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The Case for Androgens in Menopausal Women: When and How?

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Essentials of Menopause Management

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Abstract

A 55-year-old healthy married woman complains of reduced sexual desire and arousal for the past 10 years. She denies any dyspareunia. She underwent a hysterectomy with bilateral salpingo-oophorectomy at the age of 45 for symptomatic uterine fibroids. After the surgery, she started experiencing hot flashes, vaginal dryness, and decreased sexual desire. She was prescribed with a transdermal estradiol patch which relieved her hot flashes and vaginal dryness but did not improve her sexual symptoms. Her total and free testosterone levels are low at 12 ng/dl and 1.5 pg/ml, respectively. She had a normal mammogram within the last year. She asks whether testosterone replacement is an option to treat her sexual symptoms. How should this patient be assessed and treated?

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References

  1. Davison SL, Bell R, Donath S, Montalto JG, Davis SR. Androgen levels in adult females: changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab. 2005;90:3847–53.

    Article  CAS  PubMed  Google Scholar 

  2. Basaria S, Dobs AS. Clinical review: controversies regarding transdermal androgen therapy in postmenopausal women. J Clin Endocrinol Metab. 2006;91:4743–52.

    Article  CAS  PubMed  Google Scholar 

  3. Adashi EY. The climacteric ovary as a functional gonadotropin-driven androgen-producing gland. Fertil Steril. 1994;62:20–7.

    Article  CAS  PubMed  Google Scholar 

  4. Cappola AR, Ratcliffe SJ, Bhasin S, Blackman MR, Cauley J, Robbins J, Zmuda JM, Harris T, Fried LP. Determinants of serum total and free testosterone levels in women over the age of 65 years. J Clin Endocrinol Metab. 2007;92:509–16.

    Article  CAS  PubMed  Google Scholar 

  5. Laughlin GA, Barrett-Connor E, Kritz-Silverstein D, von Muhlen D. Hysterectomy, oophorectomy, and endogenous sex hormone levels in older women: the Rancho Bernardo Study. J Clin Endocrinol Metab. 2000;85:645–51.

    CAS  PubMed  Google Scholar 

  6. Bachmann G, Bancroft J, Braunstein G, Burger H, Davis S, Dennerstein L, Goldstein I, Guay A, Leiblum S, Lobo R, Notelovitz M, Rosen R, Sarrel P, Sherwin B, Simon J, Simpson E, Shifren J, Spark R, Traish A, Princeton. Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment. Fertil Steril. 2002;77:660–5.

    Article  PubMed  Google Scholar 

  7. Bhasin S. Female androgen deficiency syndrome – an unproven hypothesis. J Clin Endocrinol Metab. 2005;90:4970–2.

    Article  CAS  PubMed  Google Scholar 

  8. Shifren JL, Braunstein GD, Simon JA, Casson PR, Buster JE, Redmond GP, Burki RE, Ginsburg ES, Rosen RC, Leiblum SR, Caramelli KE, Mazer NA. Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. N Engl J Med. 2000;343:682–8.

    Article  CAS  PubMed  Google Scholar 

  9. Braunstein GD, Sundwall DA, Katz M, Shifren JL, Buster JE, Simon JA, Bachman G, Aguirre OA, Lucas JD, Rodenberg C, Buch A, Watts NB. Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: a randomized, placebo-controlled trial. Arch Intern Med. 2005;165:1582–9.

    Article  CAS  PubMed  Google Scholar 

  10. Buster JE, Kingsberg SA, Aguirre O, Brown C, Breaux JG, Buch A, Rodenberg CA, Wekselman K, Casson P. Testosterone patch for low sexual desire in surgically menopausal women: a randomized trial. Obstet Gynecol. 2005;105:944–52.

    Article  CAS  PubMed  Google Scholar 

  11. Davis SR, Moreau M, Kroll R, Bouchard C, Panay N, Gass M, Braunstein GD, Hirschberg AL, Rodenberg C, Pack S, Koch H, Moufarege A, Studd J, Team AS. Testosterone for low libido in postmenopausal women not taking estrogen. N Engl J Med. 2008;359:2005–17.

