Androgen therapy in women.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search methodology or meta-analysis
PubMed 16381985 · doi:10.1530/eje.1.02062
What was done
This narrative review examined female androgen physiology, diagnostic frameworks (specifically the Princeton consensus statement), and replacement therapies (transdermal testosterone and dehydroepiandrosterone) for conditions causing severe androgen deficiency compared to physiological menopause.
What was found
The abstract reports no numerical data. It notes that severe androgen deficiency occurs after loss of adrenal or ovarian function (e.g., Addison's disease or bilateral oophorectomy), presenting with reduced libido and energy, whereas natural menopause does not necessarily cause deficiency. Transdermal testosterone and dehydroepiandrosterone improve libido and mood, but effects on body composition and muscle function remain poorly documented, and existing diagnostic criteria carry a high risk of over-diagnosis.
Why it matters
The paper cautions against routine androgen prescribing in naturally menopausal women and underscores the lack of approved female formulations and large trial data.
Limits
As a narrative review, it presents no meta-analytic pooling, effect sizes, or participant numbers. The underlying evidence base at the time of publication was limited by a small number of randomized controlled trials and lack of long-term outcomes on muscle function and body composition.
Cited by
- supports In women, a substantial portion of testosterone is produced by adrenal synthesis and peripheral tissue conversion rather than solely by the ovaries.
- supports In women, a significant portion of circulating testosterone is derived from DHEA conversion.