Androgens in premenopausal women and women with premature ovarian insufficiency

Abstract

Premature ovarian insufficiency (POI) results in both estrogen and testosterone insufficiency. Whether testosterone therapy may be of benefit for women with POI is uncertain. Presently, the only evidence-based indication for testosterone therapy for women is for the treatment of postmenopausal women with low sexual desire with associated personal distress. Consistent with this, available evidence does not support the prescription of testosterone to prevent cardiometabolic disease, bone loss, sarcopenia, or cognitive decline or to improve well-being and low mood in postmenopausal women. Data pertaining to the treatment of women with POI with testosterone are limited. This article reviews androgen physiology in premenopausal women and the impact of POI on circulating androgen concentrations, summarizes findings from observational studies and clinical trials of testosterone therapy in premenopausal women and women with POI, and concludes with recommendations regarding testosterone use in women with POI.

绝经前女性和早发性卵巢功能不全女性的雄激素水平 摘要

早发性卵巢功能不全会导致雌激素和睾酮不足。睾酮治疗是否对患有POI的女性有益还不确定。目前, 女性睾酮治疗的唯一循证适应症是治疗性欲低下并伴有相关个人痛苦的绝经后女性。与此一致, 现有证据并不支持使用睾酮来预防心血管代谢疾病、骨质丢失、肌肉减少或认知能力下降, 或改善绝经后妇女的健康和情绪低落。关于用睾酮治疗POI女性的数据是有限的。本文回顾了绝经前女性的雄激素生理和 POI 对循环雄激素浓度的影响, 总结了绝经前女性和 POI 女性睾酮治疗的观察性研究和临床试验的结果, 并就POI女性睾酮应用提出了建议。

Keywords:

• Testosterone
• androgens
• premature ovarian insufficiency
• menopause

Potential conflict of interest

The author reports having received honoraria from Besins Healthcare, Biofemme, and Pfizer Australia and has been a consultant to Mayne Pharmaceuticals, Lawley Pharmaceuticals, Roche Pharmaceuticals, Astellas Pharmaceuticals, Theramex, and Que Oncology.

Source of funding

Nil.