    Article  CAS  PubMed  Google Scholar 

  12. Simon J, Braunstein G, Nachtigall L, Utian W, Katz M, Miller S, Waldbaum A, Bouchard C, Derzko C, Buch A, Rodenberg C, Lucas J, Davis S. Testosterone patch increases sexual activity and desire in surgically menopausal women with hypoactive sexual desire disorder. J Clin Endocrinol Metab. 2005;90:5226–33.

    Article  CAS  PubMed  Google Scholar 

  13. Santoro N, Torrens J, Crawford S, Allsworth JE, Finkelstein JS, Gold EB, Korenman S, Lasley WL, Luborsky JL, McConnell D, Sowers MF, Weiss G. Correlates of circulating androgens in mid-life women: the study of women’s health across the nation. J Clin Endocrinol Metab. 2005;90:4836–45.

    Article  CAS  PubMed  Google Scholar 

  14. Davis SR, Davison SL, Donath S, Bell RJ. Circulating androgen levels and self-reported sexual function in women. JAMA. 2005;294:91–6.

    Article  CAS  PubMed  Google Scholar 

  15. Basaria S, Coviello AD, Travison TG, Storer TW, Farwell WR, Jette AM, Eder R, Tennstedt S, Ulloor J, Zhang A, Choong K, Lakshman KM, Mazer NA, Miciek R, Krasnoff J, Elmi A, Knapp PE, Brooks B, Appleman E, Aggarwal S, Bhasin G, Hede-Brierley L, Bhatia A, Collins L, LeBrasseur N, Fiore LD, Bhasin S. Adverse events associated with testosterone administration. N Engl J Med. 2010;363:109–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Sinha-Hikim I, Arver S, Beall G, Shen R, Guerrero M, Sattler F, Shikuma C, Nelson JC, Landgren BM, Mazer NA, Bhasin S. The use of a sensitive equilibrium dialysis method for the measurement of free testosterone levels in healthy, cycling women and in human immunodeficiency virus-infected women. J Clin Endocrinol Metab. 1998;83:1312–8.

    CAS  PubMed  Google Scholar 

  17. Wang C, Catlin DH, Demers LM, Starcevic B, Swerdloff RS. Measurement of total serum testosterone in adult men: comparison of current laboratory methods versus liquid chromatography-tandem mass spectrometry. J Clin Endocrinol Metab. 2004;89:534–43.

    Article  CAS  PubMed  Google Scholar 

  18. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J, Writing Group for the Women’s Health Initiative I. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321–33.

    Article  Google Scholar 

  19. Hulley S, Grady D, Bush T, Furberg C, Herrington D, Riggs B, Vittinghoff E. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998;280:605–13.

    Article  CAS  PubMed  Google Scholar 

  20. Padero MC, Bhasin S, Friedman TC. Androgen supplementation in older women: too much hype, not enough data. J Am Geriatr Soc. 2002;50:1131–40.

    Article  PubMed  Google Scholar 

  21. Somboonporn W. Testosterone therapy for postmenopausal women: efficacy and safety. Semin Reprod Med. 2006;24:115–24.

    Article  CAS  PubMed  Google Scholar 

  22. Dennerstein L, Dudley E, Burger H. Are changes in sexual functioning during midlife due to aging or menopause? Fertil Steril. 2001;76:456–60.

    Article  CAS  PubMed  Google Scholar 

  23. Maserejian NN, Shifren J, Parish SJ, Segraves RT, Huang L, Rosen RC. Sexual arousal and lubrication problems in women with clinically diagnosed hypoactive sexual desire disorder: preliminary findings from the hypoactive sexual desire disorder registry for women. J Sex Marital Ther. 2012;38:41–62.

    Article  PubMed  Google Scholar 

  24. Zussman L, Zussman S, Sunley R, Bjornson E. Sexual response after hysterectomy-oophorectomy: recent studies and reconsideration of psychogenesis. Am J Obstet Gynecol. 1981;140:725–9.

    Article  CAS  PubMed  Google Scholar 

  25. Nathorst-Boos J, von Schoultz B. Psychological reactions and sexual life after hysterectomy with and without oophorectomy. Gynecol Obstet Invest. 1992;34:97–101.

    Article  CAS  PubMed  Google Scholar 

  26. Nathorst-Boos J, von Schoultz B, Carlstrom K. Elective ovarian removal and estrogen replacement therapy – effects on sexual life, psychological well-being and androgen status. J Psychosom Obstet Gynaecol. 1993;14:283–93.

