Oral Presentation The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2017

Androgen therapy in women (#68)

Susan Davis 1
  1. Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

Androgens are critical female hormones. Testosterone is an obligatory precursor for extra-gonadal estradiol production, particularly in women with loss of ovarian function, and has key direct androgenic genomic and non-genomic effects. Androgen levels decline with age from the 4th decade, reaching a nadir in the 7th decade of life. Testosterone levels are positively associated with sexual function in premenopausal and postmenopausal women, and multiple randomised placebo-controlled trials have shown that testosterone therapy can be effective for the treatment of female sexual dysfunction in both late premenopausal and postmenopausal women. Furthermore, low testosterone has several potential undesirable consequences that have been somewhat ignored.  In the brain, testosterone exhibits neuroprotective effects and clinical trials suggest exogenous testosterone enhances cognitive performance in postmenopausal women.  Lower free testosterone in premenopausal women and older women is associated with a greater decline in bone mineral density and a for older women a greater risk of hip fracture and sarcopenia. Observational studies implicate testosterone as having favourable cardiovascular effects measured by surrogate outcomes, however associations between endogenous testosterone and cardiovascular disease risk, and total mortality, particularly in older women are yet to be established. While attention is usually given to estrogen replacement for women experiencing primary ovarian insufficiency, or natural or surgical menopause, testosterone therapy also merits consideration.