreeva E.N., Balan V.E., Gabisov A.A., Grigoryan O.R., Ermakova E.I., Zaidieva Y. Z., Ilyina, L.M., Kasyan, V.N., Marchenko L.A., Podzolkova.M., Rogovskaya S.I., Smetnik A. A., Chernukha G. E., Yureneva S. V. Menopausal hormone therapy and preventive strategies for women's health in reproductive age. Clinical recommendations (treatment protocol). M.; 2015. 54C.(in Russian)]

Received 22.11.2018

Accepted 22.02.2019

About the Authors

Balan V.E., prof., head of the Polyclinic Department the Moscow Regional Research Institute of Obstetrics and Gynecology.
101000, Russia, Moscow, Pokrovka, 22A. Tel: +79057360800. E-mail: balanmed@gmail.com.
Zaydieva Ya.Z., prof., head of the Department of Gynecological Endocrinology the Moscow Regional Research Institute of Obstetrics and Gynecology.
101000, Russia, Moscow, Pokrovka, 22A. Tel: +79161695793. E-mail: 7726101@rambler.ru.
Tsarkova A.V., doctor of the Polyclinic Department the Moscow Regional Research Institute of Obstetrics and Gynecology.
101000, Russia, Moscow, Pokrovka, 22A. Tel: +79266809512. E-mail: alinka-lapina@mail.ru.

For citation: Balan V.E., Zaydieva Ya.Z., Tsarkova A.V. Androgens in postmenopausal women (literature review). Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (6):34-9 (in Russian)
https://dx.doi.org/10.18565/aig.2019.6.34-39

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