    Article  CAS  PubMed  Google Scholar 

  27. Celik H, Gurates B, Yavuz A, Nurkalem C, Hanay F, Kavak B. The effect of hysterectomy and bilaterally salpingo-oophorectomy on sexual function in post-menopausal women. Maturitas. 2008;61:358–63.

    Article  PubMed  Google Scholar 

  28. Mazer NA, Shifren JL. Transdermal testosterone for women: a new physiological approach for androgen therapy. Obstet Gynecol Surv. 2003;58:489–500.

    PubMed  Google Scholar 

  29. Shifren JL, Mazer NA. Safety profile of transdermal testosterone therapy in women. Am J Obstet Gynecol. 2003;189:898–9; author reply 899.

    Article  PubMed  Google Scholar 

  30. Huang G, Basaria S, Travison TG, Ho MH, Davda M, Mazer NA, Miciek R, Knapp PE, Zhang A, Collins L, Ursino M, Appleman E, Dzekov C, Stroh H, Ouellette M, Rundell T, Baby M, Bhatia NN, Khorram O, Friedman T, Storer TW, Bhasin S. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Wierman ME, Arlt W, Basson R, Davis SR, Miller KK, Murad MH, Rosner W, Santoro N. Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014;99:3489–510.

    Article  CAS  PubMed  Google Scholar 

  32. Maltais ML, Desroches J, Dionne IJ. Changes in muscle mass and strength after menopause. J Musculoskelet Neuronal Interact. 2009;9:186–97.

    CAS  PubMed  Google Scholar 

  33. Kurina LM, Gulati M, Everson-Rose SA, Chung PJ, Karavolos K, Cohen NJ, Kandula N, Lukezic R, Dugan SA, Sowers M, Powell LH, Pickett KE. The effect of menopause on grip and pinch strength: results from the Chicago, Illinois, site of the Study of Women’s Health Across the Nation. Am J Epidemiol. 2004;160:484–91.

    Article  PubMed  Google Scholar 

  34. Greeves JP, Cable NT, Reilly T, Kingsland C. Changes in muscle strength in women following the menopause: a longitudinal assessment of the efficacy of hormone replacement therapy. Clin Sci. 1999;97:79–84.

    Article  CAS  PubMed  Google Scholar 

  35. Sites CK, L’Hommedieu GD, Toth MJ, Brochu M, Cooper BC, Fairhurst PA. The effect of hormone replacement therapy on body composition, body fat distribution, and insulin sensitivity in menopausal women: a randomized, double-blind, placebo-controlled trial. J Clin Endocrinol Metab. 2005;90:2701–7.

    Article  CAS  PubMed  Google Scholar 

  36. Greising SM, Baltgalvis KA, Lowe DA, Warren GL. Hormone therapy and skeletal muscle strength: a meta-analysis. J Gerontol A Biol Sci Med Sci. 2009;64:1071–81.

    Article  PubMed  CAS  Google Scholar 

  37. Douchi T, Yamamoto S, Nakamura S, Ijuin T, Oki T, Maruta K, Nagata Y. The effect of menopause on regional and total body lean mass. Maturitas. 1998;29:247–52.

    Article  CAS  PubMed  Google Scholar 

  38. Aloia JF, McGowan DM, Vaswani AN, Ross P, Cohn SH. Relationship of menopause to skeletal and muscle mass. Am J Clin Nutr. 1991;53:1378–83.

    CAS  PubMed  Google Scholar 

  39. Rariy CM, Ratcliffe SJ, Weinstein R, Bhasin S, Blackman MR, Cauley JA, Robbins J, Zmuda JM, Harris TB, Cappola AR. 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;96:989–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Sowers M, Zheng H, Tomey K, Karvonen-Gutierrez C, Jannausch M, Li X, Yosef M, Symons J. Changes in body composition in women over six years at midlife: ovarian and chronological aging. J Clin Endocrinol Metab. 2007;92:895–901.

    Article  CAS  PubMed  Google Scholar 

  41. Cappola AR, Bandeen-Roche K, Wand GS, Volpato S, Fried LP. Association of IGF-I levels with muscle strength and mobility in older women. J Clin Endocrinol Metab. 2001;86:4139–46.

    Article  CAS  PubMed  Google Scholar 

  42. Dobs AS, Nguyen T, Pace C, Roberts CP. Differential effects of oral estrogen versus oral estrogen-androgen replacement therapy on body composition in postmenopausal women. J Clin Endocrinol Metab. 2002;87:1509–16.

    Article  CAS  PubMed  Google Scholar 

  43. Miller KK, Grieco KA, Klibanski A. Testosterone administration in women with anorexia nervosa. J Clin Endocrinol Metab. 2005;90:1428–33.

    Article  CAS  PubMed  Google Scholar 

  44. Davis SR, McCloud P, Strauss BJ, Burger H. Testosterone enhances estradiol’s effects on postmenopausal bone density and sexuality. Maturitas. 1995;21:227–36.

    Article  CAS  PubMed  Google Scholar 

  45. Gruber DM, Sator MO, Kirchengast S, Joura EA, Huber JC. Effect of percutaneous androgen replacement therapy on body composition and body weight in postmenopausal women. Maturitas. 1998;29:253–9.

    Article  CAS  PubMed  Google Scholar 

  46. Miller KK, Biller BM, Beauregard C, Lipman JG, Jones J, Schoenfeld D, Sherman JC, Swearingen B, Loeffler J, Klibanski A. Effects of testosterone replacement in androgen-deficient women with hypopituitarism: a randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab. 2006;91:1683–90.

    Article  CAS  PubMed  Google Scholar 

  47. Dolan S, Wilkie S, Aliabadi N, Sullivan MP, Basgoz N, Davis B, Grinspoon S. Effects of testosterone administration in human immunodeficiency virus-infected women with low weight: a randomized placebo-controlled study. Arch Intern Med. 2004;164:897–904.

    Article  CAS  PubMed  Google Scholar 

  48. Choi HH, Gray PB, Storer TW, Calof OM, Woodhouse L, Singh AB, Padero C, Mac RP, Sinha-Hikim I, Shen R, Dzekov J, Dzekov C, Kushnir MM, Rockwood AL, Meikle AW, Lee ML, Hays RD, Bhasin S. Effects of testosterone replacement in human immunodeficiency virus-infected women with weight loss. J Clin Endocrinol Metab. 2005;90:1531–41.

    Article  CAS  PubMed  Google Scholar 

  49. Hausmann M, Slabbekoorn D, Van Goozen SH, Cohen-Kettenis PT, Gunturkun O. Sex hormones affect spatial abilities during the menstrual cycle. Behav Neurosci. 2000;114:1245–50.

    Article  CAS  PubMed  Google Scholar 

  50. Ryan J, Stanczyk FZ, Dennerstein L, Mack WJ, Clark MS, Szoeke C, Kildea D, Henderson VW. Hormone levels and cognitive function in postmenopausal midlife women. Neurobiol Aging. 2012;33:1138–47.

    Article  CAS  PubMed  Google Scholar 

  51. Barrett-Connor E, Goodman-Gruen D. Cognitive function and endogenous sex hormones in older women. J Am Geriatr Soc. 1999;47:1289–93.

    Article  CAS  PubMed  Google Scholar 

  52. Moffat SD, Hampson E. A curvilinear relationship between testosterone and spatial cognition in humans: possible influence of hand preference. Psychoneuroendocrinology. 1996;21:323–37.

    Article  CAS  PubMed  Google Scholar 

  53. Simpson E, Rubin G, Clyne C, Robertson K, O’Donnell L, Jones M, Davis S. The role of local estrogen biosynthesis in males and females. Trends Endocrinol Metab. 2000;11:184–8.

    Article  CAS  PubMed  Google Scholar 

  54. Schattmann L, Sherwin BB. Testosterone levels and cognitive functioning in women with polycystic ovary syndrome and in healthy young women. Horm Behav. 2007;51:587–96.

    Article  CAS  PubMed  Google Scholar 

  55. Barry JA, Parekh HS, Hardiman PJ. Visual-spatial cognition in women with polycystic ovarian syndrome: the role of androgens. Hum Reprod. 2013;28:2832–7.

    Article  CAS  PubMed  Google Scholar 

  56. Hampson E. Variations in sex-related cognitive abilities across the menstrual cycle. Brain Cogn. 1990;14:26–43.

    Article  CAS  PubMed  Google Scholar 

  57. Sherwin BB. Estrogen and/or androgen replacement therapy and cognitive functioning in surgically menopausal women. Psychoneuroendocrinology. 1988;13:345–57.

    Article  CAS  PubMed  Google Scholar 

  58. Moller MC, Bartfai AB, Radestad AF. Effects of testosterone and estrogen replacement on memory function. Menopause. 2010;17:983–9.

    Article  PubMed  Google Scholar 

  59. Regestein QR, Friebely J, Shifren J, Schiff I. Neuropsychological effects of methyltestosterone in women using menopausal hormone replacement. J Womens Health Gend Based Med. 2001;10:671–6.

    Article  CAS  PubMed  Google Scholar 

  60. Westerveld HE, Hoogendoorn M, de Jong AW, Goverde AJ, Fauser BC, Dallinga-Thie GM. Cardiometabolic abnormalities in the polycystic ovary syndrome: pharmacotherapeutic insights. Pharmacol Ther. 2008;119:223–41.

    Article  CAS  PubMed  Google Scholar 

  61. Kocoska-Maras L, Zethraeus N, Radestad AF, Ellingsen T, von Schoultz B, Johannesson M, Hirschberg AL. A randomized trial of the effect of testosterone and estrogen on verbal fluency, verbal memory, and spatial ability in healthy postmenopausal women. Fertil Steril. 2011;95:152–7.

    Article  CAS  PubMed  Google Scholar 

  62. Huang G, Wharton W, Travison TG, Ho MH, Gleason C, Asthana S, Bhasin S, Basaria S. Effects of testosterone administration on cognitive function in hysterectomized women with low testosterone levels: a dose–response randomized trial. J Endocrinol Invest. 2015;38:455–61.

    Article  CAS  PubMed  Google Scholar 

  63. Shah S, Bell RJ, Savage G, Goldstat R, Papalia MA, Kulkarni J, Donath S, Davis SR. Testosterone aromatization and cognition in women: a randomized, placebo-controlled trial. Menopause. 2006;13:600–8.

    Article  PubMed  Google Scholar 

  64. Slabbekoorn D, van Goozen SH, Megens J, Gooren LJ, Cohen-Kettenis PT. Activating effects of cross-sex hormones on cognitive functioning: a study of short-term and long-term hormone effects in transsexuals. Psychoneuroendocrinology. 1999;24:423–47.

    Article  CAS  PubMed  Google Scholar 

  65. Khosla S, Riggs BL, Robb RA, Camp JJ, Achenbach SJ, Oberg AL, Rouleau PA, Melton 3rd LJ. Relationship of volumetric bone density and structural parameters at different skeletal sites to sex steroid levels in women. J Clin Endocrinol Metab. 2005;90:5096–103.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Watts NB, Notelovitz M, Timmons MC, Addison WA, Wiita B, Downey LJ. Comparison of oral estrogens and estrogens plus androgen on bone mineral density, menopausal symptoms, and lipid-lipoprotein profiles in surgical menopause. Obstet Gynecol. 1995;85:529–37.

    Article  CAS  PubMed  Google Scholar 

  67. Barrett-Connor E, Young R, Notelovitz M, Sullivan J, Wiita B, Yang HM, Nolan J. A two-year, double-blind comparison of estrogen-androgen and conjugated estrogens in surgically menopausal women. Effects on bone mineral density, symptoms and lipid profiles. J Reprod Med. 1999;44:1012–20.

    CAS  PubMed  Google Scholar 

  68. Floter A, Nathorst-Boos J, Carlstrom K, Ohlsson C, Ringertz H, Schoultz B. Effects of combined estrogen/testosterone therapy on bone and body composition in oophorectomized women. Gynecol Endocrinol. 2005;20:155–60.

    Article  CAS  PubMed  Google Scholar 

  69. Sands RH, Studd JW, Jones J, Alaghband-Zadeh J. Comparison of the biochemical effects of testosterone and estrogen on bone markers in surgically menopausal women. Gynecol Endocrinol. 2000;14:382–7.

    Article  CAS  PubMed  Google Scholar 

  70. Popat VB, Calis KA, Kalantaridou SN, Vanderhoof VH, Koziol D, Troendle JF, Reynolds JC, Nelson LM. Bone mineral density in young women with primary ovarian insufficiency: results of a three-year randomized controlled trial of physiological transdermal estradiol and testosterone replacement. J Clin Endocrinol Metab. 2014;99:3418–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Raisz LG, Wiita B, Artis A, Bowen A, Schwartz S, Trahiotis M, Shoukri K, Smith J. Comparison of the effects of estrogen alone and estrogen plus androgen on biochemical markers of bone formation and resorption in postmenopausal women. J Clin Endocrinol Metab. 1996;81:37–43.

    CAS  PubMed  Google Scholar 

  72. Lobo RA. Androgens in postmenopausal women: production, possible role, and replacement options. Obstet Gynecol Surv. 2001;56:361–76.

    Article  CAS  PubMed  Google Scholar 

  73. Sarrel P, Dobay B, Wiita B. Estrogen and estrogen-androgen replacement in postmenopausal women dissatisfied with estrogen-only therapy. Sexual behavior and neuroendocrine responses. J Reprod Med. 1998;43:847–56.

    CAS  PubMed  Google Scholar 

  74. Hickok LR, Toomey C, Speroff L. A comparison of esterified estrogens with and without methyltestosterone: effects on endometrial histology and serum lipoproteins in postmenopausal women. Obstet Gynecol. 1993;82:919–24.

    CAS  PubMed  Google Scholar 

  75. Simon J, Klaiber E, Wiita B, Bowen A, Yang HM. Differential effects of estrogen-androgen and estrogen-only therapy on vasomotor symptoms, gonadotropin secretion, and endogenous androgen bioavailability in postmenopausal women. Menopause. 1999;6:138–46.

    Article  CAS  PubMed  Google Scholar 

  76. Liu J, Allgood A, Derogatis LR, Swanson S, O’Mahony M, Nedoss B, Soper H, Zbella E, Prokofieva SV, Zipfel L, Guo CY. Safety and efficacy of low-dose esterified estrogens and methyltestosterone, alone or combined, for the treatment of hot flashes in menopausal women: a randomized, double-blind, placebo-controlled study. Fertil Steril. 2011;95:366–8.

    Article  CAS  PubMed  Google Scholar 

  77. Sherwin BB, Gelfand MM. Differential symptom response to parenteral estrogen and/or androgen administration in the surgical menopause. Am J Obstet Gynecol. 1985;151:153–60.

    Article  CAS  PubMed  Google Scholar 

  78. Glaser R, York AE, Dimitrakakis C. Beneficial effects of testosterone therapy in women measured by the validated Menopause Rating Scale (MRS). Maturitas. 2011;68:355–61.

    Article  CAS  PubMed  Google Scholar 

  79. Davis SR, Braunstein GD. Efficacy and safety of testosterone in the management of hypoactive sexual desire disorder in postmenopausal women. J Sex Med. 2012;9:1134–48.

    Article  CAS  PubMed  Google Scholar 

  80. Huang G, Pencina KM, Coady JA, Beleva YM, Bhasin S, Basaria S. Functional voice testing detects early changes in vocal pitch in women during testosterone administration. J Clin Endocrinol Metab. 2015;100:2254–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Barrett-Connor E, Goodman-Gruen D, Patay B. Endogenous sex hormones and cognitive function in older men. J Clin Endocrinol Metab. 1999;84:3681–5.

    CAS  PubMed  Google Scholar 

  82. Diamanti-Kandarakis E, Papavassiliou AG, Kandarakis SA, Chrousos GP. Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab. 2007;18:280–5.

    Article  CAS  PubMed  Google Scholar 

  83. Patel SM, Ratcliffe SJ, Reilly MP, Weinstein R, Bhasin S, Blackman MR, Cauley JA, Sutton-Tyrrell K, Robbins J, Fried LP, Cappola AR. Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab. 2009;94:4776–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. Motivala AA, Rose PA, Kim HM, Smith YR, Bartnik C, Brook RD, Muzik O, Duvernoy CS. Cardiovascular risk, obesity, and myocardial blood flow in postmenopausal women. J Nucl Cardiol. 2008;15:510–7.

    Article  PubMed  Google Scholar 

  85. Kaye SA, Folsom AR, Soler JT, Prineas RJ, Potter JD. Associations of body mass and fat distribution with sex hormone concentrations in postmenopausal women. Int J Epidemiol. 1991;20:151–6.

    Article  CAS  PubMed  Google Scholar 

  86. Janssen I, Powell LH, Kazlauskaite R, Dugan SA. Testosterone and visceral fat in midlife women: the Study of Women’s Health Across the Nation (SWAN) fat patterning study. Obesity. 2010;18:604–10.

    Article  CAS  PubMed  Google Scholar 

  87. Roth LW, Huang H, Legro RS, Diamond MP, Coutifaris C, Carson SA, Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers ER, Zhang H, Schlaff WD, Reproductive Medicine N. Altering hirsutism through ovulation induction in women with polycystic ovary syndrome. Obstet Gynecol. 2012;119:1151–6.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Elbers JM, Asscheman H, Seidell JC, Gooren LJ. Effects of sex steroid hormones on regional fat depots as assessed by magnetic resonance imaging in transsexuals. Am J Physiol. 1999;276:E317–25.

    CAS  PubMed  Google Scholar 

  89. Leao LM, Duarte MP, Silva DM, Bahia PR, Coeli CM, de Farias ML. Influence of methyltestosterone postmenopausal therapy on plasma lipids, inflammatory factors, glucose metabolism and visceral fat: a randomized study. Eur J Endocrinol. 2006;154:131–9.

    Article  PubMed  CAS  Google Scholar 

  90. Herbst KL, Calof OM, Hsia SH, Sinha-Hikim I, Woodhouse LJ, Buchanan TA, Bhasin S. Effects of transdermal testosterone administration on insulin sensitivity, fat mass and distribution, and markers of inflammation and thrombolysis in human immunodeficiency virus-infected women with mild to moderate weight loss. Fertil Steril. 2006;85:1794–802.

    Article  CAS  PubMed  Google Scholar 

  91. Huang G, Tang E, Aakil A, Anderson S, Jara H, Davda M, Stroh H, Travison TG, Bhasin S, Basaria S. Testosterone dose–response relationships with cardiovascular risk markers in androgen-deficient women: a randomized, placebo-controlled trial. J Clin Endocrinol Metab. 2014;99:E1287–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  92. Brand JS, van der Tweel I, Grobbee DE, Emmelot-Vonk MH, van der Schouw YT. Testosterone, sex hormone-binding globulin and the metabolic syndrome: a systematic review and meta-analysis of observational studies. Int J Epidemiol. 2011;40:189–207.

    Article  PubMed  Google Scholar 

  93. Holmang A, Larsson BM, Brzezinska Z, Bjorntorp P. Effects of short-term testosterone exposure on insulin sensitivity of muscles in female rats. Am J Physiol. 1992;262:E851–5.

    CAS  PubMed  Google Scholar 

  94. Patel SM, Iqbal N, Kaul S, Ratcliffe SJ, Rickels MR, Reilly MP, Scattergood T, Basu A, Fuller C, Cappola AR. Effects of metformin and leuprolide acetate on insulin resistance and testosterone levels in nondiabetic postmenopausal women: a randomized, placebo-controlled trial. Fertil Steril. 2010;94:2161–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Zang H, Carlstrom K, Arner P, Hirschberg AL. Effects of treatment with testosterone alone or in combination with estrogen on insulin sensitivity in postmenopausal women. Fertil Steril. 2006;86:136–44.

    Article  PubMed  CAS  Google Scholar 

  96. Srinivasan M, Irving BA, Frye RL, O’Brien P, Hartman SJ, McConnell JP, Nair KS. Effects on lipoprotein particles of long-term dehydroepiandrosterone in elderly men and women and testosterone in elderly men. J Clin Endocrinol Metab. 2010;95:1617–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  97. Lovejoy JC, Bray GA, Bourgeois MO, Macchiavelli R, Rood JC, Greeson C, Partington C. Exogenous androgens influence body composition and regional body fat distribution in obese postmenopausal women – a clinical research center study. J Clin Endocrinol Metab. 1996;81:2198–203.

    CAS  PubMed  Google Scholar 

  98. Yarnell JW, Baker IA, Sweetnam PM, Bainton D, O’Brien JR, Whitehead PJ, Elwood PC. Fibrinogen, viscosity, and white blood cell count are major risk factors for ischemic heart disease. The Caerphilly and Speedwell collaborative heart disease studies. Circulation. 1991;83:836–44.

    Article  CAS  PubMed  Google Scholar 

  99. Basaria S, Nguyen T, Rosenson RS, Dobs AS. Effect of methyl testosterone administration on plasma viscosity in postmenopausal women. Clin Endocrinol (Oxf). 2002;57:209–14.

    Article  CAS  Google Scholar 

  100. Montalcini T, Gorgone G, Gazzaruso C, Sesti G, Perticone F, Pujia A. Endogenous testosterone and endothelial function in postmenopausal women. Coron Artery Dis. 2007;18:9–13.

    Article  PubMed  Google Scholar 

  101. Luque-Ramirez M, Mendieta-Azcona C, Alvarez-Blasco F, Escobar-Morreale HF. Androgen excess is associated with the increased carotid intima-media thickness observed in young women with polycystic ovary syndrome. Hum Reprod. 2007;22:3197–203.

    Article  CAS  PubMed  Google Scholar 

  102. Cooper BC, Gokina NI, Osol G. Testosterone replacement increases vasodilatory reserve in androgen-deficient female rats. Fertil Steril. 2007;87:422–5.

    Article  CAS  PubMed  Google Scholar 

  103. Adams MR, Williams JK, Kaplan JR. Effects of androgens on coronary artery atherosclerosis and atherosclerosis-related impairment of vascular responsiveness. Arterioscler Thromb Vasc Biol. 1995;15:562–70.

    Article  CAS  PubMed  Google Scholar 

  104. Somboonporn W, Davis SR. Postmenopausal testosterone therapy and breast cancer risk. Maturitas. 2004;49:267–75.

    Article  CAS  PubMed  Google Scholar 

  105. Chia K, O’Brien M, Brown M, Lim E. Targeting the androgen receptor in breast cancer. Curr Oncol Rep. 2015;17:4.

    Article  PubMed  CAS  Google Scholar 

  106. Somboonporn W, Davis SR, National H, Medical Research C. Testosterone effects on the breast: implications for testosterone therapy for women. Endocr Rev. 2004;25:374–88.

    Article  CAS  PubMed  Google Scholar 

  107. Ingle JN, Mailliard JA, Schaid DJ, Krook JE, Gesme Jr DH, Windschitl HE, Pfeifle DM, Etzell PS, Gerstner JG, Long HJ, et al. A double-blind trial of tamoxifen plus prednisolone versus tamoxifen plus placebo in postmenopausal women with metastatic breast cancer. A collaborative trial of the North Central Cancer Treatment Group and Mayo Clinic. Cancer. 1991;68:34–9.

    Article  CAS  PubMed  Google Scholar 

  108. Gordan GS, Halden A, Horn Y, Fuery JJ, Parsons RJ, Walter RM. Calusterone (7beta,17alpha-dimethyltestosterone) as primary and secondary therapy of advanced breast cancer. Oncology. 1973;28:138–46.

    Article  CAS  PubMed  Google Scholar 

  109. Chlebowski RT, Hendrix SL, Langer RD, Stefanick ML, Gass M, Lane D, Rodabough RJ, Gilligan MA, Cyr MG, Thomson CA, Khandekar J, Petrovitch H, McTiernan A, Investigators WHI. Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women’s Health Initiative Randomized Trial. JAMA. 2003;289:3243–53.

    Article  CAS  PubMed  Google Scholar 

  110. Glaser RL, Dimitrakakis C. Reduced breast cancer incidence in women treated with subcutaneous testosterone, or testosterone with anastrozole: a prospective, observational study. Maturitas. 2013;76:342–9.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Section of Men’s Health, Aging and Metabolism, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Ave, BLI-541, Boston, MA, 02115, USA

    Grace Huang MD & Shehzad Basaria MD

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  1. Grace Huang MD
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  2. Shehzad Basaria MD
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Correspondence to Grace Huang MD .

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  1. Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Endocrinology and Infertility Yale School of Medicine, New Haven, Connecticut, USA

    Lubna Pal

  2. Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, Massachusetts, USA

    Raja A. Sayegh

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Huang, G., Basaria, S. (2017). The Case for Androgens in Menopausal Women: When and How?. In: Pal, L., Sayegh, R. (eds) Essentials of Menopause Management. Springer, Cham. https://doi.org/10.1007/978-3-319-42451-4_10

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